What happens when trying to be healthy becomes unhealthy?
Airdate: 
Tuesday, September 5, 2017 - 20:30
Channel: 
SBS

Every day, we encounter different messages and strategies about how to live a healthy lifestyle.

Public health messages aiming to address the obesity epidemic have increased our health awareness, while bloggers and social media personalities share their advice on what they think is best for our bodies.

Almost two thirds of Australians are overweight or obese. But disordered eating, according to some experts, is on the rise and in need of more attention.

What happens when the drive to be healthy becomes unhealthy?

Rachel Baffsky started out with a goal to complete the City to Surf fun run in Sydney. Her fitness progress after the run drove her to continue training, and seemingly positive changes in her diet and exercise regime quickly spiralled into something more serious.  

Rachel’s health started to deteriorate and within six months, she was hospitalised and diagnosed with anorexia nervosa.

“I was ignoring people being concerned about me because I thought I was just being disciplined and structured, but I realise now how dysfunctional that was.”

Adrianne noticed her young son was walking more on their WA farm, and starting to go for long runs.

“He wanted to win at the school cross country so he would just run all over the farm. He'd be gone for hours, running.

He wasn't at home on his Nintendo, so I thought, that's great.”

Adrianne’s son was just 11 years old when he was diagnosed with anorexia and eventually told his mum he thought he was being healthy.

“He just basically came out and said … ‘I don't want to be fat’, in his exact words.”

Dr Sloane Madden is a child and adolescent psychiatrist at Westmead Children’s Hospital, specialising in managing eating and anxiety disorders.

He says the clinic would admit over a hundred children each year, and they’re getting younger.

“The average age of the children we see is about 13, the youngest children we see are as young as sort of eight, nine and 10.”

This week on Insight, we hear from people whose healthy habits have strayed into the dangerous territory of disordered eating. At what point did they tip over into being unhealthy? And how have they dealt with it? 

 

 

Credits 

 

Support Services

The Butterfly Foundation - T: 1800 33 4673

Lifeline - T: 13 11 14

Transcript

THE HEALTH OBSESSION.

 

 

JENNY BROCKIE:  Welcome everyone, good to have you here. Rachel, you're 26, two and a half years ago you decided to run the City to Surf? 

RACHEL:   Yes. 

JENNY BROCKIE:  In Sydney.  Why did you want to do it? 

RACHEL:   I was actually going through a depressive period at the time and I was unable to study and concentrate and I wasn't able to achieve anything academically, so I was feeling very out of control and I wanted to kind of regain control and focus myself on an achievement and I set to running the City to Surf as that achievement and goal. 

JENNY BROCKIE:  And how did you approach it? Was it a health goal or was it a…

RACHEL:   Yeah, it was a health goal and it was just to, I guess, boost my self-esteem to feel good about myself.  I went and sought the advice of a health care professional, so I saw an exercise physiologist, and we came up with a running routine for me to do that was appropriate for the goal. 

JENNY BROCKIE:  And you started losing weight during that time? 

RACHEL:   Yeah, but that was very incidental, it was just because the volume of my exercise had increased and my food intake had remained the same. Yes, I did start losing weight. I started getting compliments about it and I started feeling good about those compliments. 

JENNY BROCKIE:  Once the race was over what happened to your exercise and eating patterns? 

RACHEL:   Well, I felt very good about myself after I did the race, I loved my running routine, I started increasing the amount that I was going to run because I set my heights higher, I wanted to do the half marathon. I slowly became a bit for restrictive with my eating. I started picking healthier options at restaurants. . 

JENNY BROCKIE:  What sort of things? 

RACHEL:  So I'd go like the fish option rather than a burger, I would kind of reduce my sugar and fat intake, where possible. 

JENNY BROCKIE:  How much exercise were you doing at your peak? 

RACHEL:   I was running twelve kilometres three times a week and then doing hour and a half weight sessions three times a week and combined with the incidental exercise of my job as a personal trainer which was much too much. 

JENNY BROCKIE:  And what happened to the eating? 

RACHEL:   So I decided to become a personal trainer because after the City to Surf I found that exercise had great benefits for my mood and I wanted to share these benefits with other people so it was again a really positive goal and when I went to the personal training course I learnt a lot about nutrition, I learnt about, like the caloric intake of certain foods and I manipulated that information to reduce the calories in my diet. 

JENNY BROCKIE:  When you say manipulated, what do you mean, why do you use that word? 

RACHEL:   Because I was selectively listening to certain information and ignoring other information.

JENNY BROCKIE:  What sort of things did you cut out all together by the end? 

RACHEL:   I'd cut out sugar all together. I had really minimised fats, and that was about it. 

JENNY BROCKIE:  Restricted carbs? 

RACHEL:   Restricted carbs, yes.

JENNY BROCKIE:  By the time you got to the point where you were diagnosed with anorexia, what sort of physical problems did you have? 

RACHEL:   I was extremely lethargic, so I was just tired all the time. I couldn't sleep so sleeplessness. By the time I hit my lowest, my iron count was extraordinarily low, I actually had to get an iron infusion before I was able to be admitted into a psychiatric hospital because I was too sick for hospital. I was protein deficient and had swelling of the ankles due to protein deficiency. 

JENNY BROCKIE:  And how quickly had all this happened? 

RACHEL:   It happened from about January until June, so it happened quite quickly. 

JENNY BROCKIE:  Jordan, moving out of home in your first year of uni you had a health goal too? 

JORDAN:   I did. 

JENNY BROCKIE:  What was it? 

JORDAN:   For me it was to focus more on healthy eating, similar to what Rachel said, sort of cut out what I thought were bad things, so sugar, high carb foods, anything that I would label as junk and that kind of, yeah slowly progressed from there. 

JENNY BROCKIE:  Mmm.  So it started out with small things? 

