Understand that you can’t always understand them. My friend had anorexia, and before she was admitted as an inpatient I went to her house for lunch. I was in a ‘healthy eating’ phase and I didn’t really want what she had made for lunch, but I knew that I should eat because it was lunchtime and I needed to be a good example for her. We sat down to eat and she didn’t touch her lunch. I asked why and she said “I can’t eat it because I will have to eat dinner later when my parents get home”, which made no sense to me then. However, a few years later I thought back about what she had said and it made perfect sense! It was then I knew that I had a problem.
As a part of my interview series with public figures who struggled with and coped with an eating disorder, I had the pleasure to interview Rachel Evans, founder of re:Wellbeing, leading expert in the psychology of eating and named one of the top 50 influencers of 2019 by the Health Bloggers Community. Rachel overcame orthorexia and bulimia and now writes blog posts, runs workshops and connects with clients 1-to-1, to help them to transform their relationship with food, their body and their wellbeing, to nourish their life.
Thank you so much for doing this with us! Can you tell our readers a little bit about yourself and what you do professionally?
I’m a Master Practitioner in Eating Disorders, certified hypnotherapist and the founder of re:Wellbeing. I work in person or via video call from my home office in Derbyshire (UK) and specialise in helping people who have a disordered relationship with food but no official diagnosis of an eating disorder, especially women who are ready to ditch the diet-binge cycle and to expand their life. I run a unique package for brides-to-be because I believe that worrying about food or your body should be the last thing on your mind on your big day. Also, I share my love of food through my multi-award-winning vegan food blog called Healthy & Psyched.
Thank you for your bravery and strength in being so open with us. Are you able to tell our readers the story of how you struggled with an eating disorder?
I don’t mind sharing my story. I know it’s a part of my journey, but I’m at a different stage in my life now and don’t feel like the same person who was struggling. In a strange way, I am grateful that I have the experience, so I can empathise with my clients, but I also feel detached from it now.
Growing up I wasn’t too concerned about my weight or body shape. I thought that I was bigger than my peers, but it never worried me that I should change how I ate or exercised. I went to an all-girls high school and was more interested in studying than boys until I moved out of home, to university halls, and began dating. I had this idea in my mind that if I was thinner then boys would like me more. I didn’t act on it much during the first semester, but in the second semester, I lost weight because I was doing a lot of extra training for an international sports competition. I vividly remember the girl who I shared a bathroom with congratulating me on my weight loss and saying how good I looked. I also felt like I was getting more male attention and made a decision that I didn’t want to put the weight back on again. Throughout the rest of my time at uni I yo-yoed between calorie counting (eating “healthy” as I saw it) and also letting loose, having alcohol and the “unhealthy” stuff. Luckily, my friendship group at the time meant that I never slid too far into obsessive behaviours around food, but looking back it was definitely something that I was too pre-occupied with at times.
After I graduated from my BSc. I studied a Masters in Health Psychology. This made me think about food in a new way as I studied in more detail about how food is linked to our physical and mental health. I didn’t know exactly what job I wanted, but I knew it would be in health promotion. Because of that, I thought that I needed to set an example and be the healthiest and fittest version of myself, so I started to eat super ‘clean’ and go to the gym almost every day. I also started to follow a lot of ‘fitspo’ accounts on Instagram and wanted to have washboard abs like the influences I was following because I thought that my body shape and size was an indication of how healthy I was and that people wouldn’t respect me unless I was tanned and toned.
Just before I graduated from my MSc. my first ‘proper’ boyfriend broke up with me in a really awful way. He was very into fitness — that’s what we had bonded over- and I was so determined to have a ‘revenge body’ (i.e. look so smokin’ hot that he would regret dumping me). I started exercising every single day and being even stricter with what I ate in order to lose weight (note: I didn’t even have extra weight to lose). It was around then that I really started to worry if I ate any foods outside of a small group that I had decided were healthy, and I felt so anxious all day if I had to eat out or if I missed a workout.
