Table Of ContentAnorexia Nervosa
The highly respected and widely known Anorexia Nervosa: A Survival Guide for
Sufferers and Friends was written in 1997. This long-awaited new edition builds
on the work of the fi rst book, providing essential new and updated research
outcomes on anorexia nervosa. It offers a unique insight and guidance into the
recovery process for those who suffer from an eating disorder as well as advice
and information for their loved ones. Written collaboratively by both an expert in
the fi eld and someone with personal experience of eating disorders, this book
offers exceptional understanding of the issues surrounding the illness.
Divided into four sections, it includes:
• an outline of anorexia nervosa
• coping strategies for sufferers
• advice and information for families, carers and friends
• guidelines for professionals who are involved in the sufferer’s life.
Families, friends, carers and professionals such as teachers and GPs are encouraged
to read all sections in order to fully understand the illness. With an emphasis on
collaboration and a layout that enables content to be referenced and read in any
order, this book is an essential resource for anyone affected, directly or indirectly,
by anorexia nervosa.
Janet Treasure, OBE, PhD, FRCP, FRCPsych, is Director of the Eating Disorder
Unit at South London and Maudsley NHS Trust, and a Professor at Kings College,
London.
June Alexander is an Australian writer and life writing educator who has a 40-year
career in journalism and has battled eating disorders since the age of 11.
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Anorexia Nervosa
A Recovery Guide for Sufferers,
Families and Friends
Second Edition
Janet Treasure and June Alexander
Second edition published 2013
by Routledge
27 Church Road, Hove, East Sussex BN3 2FA
Simultaneously published in the USA and Canada
by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2013 Janet Treasure and June Alexander
The right of Janet Treasure and June Alexander to be identifi ed as authors
of this work has been asserted by them in accordance with sections 77 and
78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identifi cation and explanation
without intent to infringe.
First edition published by Psychology Press 1997
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Treasure, Janet.
Anorexia nervosa : a recovery guide for sufferers, families, and friends /
by June Alexander and Janet Treasure. — 2nd edition.
pages cm
Revised edition of Anorexia nervosa / Janet Treasure. 1997.
1. Anorexia nervosa—Popular works. 2. Consumer education.
I. Alexander, June, 1950– II. Title.
RC552.A5T74 2013
616.85ʹ262—dc23
2012044272
ISBN: 978-0-415-63366-6 (hbk)
ISBN: 978-0-415-63367-3 (pbk)
ISBN: 978-0-203-64019-7 (ebk)
Typeset in Times
by Keystroke, Station Road, Codsall, Wolverhampton
Contents
About the authors vii
About the illustrator ix
Acknowledgements xi
Introduction xiii
SECTION ONE
Anorexia nervosa: an overview 1
1 What is anorexia nervosa? 3
2 Avoid the blame game 9
3 Centuries of trying to understand food refusal 17
SECTION TWO
For sufferers 27
4 Starting the recovery journey 29
5 Understanding your Self 43
6 The dangers of anorexia nervosa 53
7 Body composition and nutrition 62
8 Digging deeper: understanding personality patterns 68
9 Links in generations 81
10 Recovery is possible 84
vi Contents
SECTION THREE
For families, carers and friends 91
11 Helping to eliminate the eating disorder 93
12 Pulling together as a family 112
13 Confronting the eating challenge 124
14 Recovery is more than gaining weight 138
SECTION FOUR
Guidelines for professionals 145
15 Guidelines for therapists and carers 147
16 The family doctor: making a diagnosis 151
17 Guidelines for school staff 154
POOKY HESMONDHALGH
18 Where to get support 161
Appendix 171
Index 174
About the authors
Janet Treasure
I have specialised in the treatment of eating disorders at the South London and
Maudsley Hospital and King’s College London for the majority of my career since
1981. I was trained by Gerald Russell when he was implementing the Maudsley
approach to involving families in the treatment of anorexia nervosa.
My career has involved research targeting greater understanding of, and better
treatments for, anorexia and bulimia. I have been able to translate some of the
biological basics of the illness from genes and neuropsychology and scanning into
treatment. This has been an iterative process as new questions and solutions are
generated.