JORDAN:   Yeah, I wouldn't keep ice cream or chocolate or chips or anything like that in the house and then, you know, it would slowly progress to I would just eat like half of what I would have normally eaten for dinner and that kind of thing. I don't need that much food, this is excessive, you know, based on kind of, yeah, what you see and how you're thinking at the time. 

JENNY BROCKIE:  And what was the thought process for you as this was developing? What was going on in your mind? 

JORDAN:   Um, for me it was, I guess, focus less on a health fitness goal but more on weight loss.  So I was interested in achieving what I thought was a good goal at the time, and as that progressed, my thinking became more distorted. 

JENNY BROCKIE:  What reactions were you getting from the people around you initially? 

JORDAN:   Initially before it became quite serious I was getting lots of compliments from my friends and family about, yeah, my weight loss, that I was becoming more healthy, and I think that really fuelled me to keep going. And then as I became more unwell, I was getting negative comments. Somebody that I did know who hadn't seen me for a while commented and thought that I had cancer. 

JENNY BROCKIE:  Did you accept what they were saying in a sense that you thought you had a problem, or not, at that stage? 

JORDAN:   For me at that stage I didn't. I don't know, I just thought that everybody was a bit sillier than I was and that I knew what was going on and you know, often times I would think, you know, people are jealous about the way that I've been able to achieve this lifestyle that they haven't been able to achieve. 

JENNY BROCKIE:  Rahal, you're Jordan's boyfriend, you were trying to get healthy at this stage too, weren't you? 

RAHAL:  Yep, yep. 

JENNY BROCKIE:  Initially? 

RAHAL:  Initially, yeah, so I think once we started going to uni and things like that together, so we'd often, you know, go to classes together and work out together and meal prep together and everything like that.  But I think it kind of got to a stage where I kind of fell off the wagon and Jordi kept going. 

JENNY BROCKIE:  And when did you start first start thinking something might be wrong? 

RAHAL:  So we actually went on a trip, went on a trip to the beach I think halfway through uni and at this stage I wouldn't, I wouldn't say that Jordi was at a dangerous weight but I remember we were in the car and she said something like: "Oh, I need to lose another five or six kilos before we go to the beach, before I get into my bikini." And at this point, she would have been probably at the lower kind of BMI scale and that's when I realised there was a serious problem. And I think offhandedly I said something like:  "Do you think that's the best idea?" And she, you know, she burst out crying and some of things that she's kind of speaking about now in terms of the people are jealous about me, you know, I deserve this, I've worked so hard, you know, everything, everything kind of came up there. 

JENNY BROCKIE:  So Jordan, what was it like when he said that to you? 

JORDAN:   Um, I think I was quite defensive of what I was doing and so to me, when people were kind of approaching that, I found it quite difficult to accept and I honestly did feel at the time that I'd been working really hard for something I really wanted and, um, it felt to me that people were just trying to stand in my way of achieving that. 

JENNY BROCKIE:  And you were saying things to people like: "But I'm eating everything"? 

JORDAN:   Yes, I was saying things like that. In hindsight, I obviously wasn't but at the time I honestly believed that what I was doing was healthy. I was eating three meals a day plus snacks, but my meals were extremely small portions. 

JENNY BROCKIE:  How small? 

JORDAN:   Oh, I would eat one tablespoon of oats with a small amount of milk and I would call that porridge every morning. I would, got to a point where I would not eat a full piece of fruit. I would eat a quarter or a half and that would be…

JENNY BROCKIE:  A piece of fruit? 

JORDAN:   A piece of a fruit so it just got, yeah, quite dramatic. 

JENNY BROCKIE:  And how bad did it get for you? 

JORDAN:   Bad. I started off, when I first made the decision to get healthy I weighed about 68 or 70 kilos and by the time I was admitted to a psychiatric hospital, I was less than half of that.

JENNY BROCKIE:  Wow. 

JORDAN:  Mmm. 

JENNY BROCKIE:  And did you accept you needed help at that point? 

JORDAN:   Um, by the time I went into hospital I think I did. But it did take me well over a year to kind of get to that point and even then the day before I was due to be admitted I was calling my parents and kind of saying, you know, oh, I don't think I need to go and I'm committed to doing this at home. You know, because I really didn't want to. I was very afraid of what would happen when I went to hospital and was required to…

JENNY BROCKIE:  What were you afraid of?  

JORDAN:   Putting on weight and being made to eat food that I didn't want to eat, I guess, and I think when you've spent a good part of your life kind of focusing on healthy eating, or whatever that means, and you know, an exercise regime, it's very hard to then give up all self-control to the hands of doctors and nurses and hope for the best. 

JENNY BROCKIE:  Rachel, did you feel like that? 

RACHEL:   I actually found it somewhat freeing to go in there and give over control to the health care professions because I'd just spent so much of my mental energy obsessing over my diet and my exercise and just to be able to not think about that I found quite liberating for me at the time.

JENNY BROCKIE:  Suzie, you were sixteen when you started thinking a lot about being healthy. Why? 

SUZIE:  I'd just come back from a trip to France with school, eating a lot of pastries and cheese and that kind of thing and I thought that I had gained a whole lot of weight, although I don't necessarily think that I did, and I basically wanted to lose a few kilos.  And so I started to cut down my portion sizes a little bit, so maybe a three quarter size of what I would have previously eaten. I started to exercise maybe three times a week and just choose healthier options for food. 

JENNY BROCKIE:  You decided to become vegetarian.  How did you explain that to people? 

SUZIE:  Yeah, so I went vegetarian, stopped eating all meats and seafood, I said that it was an ethical thing at the time. 

JENNY BROCKIE:  Was it? 

SUZIE:  No, it was about losing weight. Meat was sort of one of my bad foods that I thought would be either too fatty or too oily or something. So yeah, I explained it as an ethical thing and everyone was quite okay with that and no one really asked any questions and it was very easy to put up a front of it being healthy and ethical when it really wasn't. 

JENNY BROCKIE:  What were you actually eating? 