I was living with my parents during my Masters year to save money, and even though I was 22 at the time, they had an influence over what I ate. My mum would cook us family meals, which I could alter a bit (e.g. plain chicken instead of in a sauce) but I couldn’t eat exactly how I wanted while I was living at home. A few months later, I moved to Singapore to start my job as a research assistant studying motivation. By this time I had convinced myself that I should exercise hard every single day and only eat ‘clean’ food. My idea of ‘clean’ food got smaller and smaller until I was almost eating nothing but fruit and vegetables, and even then only certain ones were ‘allowed’. I felt so free being in total control of what I ate, but actually I was totally out of control; controlled by my fears and the eating disorder that had developed. I was thrilled that I lost weight quickly, but still desperate to have a totally flat stomach and visible abs.
My dad came to visit me after three months and was shocked when he saw me at the airport- my bones were visible, my hair was thinning and my skin was dull. He tried to convince me to eat more but I was so scared to put on weight and to eat ‘unclean’ food. I actually couldn’t understand how he thought I looked too slim and was in total denial that I needed to change how I was eating. I had developed so many rules around food; what I could and couldn’t eat, how much I could eat when I could eat it … the list was endless and it felt impossible for me live any other way apart from according to the rules that I had set myself.
I didn’t have a great time living abroad because food and exercise was on my mind for most of the time. I felt very lonely and miserable; it was hard for me to meet people because I didn’t want to do any activity that involved food and the lack of energy to my brain was most likely having a negative impact on my mood. After 8 months I returned home, thinking that things would be better, but they got worse.
I moved back in with my parents and I would literally spend all day every day thinking about food that I wouldn’t let myself eat. I was constantly hungry, grumpy and eating anything was a mental battle. I lived with my parents, worked for my parents and fell out with my parents daily. They were distraught that they could see me wasting away in front of them but do nothing to stop it.
Then one night I woke up and couldn’t ignore that I felt starving. After a mental battle with myself I decided to go downstairs at like 3 a.m. and eat some oats (one of my ‘safe’ foods at the time). I took a spoonful and I can only describe it as the most amazing thing that I have ever tasted — it was almost like angels started singing when I took that first bite. I was totally distraught with myself for breaking so many of my food rules but the next night I woke up again for a snack. And the night after that…. And the night after that.
I would wake up and raid the kitchen for absolutely anything I could get my hands on — whole jars of Nutella, boxes of cereal, multipacks of crisps, 500g tubs of yoghurt- and that was just in one night. Things got so bad that my mum had to start hiding food so I that wouldn’t eat it. I felt totally hopeless and out of control; like I was actually possessed.
Finally, on the insistence of my family, I started to see a therapist. At this time I also began a regular yoga practice and keeping a gratitude journal, which I think contributed to my recovery. Gradually my eating during the day time began to normalise and I stopped restricting myself so much. I was still deeply upset about the night eating situation and I started to gain weight rapidly which terrified me and made me feel awful. My clothes didn’t fit anymore and I was desperate to do something about it. I started to exercise even more and searched online for different ‘miracle’ diets, including paleo, cutting carbs, cutting fat. But nothing worked and I ended up bingeing earlier and earlier in the day and had started to make myself sick after a binge.
I felt quite hopeless about what to do with my life and, luckily, my therapist helped me to set some goals. I studied a course in Nutritional Therapy and was awarded funding for a PhD in the psychology of health behaviour change. When I started my PhD things weren’t exactly perfect but they were a whole lot better. I wasn’t seeing the therapist anymore and I was eating from all food groups, exercising regularly (but not religiously) and feeling more positive. I decided to start my blog, Healthy & Psyched, at this point. However, when deadlines loomed or I felt that I wasn’t making satisfactory progress the night time binges would begin again. It feels awful to admit it now, but I would steal my housemates' food and then panic about replacing it the next morning.
Over time the act of making myself sick became a coping mechanism to deal with stress; it releases endorphins and can become addictive. It got to the point that I could barely make it into uni if I hadn’t binged and purged that day, and when I was there all I was thinking about was the food that I wanted to buy on the way home. I really knew things had to change because I just didn’t have the energy to carry on as I was.
