Submitted by Holly C

I’m Holly and I have recovered from bulimia nervosa.  I’ve often been asked what it’s like to get help for themselves or someone they know who is suffering. I am not a medical professional, just someone who has been there, done that and now quietly but proudly wears the t-shirt.

The easiest way for most people to begin the process of seeking help is to talk to their GP. Going to the GP to talk about eating disorders for the first time is an extremely daunting step to take. Most GPs are trained to try and get to the root cause of a problem as quickly as they can and to provide answers for the best treatment in just one ten-minute appointment. However, this is simply not possible with eating disorders. I always say to people when talking about the first time you reach out to a professional for help with mental health: getting better will be hard, but nothing will ever be as hard as taking that first step. By doing so, you’ve cleared your biggest hurdle on the way to feeling better, even if you don’t feel it yet.

Unfortunately I didn’t feel better after the first time I told my GP, but I’d like to share what I learned from that experience along with some advice for anyone thinking about taking that first step.

My story

I was 17 when I finally made an emergency appointment with my GP to talk about how terrible I felt. It had been a long time coming, and deep down I knew that a big part of my problem was to do with food and eating. However, at that point I was so sad and anxious that I couldn’t properly explain myself. I just wanted to stop feeling so awful all the time. Once I was in front of the doctor, I broke down in tears and could barely get my words out. I managed to explain some of the unpleasant things I’d been doing to myself, and the huge fears I had about food and gaining weight. I was given a tissue and watched as the doctor mis-typed ‘bulemec’ into their computer. I fought the urge to correct the spelling as I sobbed. I was also weighed and told my BMI, with a strong emphasis being put on how my BMI score was ‘perfect’, which only served to make me more disgusted and frustrated with myself. However, the GP did get two things right: they asked what else I had going on in my life at that time and as I confusedly tried to explain all of the different pressures I was under, they reassured me that none of it was my fault. Hearing someone say that to me when I was completely consumed by guilt and fear was comforting. They also immediately booked me in for another appointment in two weeks’ time, and suggested that I bring someone I trusted for support.

“I will forever be grateful to that friend for insisting on my behalf that I needed further help.”

Unfortunately, when I did take along a friend I had confided in, the GP weighed both of us and compared our BMIs. We happened to weigh the same, and I believe the point was supposed to be that I had ‘nothing to worry about’. Of course, this only opened up a new avenue of shame in my mind. Yet again, I left with another appointment booked for two weeks’ time. These fortnightly appointments continued for some time, and I got passed around various different doctors at the surgery. I was repeatedly told that I was probably just going through a phase, that my age was causing me to be dramatic. This last accusation was very hurtful, as my own mind was working hard to convince me that I was overreacting, ‘making a fuss’ and causing everyone around me a lot of problems. Yet something deep inside kept me going back each time, until finally, I was referred for some proper, specialist psychological treatment. The most difficult conversation had been that very first one, where I had to put into words how desperate I felt.

“Once I had started to find those words, I could keep refining and repeating them until the right person was listening.”

It was not the best start to my eventual recovery, and there were many battles ahead for me, but it was certainly the most important step I took on the road to where I am now. The GPs I spoke to then were not equipped to handle my eating disorder, but both they and I persisted until ultimately, they got me access to the help I needed. I have been recovered for over 10 years and though some days it can be harder to stay well than others, I have never fully relapsed. This is not something I could’ve done alone. I promise that recovery is possible and that life can be everything you hoped for, but we all need help to get there.

 

My tips for talking to your GP

As you can see from my story, the most important part of talking to a doctor for the first time is simply turning up. It will take more than that first visit, but think of it as the stepping stone to the services that can help you to feel so much better. However, here are some things that I would have done differently if I could and that I know have worked for others when they’ve talked to their GP for the first time:

Book a double appointment: Standard appointments are only 10 minutes long so it’s a good idea to book extra time. Remember that you don’t have to tell the receptionist the exact nature of your problem when you book, you can just say it is something you only wish to disclose to the doctor.

Be as honest as possible: You’re being very brave by talking to a professional in the first place, so it’s not a time to hold back. Your privacy is guaranteed and you will not be judged.

Have plan for what you want to say: As well as describing how you are feeling, it’s helpful to give your GP specific details of how much and how often you have been binging, purging, restricting (or engaging in any other disordered eating behaviour). Take information you have found online or written notes/prompts with you, e.g: “I’ve been having a lot of difficult thoughts like ___” or “I do things like ____ and I’ve been doing this approximately ___ times per day/week/month.”

Expect to get emotional: It doesn’t matter how well prepared you are, you’re doing something very challenging and personal. It’s ok to be overwhelmed.

You do not have to be weighed or told your weight/BMI if you don’t want to know it: You can absolutely say no if you would rather not be weighed during your appointment. If the doctor is very keen to do this, you can ask them not to tell you your weight or talk about BMI’s with you (I wish I had known that I could do this).

Take notes if needed: It can be useful to take notes or tell someone you trust exactly what happened or was said quite soon afterwards, as it can be hard to recall these details later on. You could also ask the doctor to provide you with a brief written or recorded summary at the end of your appointment if they are able to.

Do not let your problems be dismissed: This can be very hard to do at first, and perhaps like me, you’ll find it’s not something that comes easily. But remember that eating disorders are serious and you’ve made the effort to start talking about your concerns, which is the right thing to do. Eating disorders can happen to anyone of any gender, age or weight. None of these things should be suggested to you as a reason for your feelings, or as a reason to take your concerns less seriously.

Make sure to book a follow-up appointment: The doctor will most likely suggest a further appointment, so be sure to book it as soon as you can. If you think you would feel more comfortable speaking with another doctor this is something you can request. You may not be able to insist on seeing a particular GP, but you should not be made to speak with someone that you do not want to.

Take a friend or have someone you trust waiting for you nearby: If you feel it would help you to open up to the doctor, consider having someone you’ve confided in with you for moral support (during the pandemic, it’s best to check this is ok ahead of time). Alternatively, you could ask that person to be ready to support you after the appointment when you may be feeling very tired and emotional.

Have some safe, chill out time planned for afterwards so you can decompress: Don’t plan anything else stressful or important after your first appointment. The effect of acknowledging and admitting to having worries about your mental health can never be underestimated. You’ve just done something incredibly brave and difficult, and you may be feeling overwhelmed or completely numb. Be kind to yourself and rest for however long you need to.

The very best thing I’ve ever done for my mental health was to talk about it. The most important tool in my eating disorder treatment was talking and that continues to be true now as I work to maintain my recovery. Fight through any feelings of shame or fear about seeking treatment because the good news is that you will never regret seeking help.

Useful resources:

• Hope Through Recovery by Hope Virgo
• Overcoming Binge Eating by Dr Christopher Fairchild
• https://psychiatry-uk.com/talking-gp-mental-health-expect
• https://www.citizensadvice.org.uk/health/nhs-healthcare/nhs-patients-rights/