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"You're just sitting there obsessing over what's happening with your fat cells. It's fucking wild." These raw words capture the mental torment of anorexia nervosa—a reality I knew intimately as both patient and physician.
My relationship with food began as an obese child enduring bullying and humiliation. By fifteen, amid my parents' divorce, I found control through extreme calorie restriction. I dropped weight dramatically, earning praise until crossing that invisible line where congratulations turned to concern. At 45 kilos, I was a shell—perpetually cold, depressed, unable to enjoy my passion for drama. The black-and-white thinking of anorexia trapped me: I couldn't eat normally without fearing I'd become "a fat fuck again."
A child psychiatrist's blunt assessment—that I'd spend years in an eating disorder bed rather than attending university—finally flipped a switch. Medicine became my lifeline, my reason to recover. Yet recovery wasn't linear. Bulimia followed, with up to ten purging sessions daily through university. Later, stimulants became another way to suppress appetite, creating a dangerous addiction pathway.
Years later, as a renal physician, I helped build what became a model eating disorder unit in regional Australia. Drawing from personal experience, I transformed nursing culture from judgment to compassion. We'd tell nurses: imagine someone forcing you to eat something disgusting—that's how these patients feel about normal food. Through painstaking work, we created an environment where severely ill patients could heal.
Perhaps most transformative was my professional work with obese patients. Research revealed that much of what we believe about weight is wrong. Some bodies are genetically programmed to retain weight—traits once beneficial during famines. The blame and shame heaped upon larger people isn't just cruel but scientifically unfounded. Studies show people with BMIs around 31 actually live longer than those at the lower end of "normal."
Whether you've struggled with eating disorders, work in healthcare, or simply want to understand these complex conditions better, this episode offers insights from someone who's experienced the battle from both sides of the treatment room. If you take away one message, let it be this: compassion trumps judgment every time.
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