SUZIE:  Um, so I was eating a lot of fruit and vegetables, that kind of thing, I cut more and more things out of my diet, so eventually it was just entirely clean food. 

JENNY BROCKIE:  What does that mean? 

SUZIE: So…

JENNY BROCKIE:  What did it mean to you? 

SUZIE:  Yeah, it meant things like fruit and vegetables, whole grains, things like brown rice, wholemeal bread over white rice or white bread. 

JENNY BROCKIE:   How did it start affecting you? 

SUZIE:  I lost a few kilos and initially it affected me mentally in a way that was quite positive. I felt happy about losing weight.  

JENNY BROCKIE:   What about exercise, what were you doing and why? 

SUZIE:  So exercising, I was doing running mainly.  So I would run around my neighbourhood, initially it was three times a week and soon it was pretty much every day and I, to everyone around me I said that I was running for health reasons but really it was more of a punishment for eating food. So there were times when I would eat an apple or something that I hadn't planned to eat for the day and as a punishment I would run for, you know, half an hour or something because I thought that it would make me gain weight. So yeah! 

JENNY BROCKIE:  How much time were you spending thinking about all of this in a day? 

SUZIE:  Sometimes I felt like I couldn't think about anything else other than food, what I'd eaten already, what I was going to eat later, whether it was healthy enough, how many calories it was, and it was just really intrusive thoughts pretty much all day I suppose. 

JENNY BROCKIE:   Melanie, how did you first get fixated on eating and fitness? 

MELANIE:  Um, I had an autoimmune condition and, and was just basically told to stay on medication for the rest of my life. So, I sort of started exploring the natural world.  I saw a functional medicine practitioner and he put me on a diet that completely got me off of all medication and …

JENNY BROCKIE:  How restrictive was the diet? 

MELANIE:  The diet at the time was not very restrictive, he put me on more of a paleo diet but it was quite balanced and what I would consider now quite healthy.

JENNY BROCKIE:  So when did it become unhealthy? 

MELANIE:  Well, so it wasn't until I, my husband and I decided to start trying for a baby and I was diagnosed with polycystic ovarian syndrome and so I started researching fertility diets and I truly believed that I could engineer my own fertility. So when I would do research and if something was questionable, I would essentially just cut it out. If everybody agreed that it was healthy, then I would keep it in. So…

JENNY BROCKIE:  So there's conflicting information all the time? 

MELANIE:  There's conflicting information constantly, absolutely, so I would be…

JENNY BROCKIE:  So how many things were you cutting out on the basis that there was a bit of criticism of it? 

MELANIE:  So by the end, so at my most obsessive I guess, I had cut out gluten, dairy, meat, refined sugar, I was, um, having low sugar fruits like apples and strawberries and that would be it in terms of fruit. And refined carbohydrates, sort of white carbohydrates, but I wouldn't even eat the multi-grain bread. 

JENNY BROCKIE:  How did it affect you physically and mentally?

MELANIE:  So physically from the outside, you wouldn't have noticed a difference. But I was definitely getting sick a lot, in terms of just I had low immunity.  In terms of mentally, I didn't see a problem and it wasn't until I went to a friend's birthday party at a pub and there were no healthy, healthy options on the menu and it completely stressed me out. But that wasn't the moment that I realised, it was when I was  talking to a friend afterwards about that a couple of weeks later and you know, I said how stressful it was that there was just nothing healthy as though it was normal and she said you do realise that's not normal? Like you should be able to have a night out and relax and have a pub meal and enjoy it. 

JENNY BROCKIE:  Who else has gone on diets thinking you'll get healthy and then realising it's gone too far?  Olga, you said that that had happened to you? 

OLGA:  So, yeah, last year I decided I'd wanted to cut out wheat and gluten and alcohol and processed foods, um and I …

JENNY BROCKIE:  Why did you decide you wanted to do that? 

OLGA:  At my old job we all kind of decided we all wanted to be healthy, but I guess I took it a bit further than some other people and then I was exercising about four to five times a week and I lost quite a bit of weight.

JENNY BROCKIE:  And how did you stop doing that? 

OLGA:  Just, I think because my mum and my family became worried about me and they kept on saying that I didn't look good and I need to put some weight on and I went down to a size 6, I kind of gradually realised that it's not healthy. 

JENNY BROCKIE:  So you turned it around before it got too serious? 

OLGA:  Yeah, turned it around. 

JENNY BROCKIE:  Priya, you went on a diet, didn't you?

PRIYA:  Well I was on a watermelon diet but I didn't go too far. 

JENNY BROCKIE:  A watermelon diet? 

PRIYA: Yeah. 

JENNY BROCKIE:  Only watermelon? 

PRIYA: Yeah, someone told me you take watermelon for a week and you lose a lot of weight. 

JENNY BROCKIE:  And why did do you that?  Was it for weight reasons or for health reasons? 

PRIYA: Well I think it was more sort of, you know, wanting to lose weight and I think my husband was saying I think you have to go back to when you got married, now I think I are too overweight, so that was also working in my mind. So I said okay. 

JENNY BROCKIE:  He should be here, we could ask him about that? 

PRIYA: So he brought me this watermelon day in and day out.  By the end of the week I said I had it, I'm going back to my old self. 

JENNY BROCKIE:  Okay. Sarah, you're a clinical psychologist, you specialise in people's relationships with food and body image. How do you react when people say they want to make big changes to the way they eat to get healthy? 

SARAH:  I can't help but be worried working in that area, seeing the sorts of changes people make and when someone's starting to eliminate entire food groups, to me that screams alarm bells that something's wrong. 

JENNY BROCKIE:  So is that the sign? I mean there's nothing wrong with wanting to be healthy? 

SARAH: No, I think the issue is that when we're talking about disordered eating it's a very slippery slope and when someone starts to make dramatic changes, it can, it triggers a raft of issues and some people can dabble in this behaviour without experiencing serious problems but for a lot of people it can lead them down to the pathway of developing a clinical eating disorder. 