Much of my research focusing on the development of new treatments has been
carried out collaboratively with, and often inspired by, patients and their families.
This book is a sister to the book jointly written with Anna Crane and Grainne
Smith, who have personal experience to share expertise and understanding with
carers.
June Alexander
I developed anorexia nervosa at age 11 in 1962. Twenty years would pass before
my illness was diagnosed. There were no wonderful books such as Anorexia
Nervosa: A Recovery Guide for Sufferers, Families and Friends around when I was
young. There was no wonderful researcher and clinician such as Professor Janet
Treasure to reassure my parents or me that I had an illness and could recover.
I was in my thirties when my recovery journey began. But the eating disorder
thoughts were deeply entrenched in my brain. I was also battling chronic anxiety
and depression. I had no idea who I was. Untangling and separating the real me
from the illness became a battle supreme. Although by now aware of the illness, I
was afraid to let go of rules and thought processes on which I had survived, though
barely functioned, since childhood. Losses were many.
There was, however, an ace card – my four young children. My love for them
and a desire to watch them grow up, gave me the strength to gradually reach
out – and let go. I began to trust therapists who, thanks to research outcomes, were
viii About the authors
becoming increasingly better informed. In my forties, I began to learn skills to
recognise and defuse eating disorder thoughts. I progressively conquered fears, got
in touch with suppressed feelings and rebuilt my identity. This involved learning
to love, trust and respect myself, and eating three meals and three snacks every
day, without fail. Easier said than done for someone with an eating disorder, but at
age 55, I ticked all the boxes and crossed the line in regaining me. The years of
struggle and hard work, tears and desperation, were over. My story is told in the
memoir A Girl Called Tim and on my website www.junealexander.com.
At the time of writing, my life is fi lled with purpose. Writing books to give hope
to others helps to turn my eating disorder experience into a big plus. I love life.
I love every second. A loving partner, our children and grandchildren complete my
happiness. They are my present and my future.
Early intervention with family-based treatment is best by far, but no matter
how long you have lived with an eating disorder – if you are 20, 30, 40, 50 or 60
or more – you can regain quality of life. You can be free. Yes, you can. Reading
Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends and
applying it to your life is a marvellous fi rst step.
Pooky Hesmondhalgh
Years into recovery from anorexia, the bully still lurks. When I battled this illness
I pushed everyone from me: family, friends, teachers. I didn’t let anyone in; my
only friend was the anorexia bully. People tried to help – especially at school. But
there was no training in those days, no proven ideas on how best to help, so when
I left the safety and support of school I was unprepared for the outside world. I lost
a lot of weight during my fi rst year at Oxford University.
With help from family and friends, I fi nally locked the anorexia bully out of my
life. At the same time, I realised that school staff lacked eating disorder awareness
and that I was the perfect person to provide this, so I embarked on a PhD. I hope
that you’ll fi nd my contribution to Anorexia Nervosa: A Recovery Guide for
Sufferers, Families and Friends (Chapter 17) useful.
Today I make positive decisions about my eating every day despite the bully’s
background presence. I have to – I’ve research to do, two beautiful daughters who
need me, and a husband who loves me. No way will I let the anorexia bully waste
more of my time.
About the illustrator
Elise Pacquette
Being an artist who understands the issues raised in this book (I know all about the
bully inside the head), doing the illustrations has enabled me to utilise what was a
‘potentially’ negative experience and make it positive.
When I illustrated the fi rst edition of this book in 1997, I was an in-patient under
Professor Treasure. For years anorexia had been my identity, and this was one of
the scariest things about recovery. Who would I be without it?
How did I let go of it? I found something I wanted more, a lot more. I found a
career as a stage manager, which meant I had to start looking at my body as a ‘tool’
rather than ‘my secret trophy of self-denial’. As a stage manager I had to be
physically strong. Therefore, I had to make the painful choice to let go of my
illness. And as I let go, I found that I could grasp hold of new things, new
experiences; and I discovered life was more fun and a lot less lonely.
Fast forward to my identity today: a wife, a mum of two beautiful girls, a sign
language interpreter, a cellist, a teacher, a painter, an illustrator, imperfect perhaps
but good enough. Oh yes, recovery is worth the fi ght.
