Anorexia nervosa
At 21, Katie Metcalfe was s tarting a creative writing degree at Cumbria Universitybut seven years before thisher life was very different.
"My battle with anorexia started when I was 14. My situation at the time was unusualI was at a Rudolf Steiner school in Botton Village, near Whitby, in a class with three boys.
"The pressure of being the only girl with hormone-raging teenagers was enormous. I had no self-confidence and my body became a focus of paranoia.
"Stress in my life multiplied when my parents told me their marriage was in trouble. In addition, we were about to move house.
"Nothing in my life seemed to be right. I started to think that perhaps if I lost some weight and improved my fitness, things would change for the better. I assumed that thin people had fantastic lives and I could, too.
"I made a New Year's resolution to go on a diet, so I began to restrict my eating. I cut out fats, carbs and dairy, and lived on rice cakes, apples and lettuce.
"As I began to lose weight, I started to feel that life was worth living. At last I seemed to be achieving something. A voice began to whisper in my ear andas I lost more weight, it became louder. Eventually, it was all I could hear. Nothing mattered more than satisfying the voice's need for weight loss and, ultimately, perfection.
"My weight dropped from 8.5st to under 5st. My hair fell out, my skin cracked and bled, my bones ached and my Periods stopped. I was also cycling between 13km (8 miles) and 24km (15 miles) a day to satisfy anorexia's need for exercise. But I still didn't believe I was thin enough. When I looked in the mirror, a mound of blubber stared back.
"My mum took me to the GP when my periods stopped, but they sent me home with a diet sheet, which said I must try to eat more.
"Eventually, I collapsed and ended up in hospital after having a minor heart attack while riding my bike. I was kept on a heart monitor for two days. Iwas sent home with another diet plan and the simple instruction to 'eat'.
"Eventually, my GP realised I needed help. I was admitted to a psychiatric ward in a hospital in Middlesbrough, where I stayed for the next nine months.
"I was put on bed rest for five months. My treatment involved cognitive behavioural therapy (CBT) sessions once a week, and I gradually started to eat small amounts of food again.
"My recovery was slow. What really helped to pull me through was writing and the consistent support from my family. I started to write about my experiences, and realised that I wanted to recover so I could help others who were battling with the same problem. I gradually got better and went back home the day before my 16th birthday.
"I've had a couple of relapses, but five years on I'm fully recovered, with few long-lasting effects. Although I have been diagnosed with the early stages of osteoporosis , my periods have come back, so I can have children.
"I still feel depressed at times, but writing about it helps me get over it. I eat healthily and exercise for pleasure, not punishment. My book, A Stranger in the Family (Accent Press), has been published andI've started a university degree. A few years ago I would never have imagined that.
"If you're going through what I went through, you must talk about how you're feeling to your parents, friends or doctor, no matter how insignificant you believe your issue might be. It's vital to express depressive feelings because things only get worse if you bottle them up, and this can lead to major health problems.
"Aim to live every day as though it's your last and not submit to anorexia. Try to defeat anorexia before it defeats you. Always remember that help is out there."
Anorexia nervosa is a serious mental health condition. It's an eating disorder where a person keeps their body weight as low as possible. Anorexia most commonly affects girls and women, although it has become more common in boys and men in recent years.
The main symptom of anorexia is deliberately losing a lot of weight, although there are often a number of other physical and psychological signs there's a problem.
The exact causes of anorexia nervosa are unclear, but most specialists believe it's likely to be the result of a combination of factors. Anorexia often starts off as a form of dieting that gradually gets out of control.
When trying to determine whether you have an eating disorder, your GP will probably ask questions about your weight and eating habits. In some cases, they may also check your BMI.
The treatment for anorexia nervosa usually involves a combination of psychological therapy and supervised weight gain. It's important for a person with anorexia to start treatment as early as possible.
If anorexia nervosa is not treated, the condition can lead to a number of serious health problems. Long-term anorexia can lead to severe complications and health problems, oftenas a result of Malnutrition .
At 21, Katie Metcalfe was starting a creative writing degree at Cumbria University but seven years before this her life was very different. My mum took me to the GP when my periods stopped, but they sent me home with a diet sheet.