Luckily, I knew a lot about psychology and behaviour change and was able to apply it to myself; to understand the reasons for my behaviour and how to improve my relationship with food. It was hard at first and I got strong urges to binge, but the longer I ignored them the quieter they got. I realised that there is no ‘magic’ diet and the importance of accepting and loving yourself. Now I eat healthily from a place of compassion and enjoyment. Healthy plant-based eating is important to me, but I can have a delicious sugary brownie or glass of wine with absolutely no guilt and it feels fantastic. I think that finding balance with food is so important so even though my clients now all have different specific goals, I feel like helping them to gain more balance is non-negotiable.
What was the final straw that made you decide that you were going to do all you can to get better?
I spent the evening of Christmas day binging and purging alone in my boyfriend’s house, instead of going out to a party, and I just knew I didn’t want to carry on like that. I was totally exhausted and I felt like it was taking over my life. It was my New Year’s Resolution to stop and I managed for a month, but then stress leads me to binge and purge again. I tried to get help from a local charity, but they said I was too severe for them and needed to go to the NHS. I went to the NHS and they offered me CBT and suggested that I would need anti-depressants to help me stop purging. I didn’t want CBT at the time and as the only option was to take it or leave it I felt quite dismissed by them when I chose to leave it like they didn’t care if I got better or not. I was also really angry that they didn’t think I could get better without drugs to help me and used that as my motivation to get better — like ‘I’ll show you”.
Also, I just want to clarify that I think that medication can be really helpful for some people, but coming from a psychology and not psychiatry background, I just didn’t want to choose that option.
And how are things going for you today?
Really great thank you. I feel like dropping the obsession with food has given me so much more headspace to pursue the things in life that are really important to me. In the past year, I have completed my training as a RRT certified hypnotherapist, worked with hundreds of women at events and 1–1, moved house, planned my wedding and got married, which would never have been possible if I wasn’t in a good place with food myself.
I’m also brimming with ideas for the future and I can’t wait to release new programs for clients, to go on my honeymoon and to decorate our house!
Based on your own experience are you able to share 5 things with our readers about how to support a loved one who is struggling with an eating disorder? If you can, can you share an example from your own experience?
1. Understand that you can’t always understand them. My friend had anorexia, and before she was admitted as an inpatient I went to her house for lunch. I was in a ‘healthy eating’ phase and I didn’t really want what she had made for lunch, but I knew that I should eat because it was lunchtime and I needed to be a good example for her. We sat down to eat and she didn’t touch her lunch. I asked why and she said “I can’t eat it because I will have to eat dinner later when my parents get home”, which made no sense to me then. However, a few years later I thought back about what she had said and it made perfect sense! It was then I knew that I had a problem.
2. They are listening to the things that you say, it just might take a while for it to click. If your loved one has been starving themselves, and their brain, it’s difficult for them to change their rigid thinking patterns. There’s also likely to be a lot of resistance, but there are ways that you can get through to them if you give it time.
3. Try not to get anxious around food. When I was recovering from the restrictive phase of my eating disorder my family and my boyfriend would get so anxious if we went out for dinner in case my food didn’t come out perfect and I started crying (which did used to happen). Them being anxious made me more anxious and sometimes caused a problem when I might have been fine. I remember my boyfriend being upset that I could go out with friends and eat ‘normally’, but that was because they didn’t trigger me in the same way that he did.
4. Recovery is possible. Just look at the people in this interview series!
5. Get help! I think it’s important to get help from a professional who has been trained to work with people with an eating disorder. People do get better by themselves, or with therapists without specific training, but I worry that sometimes people could have been helped quicker- and got their life back sooner- if they had seen a qualified professional. Also, when I was struggling I feel like my family and friends made things worse when they tried to help (sorry dad!) and sometimes it’s good to have a third person who is more detached from the situation to be able to see what is going on and what needs to be changed.
Is there a message you would like to tell someone who may be reading this, who is currently struggling with an eating disorder?
You have the strength within you to change everything and live the most wonderful happy life. Your mind is so powerful — right now a part of your mind might be telling you not to eat or that you’re not worth getting better. But you can absolutely set your mind to recovering and you absolutely deserve it! It might feel like a struggle on your own, but you can do it and help is available if you ask for it.