JENNY BROCKIE:  Bastian, you represent GPs.  How easy is it for a GP, often the first port of call, to pick up signs of disordered eating? 

BASTIAN:  It's actually very difficult because eating disorders present in many disguises.  Patients don't come to us and say I have an eat disorder and I would like to have some evidence based treatment now, that's just not the case. So patients present because they are feeling unwell, they are tired, they are fatigues, they can't really concentrate.

And it's, you know, often actually family members or friends or partners who raise concerns and say look, you've got to go and see a GP to talk about your concerns. And for us as GPs, we have to be sure that, you know, nothing serious is going on but when we take a proper medical history and when we do a proper physical examination, it becomes very clear when we talk about what do you actually eat on a day, that all of a sudden there is a pattern that actually doesn't make a lot of sense. 

JENNY BROCKIE:  Do people tell the truth though? 

BASTIAN:  Well initially they say I have a healthy balanced meal. And when you try to narrow things down it becomes very clear.  Look we have a teaspoon of oats, I'm only eating watermelons and, you know, of course, you know, then we realise there's something more going on.

JENNY BROCKIE:   Thomas, you were treated for anorexia from the age of fourteen. You'd begun putting weight back on by the time you were sixteen. What happened after your weight stabilised when you were about nineteen, what happened then? 

THOMAS:  My weight stabilised for about two years and then after that I sort of fell into that whole a clean eating obsession and part of my brain rationalised look, I've been down this eating disorder path, I don't want to go down that again, but I'm still anxious around food and I still have thoughts continuously about food, about diet, about exercise.  Being naturally an anxious person I sort of fell into, you know, whatever the latest health trend was. I was going to follow it to sort of clinically monitor my own health, I suppose. The issue with that is that monitoring and sort of tailoring your diet to suit your lifestyle, I suppose, ends up making you restrict your food more and more and more, and having had that eating disorder background, I quickly fell into an orthorexia behaviour pattern. 

JENNY BROCKIE:  Now orthorexia meaning?  

THOMAS:  The obsession with healthy eating or clean eating.  Now orthorexia though, the problem is that the definition of clean eating is different to every individual. 

JENNY BROCKIE:  What was your definition of clean eating? 

THOMAS:  My definite of clean eating was removing all refined carbohydrates, all gluten, all diary or sugar or legumes, anything that pretty much didn't fit into a paleo lifestyle was basically off limits 100 percent of the time. 

JENNY BROCKIE:  And you got that from media, just from reading stuff yourself or…

THOMAS:  Yes, or the blogs on the internet, the Instagram accounts, the websites, all these sort of obviously health blogs and trends that are on, face value, quite harmless, it seems, but there's a lot of people who follows it like a cult and it is becoming like the new religion, these health trends where it is very much, you know, vegetarians versus the paleos and sort of all these different kinds of diets where everyone thinks that they have the answer and the answer… 

JENNY BROCKIE:  But you'd transferred really what had gone on with your anorexia, you kind of transferred your fixation …

THOMAS:  Correct. 

JENNY BROCKIE:  To health and to…

THOMAS:  Correct. 

JENNY BROCKIE:  What you call clean eating? 

THOMAS:  Yes, it became a very easy way to sort of fall into old habits but in a much more socially acceptable manner, I suppose. 

JENNY BROCKIE:  What were you actually eating then?  You talked about what you cut out, what were you eating? 

THOMAS:  Again a lot of vegetables, not a lot of fruits because of the sugar content, so I was basically eating lean protein.  So I suppose sort of like chicken, fish, lots of tuna as well, and lots of vegetables and cutting out any sort of vegetables that were considered in the media as potentially hazardous, for example a lot of the night shades, the potatoes and capsicums and sometimes even at one stage tomatoes because I read that they could cause inflammation in the body. 

JENNY BROCKIE:  How much was what you were eating changing depending on what were you reading? Like was this changing all the time or was it fairly stable? 

THOMAS:  To me it was stable, but of course it wasn't. I thought sort of when I read something that was potentially hazardous, it just was out, it was cut out and to me that made perfectly, it made logical sense but nobody else around me was doing the same thing and I sort of at the stage just felt as if they were less informed that I was. They weren't doing the research, you know, they were very ignorant about what was happening and just needed to catch up. 

JENNY BROCKIE:  Your mum is dying to talk here. She's dying to say something.

MAREE: It would depend on what Thomas had read. So because he had been down the path of anorexia, whatever he wanted to eat I would make sure we had plenty of it, but it would change so we'd end up with all these things left because he'd read something else on the internet and that wasn't healthy this week, I would say.  So what he thought was healthy would change basically from week to week.  And I'd be saying you need to eat this, you don't need to restrict your food like that, it's not healthy. But he couldn't see that. 

JENNY BROCKIE:  How old were you when you first started thinking about food and your weight? 

THOMAS:  Oh, gee, I probably would have been about twelve to thirteen years old when I first became quite conscious of my weight. As a child I was quite heavily overweight and I was bullied for that as well so I would…

JENNY BROCKIE:  From what age? 

THOMAS:  I was overweight from probably the age about six or seven, all the way till as a teenager when I lost the weight. So during that entire sort of childhood period I didn't know what it felt like to be at a normal weight or what was considered a healthy weight.

JENNY BROCKIE:  So what was your relationship with food like when you were a child? 

THOMAS:  For me it was always almost like a little bit too obsessive. I would even say as a child I can remember at times my mum coming up to me as a child at parties and saying "that's enough now Thomas, you know, step away from the food table, you've had enough lollies now", that sort of thing. 

JENNY BROCKIE:  A lot of mums say that, particularly about lollies? 

THOMAS:  Yeah, correct, but I think over time obviously I've always just had that relationship and I feel that some people do have a stronger relationship overall. Some people…

JENNY BROCKIE:  So you feel like that you were more interested, engaged with…

THOMAS:  Interested in food overall, yeah. 