One really practical thing that you can do is ask yourself what you would say if your loved one (a family member, friend or even a pet) was acting as you are, for example, starving themselves, over-exercising, binge eating or they hated their body? You would most definitely take your dog to the vet if it stopped eating because you’d be worried about it, and you would tell your friend how beautiful they are and how much they mean to you. If you can do this for a friend, then why not yourself? Choose to be your own friend.
According to this study cited by the National Association of Anorexia Nervosa and Associated Disorders, at least 30 million people in the U.S. of all ages and genders suffer from an eating disorder. Can you suggest 3–5 reasons why this has become such a critical issue recently?
I can’t really comment on the US, because most of my clients live in Europe or Australia, but one possible reason may be an increase in awareness and diagnosis since the classification of ‘other specified feeding or eating disorder (OSFED)’ in the DSM-5. I think that this has helped some people to be able to access care through their insurance provider when they may have previously been unable to do so. However, accessing help can sometimes be a long process, or as happened in my case, it took a long time for my family to convince me that I needed to seek help. The lack of early intervention can cause an eating disorder to escalate in severity and can impact on the duration and success of treatment.
Something that we have to remember about eating disorders is that there is no single underlying factor and the presentation can be different between individuals. For example, social media has often been blamed for the rise in eating disorders and poor body image. In my case, wanting to look like an influencer (who clearly had a very different body type to me, and one of whom has since spoken out that she had an eating disorder) did play a role in the development of my eating disorder. But low self-worth, lack of direction in my life and a general tendency to be a perfectionist (i.e. if I have diet rules I’m going to follow them perfectly), also played a role. Not everyone who followed the same accounts as I did would have been negatively affected and gone on to develop an eating disorder.
Family breakdowns and academic pressure may also be a trigger for eating disorders in younger people, but again, it’s part of a more complex picture.
Based on your insight, what can concrete steps can a) individuals, b) corporations, c) communities and d) leaders do to address the core issues that are leading to this problem?
a) My journal helped me so much, every day I would write one thing that I was grateful for, one thing that made me happy, and one thing that I was looking forward to. It made me realise and appreciate the good things that I did have in my life and helped me to stop striving for the perfect body and diet. It takes only 5 minutes a day and I think it’s a great thing that you can do to prioritise your mental health. There is so much research on the association between gratitude and wellbeing.
b) I think that corporations have a responsibility not to glamorize dieting, promote unhealthy diet products (e.g. laxative teas) and to show real bodies in their advertising. Some brands do this really well, but I hate to see companies taking advantage of people’s insecurities. It’s also important that employers take mental health as seriously as physical health in terms of sick days and care.
c) There is an amazing local community group where I live in Derby called THRIVE who are committed to health, wellbeing, and empowerment for the community. They run monthly education events from qualified professionals who are happy to give their time for free to help with a wonderful cause. For example, last year I did a talk about intuitive eating that was really well attended and there is a nutritional therapist who often speaks about eating for health in a very non-restrictive way. It would be great if there were more groups like this, and people knew about them, but I realise that it often takes someone very passionate to run them and to ensure their continued success.
d) Given the prevalence of eating disorders, I think it’s important that leaders allocate funding to treatment and research. Also, some are in a position to influence education policies and advertising regulations to ensure that young people learn to be resilient when faced with risk factors for poor mental health and grow up in an environment that does not promote disordered eating.
As you know, one of the challenges of an eating disorder is the harmful, and dismissive sentiment of “why can’t you just control yourself”. What do you think needs to be done to make it apparent that an eating disorder is an illness just like heart disease or schizophrenia?
I’ll be honest, when I had an eating disorder I didn’t like thinking of it as a ‘disorder’ or illness because that made me feel like I had less control over it or it wasn’t in my power to change it. At times I did feel totally out of control and, as I said at the beginning of this interview, almost possessed to eat. I think it’s important for those making dismissive sentiments to realise that it’s very rare that someone can just snap out of an eating disorder. The sufferer can change their beliefs and habits, but that usually takes time, it’s unlikely that someone will wake up one morning and be totally over it.