JENNY BROCKIE:  Thinking about food?  Maree, when did you first realise something was wrong in Thomas's relationship with food? 

MAREE:  Not until he was fourteen. 

JENNY BROCKIE:  Anorexic? 

MAREE:  Yes, and um, initially we all, we were all saying how terrific he looked, like the other girls said, and encouraging him, I guess, but then just by looking at him I knew that it had gone far too far.  

JENNY BROCKIE:  How did you deal with the whole question of food and eating at home as a mum? 

MAREE:   I used to try to have healthy options as much as I could and he has two younger brothers and they say now they used to be devastated that they were the only children at school without chips in their lunch box. Because I didn't want Thomas to have it so I didn't give it to them either. 

JENNY BROCKIE:  Adrianne, your older son is sixteen, you live on a farm. When did you first notice him starting to exercise more? 

ADRIANNE:  I actually first noticed him being really, really skinny. My sister actually saw him before he went to a heated pool, because this was winter, he was covering up with baggy jumpers and stuff and she happened to walk past his room when he took his top off and put his rashy on and she said to, pulled me aside and she said oh, my God, I can't believe how skinny he is. So that, yeah, rang alarm bells for me and that's when I began to notice that, yes, he was excessively exercising.  So he would get on my exercise bike for half an hour every day, could be longer.

JENNY BROCKIE:  How old was he then? 

ADRIANNE:  He was eleven and he had very high expectations of himself. So he wanted to win at the school cross country so, yeah, so he would just run all over the farm. He'd be gone for hours running, run, run, run, run. 

JENNY BROCKIE:  And you thought that was healthy? 

ADRIANNE:  Well yeah, he wasn't at home on his Nintendo. I thought that's great. 

JENNY BROCKIE:  Yeah, he's out in the sunshine and the fresh air? 

ADRIANNE:  Yeah, yeah. 

JENNY BROCKIE:  Yeah. Did his eating habits change? 

ADRIANNE:  Um, yes, yes. At first it wasn't really noticeable but I rang the school and they told me that he was throwing his lunch in the bin.

JENNY BROCKIE:  Why do you think he was doing this?  What do you think was driving it at such a young age? 

ADRIANNE:  Yeah, like I think there's several factors, several triggers, his personality type being one of them. 

JENNY BROCKIE:  What personality type is that? 

ADRIANNE:  He's a people pleaser, perfectionist, has high expectations of himself.  He was always well behaved, always did what was asked of him, no complaints, never argued. 

JENNY BROCKIE:  Rahal is nodding his head here about your  girlfriend, the description of your girlfriend as well? 

RAHAL:  Yeah, definitely, definitely perfectionist, I guess very ambitious and yeah, I guess nothing's ever good for her, I mean in the sense that she's always trying to get to that next level. 

JENNY BROCKIE:  Is that right? 

JORDAN:  Yes, I think so. 

JENNY BROCKIE:  Sorry, I'm not trying to, you know, put you on the spot but it's interesting, isn't it? 

JORDAN:   Yeah. 

JENNY BROCKIE:  I mean and if there are patterns here it's worth exploring them. 

JORDAN:  Mmm. 

JENNY BROCKIE:  I'm sorry, I interrupted you, you were halfway way describing why you thought? 

ADRIANNE:  Yeah, look, and being at a very small town there was only two classrooms and he was the only person in his year, so he didn't have that many male peers or role models, if you like, older boys. But there was one particular older boy and he was quite overweight and I think that might have been a bit of a trigger having him in his life and thinking probably oh, I don't want to be like that. 

JENNY BROCKIE:  Did he say that? 

ADRIANNE:  Only after he sort of recovered.  He just basically came out and said yes, I don't want to be fat, in his exact words. 

JENNY BROCKIE:  Sloane, you're a child and adolescent psychiatrist.  You specialise in managing eating and anxiety disorders. Your response to what you're hearing? 

SLOANE:  Oh, look, I think particularly the last two stories are absolutely typical of what we see.

JENNY BROCKIE:  So what are you thinking is driving some of this? 

SLOANE:  Look, I think we know that there really is a strong genetic risk for eating disorders and as we've heard here, some people can diet and leave it alone, but there are other people, once you start dieting it gets out of control really very quickly.

JENNY BROCKIE:  I mean how old are the kids you're seeing and is that changing? 

SLOANE:  Look, absolutely.  So the average age of the children we see is about thirteen, so we'd admit over a hundred children a year and see at least a hundred other new kids a year as part of our service. The youngest children we see are as young as sort of eight, nine and ten. 

JENNY BROCKIE:  And why do you think that's happening more? 

SLOANE:   I think there is an increasing exposure to messages about health and about the benefits of healthy eating and being slim. 

JENNY BROCKIE:  Is that what they're saying, that they want to be healthy or that that want -- 

SLOANE:  Yeah, absolutely. But for some of them there is really that concern about weight and shape and the message we're getting all the time, you know, we're in the obesity epidemic and being healthy is being slim and about being thin, and at nine, ten, eleven and twelve you don't have the sophistication to understand the nature of that message. 

JENNY BROCKIE:  Rachel, when did you realise what you were doing might not be healthy? 

RACHEL:  Um, I realised when I was starting to prioritise exercise over socialising and work. I think I first realised when I was at a party and I was getting very flustered because the food was taking too long and I was starving and I had my bag packed with all my exercise gear because I needed to get to the gym after the party and at that point I realised it was just an unhealthy priority in my life. 

JENNY BROCKIE:  When were you diagnosed with anorexia? 

RACHEL:  In May of 2016. 

JENNY BROCKIE:  What did your treatment involve? 