Also, it’s a massive miss-perception that people with restrictive eating disorders have incredible will-power while those who binge eat have none. I wrote a whole chapter of my thesis on the correlation between measures of self-control and eating behaviour; the association is very weak and inconsistent when we study it through surveys or in the lab. There are so many other factors that determine someone’s behaviour. I thought about publishing my meta-analysis (a re-analysis of 120 studies) in the hope that it would gain traction on the web, and people can see this evidence for themselves! But I decided that for my own mental health, I don’t want the pressure of publishing journal articles and I prefer to write blogs and work with clients to make a positive impact.
What are your favorite books, podcasts, or resources that have helped you with your struggle? Can you explain why you like them?
I think that eating disorders are so diverse and the material that people will connect with is so different. I tried reading many books about binge eating but didn’t make it half-way through most of them because I didn’t like the tone or just didn’t connect to it.
One book I really like is The Power of Habit by Charles Duhigg. It helped me to analyse the situations that were making me binge and the reward it was giving me, so I could alter the situation and rewards to change my behaviour. But I think you need self-awareness and motivation to be able to do that for yourself.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
It’s a life lesson quote not to live by. When I was about 14, one of the older guys at my swimming club, who had won lots of national championships, said: “winners never quit; quitters never win”. I admired him and I took that on board for a long time. To be fair, it probably helped me to win national and international medals, but when applied to dieting or exercising to lose weight it became quite dangerous. Now I think it is totally fine, and actually a good thing, not push yourself 100% all of the time. Sometimes slow and steady wins the race in our everyday life.
Are you working on any exciting new projects now? How do you think that will help people?
I am so excited to offer a really unique and bespoke service to brides in person or via video call. I feel like it’s the thing they don’t realise they’re missing; wedding therapy! The ADORE package combines hypnotherapy, psychotherapy, NLP and CBT, tailored to each individual bride and her dream wedding.
I got married recently and I had such an amazing day. I remembered going to a friend’s wedding as a guest back when I had a disordered relationship with food; I hated my body (even though it was pretty much the same as it is now) and analysed everything that I was eating, so I couldn’t really enjoy the day. I could have had those same toxic feelings and worries on my own wedding day if I hadn’t have changed my relationship with food, and it really breaks my heart to think that there are people out there now who are letting their mental health difficulties or even low-level stresses ruin a day that should be about love and celebration. In addition, I’ve had so many clients for eating disorder therapy who say that they look back on their wedding photos and think “I looked amazing, why did I hate my body?”
Relationship with food and body image is a big part of my work, but the hypnotherapy side of my business is more diverse and includes issues of anxiety, stress, confidence, self-worth. All of which someone can struggle with before their wedding. For example, I see brides running round like a headless chicken before the wedding and they don’t enjoy the day because they’re still in organisation and control mode. They can use their tailored ADORE package to help them to relax and be present, at the moment, and enjoy their day. I know a ‘dream day’ is different for every bride, so the package has the flexibility to help them step into their confidence and self-worth, and to project that on the day; maybe that’s being a classic and serene bride, or super high energy and flamboyant.
With all of the money and planning that goes into a wedding, it’s such a shame when issues such as perfectionism, anxiety, or lack of body confidence cast a shadow over the day. My new package will really help people to tackle those issues and glow from the inside on their big day. I’m just so passionate about it because this is really deep and life-changing work.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the largest amount of people, what would that be? You never know what your idea can trigger. :-)
Just to spread the idea that you are not defined by your body and that we should appreciate our body. Even as you are sitting reading this there are so many small but vital processes happening in your body to keep you alive and breathing. It’s amazing when you think about it, and sad when you think how much time so many people spend hating a body that is only trying to help them live.
How can our readers follow you on social media?
I’m @healthyandpsyched on Instagram and Facebook for healthy recipes and general behind the scenes — like stories of my cat. And @rewellbeing on Instagram and Facebook for content on the psychology of eating, inspirational posts and client enquires.
Thank you so much for these insights! This was so inspiring!