RACHEL:  In April I hit my lowest weight and this is when I graduated and I very vividly remember like accepting my, like being at graduation ceremony and just feeling completely numb because I was so malnourished and I was so miserable and agitated by my inexperience to feel joy, and at that point I really realised it was affecting me so I tried to increase the volume of what I was eating, but then I'd go through a stressful period and lose a bit of weight so it was very yo yo and it wasn't until June when I went to a play with one of my clients, and I love musical theatre, I love doing  things with my clients, and again I was so depressed and tired from the eating disorder that I wasn't able to concentrate and I just had an existential crisis and realised just how much joy the illness had robbed me of my life. 

JENNY BROCKIE:  And so what did you do? 

RACHEL:  So I went to my GP and he suggested that I go to Northside Clinic for inpatient care and I did that. 

JENNY BROCKIE:  And what did that involve? 

RACHEL:  So the inpatient treatment involved, you go there and you stay in there and they completely control your meals.  So you have a meal plan, you have group therapy throughout the day and you see a psychologist and that was just completely amazing for me.  It was exactly what I needed because I really just needed to gain the weight because I was so malnourished that my cognition was impair and I just wasn't able to stick with my motivation or commit to a psychological recovery until I restored the weight. 

JENNY BROCKIE:  How long were you there? 

RACHEL:  I was there for five weeks. 

JENNY BROCKIE:  Jordan, you were diagnosed with anorexia too, did you accept the diagnosis? 

JORDAN:   No.  Yeah, following a visit to my GP I went to see the university counsellor and she kind of suggested that I might have anorexia and I kind of took that in the same way that I was taking people's like comments about my weight. Like she doesn't know, what could she possibly know? And she eventually put me in touch with a kind of an outpatient clinic in Canberra which I went to on a weekly or bi-weekly basis, and so following that period, I also went to the Northside Clinic. I was there for about three months and then went home for about a month and then went back for another couple of months.

JENNY BROCKIE:  In between the time you went there, you got the diagnosis and you went there, you went away to Bali rather than accept the diagnosis, yes? 

JORDAN:   Yeah, Rahal and I made plans to go to Bali as our first overseas trip together so we were very excited, but I'd hit my lowest weight just prior to going and so I made a deal with my doctors and my family that I would put on five kilos before I went and so I did. 

JENNY BROCKIE:  Did you? 

JORDAN:   I did, which was tricky and I think while we were in Bali I was obviously still very unwell and so probably wasn't the most enjoyable holiday, but I think it was good. I was less restrictive while I was there so I think it almost eased me into …

JENNY BROCKIE:  Accepting that you needed treatment? 

JORDAN:   Yeah.

JENNY BROCKIE:  Thomas, having had anorexia, you know, and had to address that when you were fourteen, when did you realise you needed help again? 

THOMAS:  So I think the real tipping point for me was probably when I started developing really bad gastro intestinal issues and I ended with up with ulcerated colitis which is not - it hasn't been determined whether that was caused from an eating disorder but chances are it was.  So for me it was the physical symptoms as well. I, mentally I knew there were still issues but I felt like I was managing it and I was in control of it, but it wasn't really until I was physically really feeling quite sick and feeling as if I was actually slowly killing myself through this process that I really did - alarm bells!

JENNY BROCKIE:  So that really was the factor that drove you to get treatment? 

THOMAS:  I think so because I, the second time round with orthorexia I didn't really seek external treatment.  I was able to sort of pull myself out of that myself through sort of doing a lot of, rather than seeing a sort of a psychologist or following a more traditional pathway I was reading a lot of self-help books and trying to find ways where I could justify to myself wanting to get better, because I had a very, I was very adverse to the whole clinical pathway and I was very much wanting to be in control of my own situation because I'm a bit of a control freak and trying to improve that through a proper healthy balanced lifestyle and diet that wasn't restricted any longer. 

JENNY BROCKIE:  Where did you all get this information that you used about health and nutrition when you were trying to be healthy or lose weight?

RACHEL:  The Australian Dietary Guidelines. I looked up what the recommended serving of carbohydrates was for a person of my age and gender, but again I didn't factor in that I was very active as a personal trainer and I was doing a lot of cardiovascular exercise, so my demand for carbohydrates was higher than the average person. 

JENNY BROCKIE:  Where else did you get…

THOMAS:  I didn't trust the Australian Dietary Guidelines and because I thought it was very backward and my mum would even testify, I used to say what the current, what's currently being taught in the media and the government isn't correct. I'm following, you know, the new wave of the health blog so I'd listen to pod casts, I'd read journal articles, all sorts of bits and pieces, and I'd kind of string it all together and sort of look at highlight the underlying commonalities or the things that sort, I suppose, suited me personally as well, let's be honest, and sort of pulled that together to sort of define what I felt.

JENNY BROCKIE:  Pulled together what you wanted? 

THOMAS:  Was ideal health. 

JENNY BROCKIE:  Jordan, what were you, where were you getting information? 

JORDAN:   Yeah, I kind of just made it up in my head. I guess I probably started from an idea of what, you know, like a normal healthy diet would look like and then kind of made up rules of what was good and what was bad and how much to eat. 

JENNY BROCKIE:  What about social media? 

THOMAS:  Absolutely.  Instagram.  All these health bloggers now, they sort of taunt themselves as nutritional therapists or health advocates or spokes people or influencers, that are really just people sort of, just like any other person, sort of running around sort of claiming certain health benefits or ideas. You know, all these different pieces of information where everyone's suddenly an expert about health and nutrition, when really they don't have any formal qualifications, they've never been to a school about this and they're kind of just professing their own sort of almost quasi religion as such. 

JENNY BROCKIE:  Emma and Carly, you're sisters, where did you get your information from about health, food and fitness? 

CARLA:  Yeah, from back when we first started dieting, it would have been at age eleven for me, and that would have just been from media and advertisements and following certain ways of eating specifically to lose weight because I was never happy with how I looked.  I always thought I needed to look like the people in the magazines, always thought I needed to look like the cool girls at school. 

EMMA: Yeah, I had a similar story where I wasn't doing dieting but I was restricting what I was eating all through high school and then started vomiting, just on the weekends. So I'd binge eat and vomit on the weekends, so obviously that wasn't for health, that was just to be thinner and that was because my version of healthy was just thin.  I didn't know what health was, it was just what the models looked like.

JENNY BROCKIE:  How many diets do you think the two of you would have tried since you were say eleven? 

CARLA:  I feel like I've tried every diet under the sun, lemon detox diet, Ducan diet, 80/20 diet, everything that I read about I would have tried all in the idea to lose weight. 

EMMA:  And can I also add though, me starting to eat a paleo diet actually stopped my vomiting though. So it's like everyone is so different, I mean like paleo can be devastating for someone but then it can also help someone and make them healthier and it made it like it was literally the day I ate paleo it was like my relationship with food changed, it became a positive one, I stopped binging and I stopped vomiting. 

JENNY BROCKIE:  What drove your interest in trying all those different diets? 

EMMA:  I think um, I connected my self-worth with what I looked like and I was never good enough.  So I think a very common thing, you're never good enough but what is the core problem, it's our relationship with ourselves, it's not accepting who we are. It's having no self-worth and what creates that is media, it is Instagram and that's why what we do it's like we want to create a positive.

CARLA:  But there's pros and cons to everything. 

JENNY BROCKIE:  You have a blog? 

EMMA:  Yeah. 

JENNY BROCKIE:  And you describe yourselves as magic creators and health coaches. Let’s have a look. 

 

VIDEO PLAYED. 

 

CARLA:  We are about to film with SBS.

EMMA:  With good lighting for a change. Soft lighting!

CARLA:  Let's do it. I guess it all started back in 2012.

EMMA:  Yeah, so that was when I discovered I had the gluten intolerance and started eating real food and felt amazing. We started posting photos of like things that we'd made and Carla decided to share it all on Instagram. All of a sudden you had like a thousand followers on Instagram.

CARLA:  And look up to the sky.

EMMA:  Realised that we could actually make a business out of this thing.

CARLA:  We remember, like one day this account with 25,000 followers shared us and we were watching the numbers go up. I was like this is insane.

EMMA:  We are making a delicious movie, look at the stars. Yum. 

CARLA:  So getting all these comments of people asking us like how did you make that recipe, why aren't you using gluten, why aren't you eating grains, why are you so happy? Like  they were literally questions we were getting on Instagram and we just had this moment where we looked at each other and like maybe we could do something with this?  Maybe we could put all this information that we're reading about, that we're discovering, on line on the internet.

EMMA:  And like share our own experiences. Strawberries! 

CARLA:  We're also going to be putting avocado, peanut butter, pasta, gluten free, gelatine, raw cacao, grain free, sugar free, protein, rachy mushrooms, cinnamon, all the good stuff to make you super merry this morning.

Our favourite stuff is definitely gelatine, sprinkle it on Em, because it heals the gut, it repairs the gut lining and basically you can't taste it so it's like this magical supplement that makes you healthy. Woo hoo.

EMMA:  Get your elbow into it, your arm. Fill it up the topping.

CARLA:   It's definitely all about the topping. So basically we just love to help people live healthier happier lives.

EMMA:  With a smile. 

 

END OF VIDEO. 

 

JENNY BROCKIE:  You offer recipes on your website that you say will get you feeling your best and that only good stuff is allowed, so no gluten, no refined sugar, no grains or dairy. How do you work out what good stuff is? 

EMMA:  So again, it's all through our own experience and we say that. We say that, you know, this is, we share exactly what we go through and it's benefited our lives and we put it on-line and we inspire people to, to connect with themselves.  And I mean, you know, we have recipes on there now that do have dairy and grains. So obviously like we've, our journey has transitioned as well so we've like started paleo, but now it's a little bit different. So like…

JENNY BROCKIE:  Why, why is it different, why have you shifted away?  Is it because there's been controversy around paleo? 

CARLA:  Basically throughout the journey of what we've both been through, it was this obsessive way of eating and paleo alleviated that for us in the first instance, but then when we started the Merrymaker Sisters and we started advocating paleo, we realised that we became obsessed again and we were self-aware enough to realise oh, warning bell, actually that's not healthy and we don't want to be feeling that way.  So we decided to strip label and just keep it simple and that's basically what we do.

EMMA:  And also like I have a gluten intolerance so that's why I've cut out gluten. So if I eat bread I'll look three months pregnant.  Like my belly will just balloon so it's like there are reasons why you do cut out certain foods because you do feel better. 

JENNY BROCKIE:  But that's for you, you're giving advice to other people. 

EMMA:  Exactly, and that's why like we're sharing, I'm sharing my experience and I mean, like …

JENNY BROCKIE:  Can I just ask you a little bit more about the website? You have a challenge that you run for your followers with meal plans. How does that work, how do you devise meal plans? 

EMMA: Yeah, so we create delicious food filled with vegetables, proteins, fats, lots of good healthy fats, we create the meal plans, we talk to naturopaths and other experts as well. 

CARLA:  Nutritionists.  We kind of see ourselves as connectors. 

EMMA: Yeah. 

CARLA:  To all these other experts in the health and wellbeing industry, like chiropractors, naturopaths, nutritionists.

EMMA:  Doctors as well? 

CARLA: Doctors. The people who have done the research and can share what is working, what could work for these people who are feeling lost. They're lost. 

JENNY BROCKIE:  Do you have qualifications around diet and nutrition? 

CARLA: We're health coaches but we don't see that as a qualification. We see ourselves as people who can inspire people to make, one positive change and doesn't just have to be with food.

JENNY BROCKIE:  Rebecca, you're a nutritionist and you lecture at the University of NSW. Your reaction to these, I mean there's lots of blogs like this around, lots of information floating around? 

REBECCA:  I mean, I always second guess someone giving nutrition advice when they're not university qualified I'm afraid. So dietitians in Australia are always university qualified or is very much evidence based and I really believe in evidence based medicine, including nutritional medicine, it's really important. And a lot of things I see in the media, including on social media and Instagram, are not really using the strongest evidence and not really evidence based and I have a real problem with that. 

JENNY BROCKIE:   Sarah, why do you think people are so interested and obsessed with getting healthy? Why do you think that's become such a thing? 

SARAH: I think there are a number of factors. One of them is just from a public health perspective, we're living in what's considered to be an obesity epidemic and I think a much more healthy, much more useful thing for us to be thinking about is an epidemic of disordered eating. Everyone is confused about what health actually is.

JENNY BROCKIE:  Do you think there's too much emphasis on obesity and too much of that in the way of health campaigns? 

SARAH: I think that the health campaigns can be very dangerous that we are exposed to because they're focused on around weight and losing weight and that that's the key focus. It's not, again this information often falls in the wrong hands so it falls into vulnerable who probably don't have a weight problem to start with, and we need to start to see health as an on-going process that involves all aspects of our life.

JENNY BROCKIE:  Amelia, I'm interested in your response to this because you run health campaigns for State Governments. Are we focusing too much on obesity and is there a danger that that message gets into the wrong hands? 

AMELIA:  I think putting it in the context of Australia today, so two-thirds of people are classified as either overweight or obese, not all those people would be unhealthy, but the evidence suggests that the further your weight goes above the healthy weight range, the greater your risk of diseases such as type 2 diabetes, heart disease, thirteen cancers and several other conditions. So there is an issue around weight and lots of people are looking for advice. So I work as a dietitian for the Live Lighter Campaign and we promote people to eat better and to move more and aim to achieve and maintain a healthy weight. So we have advertisements that look at toxic fat which does appear shocking at times. 

JENNY BROCKIE:  This is the Grabbable Gut Campaign? 

AMELIA:  Yes, it is, yeah, toxic fat. 

JENNY BROCKIE:  Do you think that could unintentionally have a negative effect on some people? 

AMELIA:  Well I think when you look at public health campaigns there's always going to be an element of unintended risk and the evidence we've got so far from the last five years and over 7,000 people is that the people exposed to our campaign, there are no negative associations in terms of stereotypes towards people who carry extra weight and those who haven't been exposed to our campaigns.

JENNY BROCKIE:  This is really tricky, isn't it? Striking a balance with all this stuff, yeah? Do you have views about that Sarah? 

SARAH:  I think, and certainly I know this isn't what you're saying but the idea that the odd anorexic is a small price to pay for public health is a really dangerous attitude to be having and I think that scaring people around fat is also, there's a lot of research that shaming people and making people feel uncomfortable in their own skin isn't motivating. 

JENNY BROCKIE: Sloane? 

SLOANE:  Yeah, look I have a pretty strong opinion.  I think messages that focus on weight, shape, weight loss and measuring haven't worked for obesity. So all of the public health campaigns have really made no difference and they put people at risk. I think fortunately now we're moving to a more nuanced sort of message which is health is being a balance. You know, flexible eating, fun, flexible activity and sort of seeing health in, physical health in those ways but also psychological health and really taking out the issues of measuring, weighing people.

JENNY BROCKIE:  Jordan, where are you up to now, how are you doing? 

JORDAN:   I'm doing well, I'm in a healthy weight range and I have been for the last few years which is great. I do still struggle with mental health, including eating, but I have confidence that I can get through that and work towards more normalised eating behaviours and enjoying the pieces of cake. 

JENNY BROCKIE:  Rachel, what about you how are you doing? 

RACHEL:  Yeah, really well. Yeah, I've restored my weight and I've got only a couple of weeks to go until I'll hit my target weight and I'm having conversations with my boss about going back to work so that should be in two weeks.  And yeah, I'm just really, really positive and I think I've noticed in my recovery I'm just like greater portions of my day are going past where I'm not thinking about food or exercise whatsoever.

JENNY BROCKIE:  Adrianne, how's your son doing? 

ADRIANNE:  Yeah, really well. Yeah, he eats like a normal teenager, I just can't keep food up to him or his brother. Yeah, look, really pleased with his progress, although we're always well aware things, you know, at that age could still, you know, slip backwards.  But no, for now he's great. 

JENNY BROCKIE:  Emma and Carla, what's your relationship with food like now? 

EMMA:  Yeah, the best it's ever been, I mean like when I was sick last week I didn't exercise and I didn't feel bad about it. Last night we were out at an amazing event and I ate half the cake and I didn't, because I didn't need the whole piece of cake but I ate half the cake, had sugar in it, had gluten in it and I felt good. 

CARLA: No guilty feelings. 

JENNY BROCKIE:  And how long has it taken you to get there?  I mean how recent has that been? 

CARLA:  Literally last night I was, I felt the freest from food that I've ever felt, so from age eleven until now, age 26, that's how long it's taken. 

JENNY BROCKIE:  Suzie, where are you up to? 

SUZIE: So now I am enjoying a healthy lifestyle. I feel sort of like a normal person again in that I can just work out or have some desert and not even think about it. I'm still vegetarian but really for ethical reasons now. Although I stay away from restrictive diets of any kind, like I've tried to go vegan or do like a low carb diet and I just straight away realised it was a bad idea. 

JENNY BROCKIE:  Thomas, what about you, where are you up to?

THOMAS:  I'm loving the whole flexibility that a healthy normal lifestyle brings. So being able to go out with friends, socialising and having what I want to eat when I feel like it, but also at the same time obviously having a balance and that's what it's all about, just having that balance, having your cake and eating it too basically. 

JENNY BROCKIE:  Thank you so much for joining us tonight and for sharing your stories, really appreciate it. Thank you to everybody tonight who shared your stories with us. That is all we have time for here but let's keep talking on social media. We'll have a Facebook live on Thursday, let us know what you'd like to talk about coming out of tonight's show. Thanks everybody, thank you.