Losing your period – amenorrhea and training

This piece is part 2 to last week’s blog post on how periods affect training. If you haven’t already, give it a read!

When it goes wrong

A topic I have spent some time (though probably not enough) discussing on my Instagram page, as well as on here, is overtraining and RED-s, or Relative Energy Deficiency in Sport. The condition has spent more time in the limelight recently, with high profile cases coming to the fore, and more people on social media opening up about their experiences too. However, unfortunately the topic is still shrouded in mystery and shame, meaning that every year more people are affected. Even worse, it’s often assumed that losing your period is a normal, even healthy side effect of training, and isn’t anything to be concerned about. This is a myth that needs to change

Exercise is a stressor to the body. For the most-part, it is a good stressor, leading to adaptive changes to make us faster, stronger, fitter. There comes a point, however, where the demands of a particular sport go beyond the recovery that is given, and beyond what the body can handle. There are many ways that this can happen, and the outcome is a cascade of physiological responses with serious, even life-changing, consequences. RED-s refers to a state where there is insufficient energy intake for the amount of training being undertaken, leading to reduced bone density, low energy availability and, among other things, hypothalamic amenorrhoea, or stopped periods. In the general population, around 2% – 5% of women are affected. Within athletes, the prevalence is much higher, at 3.4% to 44%. 

Somewhat problematically for diagnosis and recovery, there are many stories of athletes having their best seasons right before their body starts to shut down. This is because the effects of RED-s take time to come into play, and can be caused by the most innocuous-seeming deficiency in calories over a long period of time. However, this is an important issue as it is increasingly common even among for-fun athletes, even those of a ‘healthy’ BMI, and RED-s is quietly sidelining more and more people.

Periods are important. They show that your hormones are functioning as they should – it is impossible to function optimally as a human and athlete without the hormones your body needs.

RED-s, a condition that encompasses a number of symptoms, including menstrual irregularity

Why do people lose their periods?

Secondary amenorrhea is when you have experienced regular periods before, but then stop menstruating for 3 months or longer after that point. Functional hypothalamic amenorrhea (FHA) is a type of secondary amenorrhea, caused by low energy intake, weight loss, stress or a combination of these factors. Note: you do NOT have to be underweight and be training loads and have a really low calorie intake for this to happen. All of these make it more likely, but FHA can happen to anyone. It is also important to rule out other causes of amenorrhea, in case it is caused by some other factor. 

Losing your period as a side-effect of training should never be seen as acceptable. The idea that it’s a sign that you’re working hard is both harmful and wrong – you can train much better if you have a healthy cycle. 

Evolutionarily speaking, FHA in times of stress may have been adaptive. If you can’t support your own body and health, there’s no way you could support another life (i.e. a baby), so it doesn’t make sense to ovulate, as this is energy consuming. The downregulation of the body’s natural functions protects the brain and vital organs. However, there’s no questioning that it is a red flag that something is up, and in this day and age we are lucky to have the knowledge to protect ourselves against such outcomes. 

What happens when you lose your period?

FHA results from changes in the hormone GnRH, which in turn reduces luteinising hormone (LH) and eventually oestrogen availability. This has a number of negative consequences affecting the whole body, including bone density, cardiovascular health and mental health. The longer it continues, the greater the effects. Conditions such as osteoporosis, previously associated with post-menopausal women, also become more likely, due to the reduction in oestrogen’s protective effects on bone density. This in turn increases risk of injury such as fractures. Research suggests that athletes with menstrual irregularities are also likely to experience more injuries and recover slower from those injuries.

There can also be short and long-term consequences for reproductive health. Of course, if you are not ovulating, you cannot get pregnant (though this should never be used as a form of birth control!!), but there may be long-term impacts on fertility in response to chronic amenorrhea. However, when treated properly, the prognosis for future fertility is good

How can I get my period back?

This is a question I get asked a lot, and I am reluctant to give prescriptive answers, as I am not a medical professional. Generally speaking, reducing stress on the body and increasing energy availability are good places to start. Often the causes of FHA are not entirely physical, and seeking professional mental health help can assist too. 

These are some of the factors most important to optimising physical health:

  • Ensure you are allowing for adequate rest between training sessions. 
  • Reduce the number of very intense sessions per week, and space them out.
  • Make sure you are eating enough carbohydrates, fats and proteins. 
  • Avoid fasted training sessions. 
  • Get enough sleep – it is vital to recovery! 
  • Eat within 30 minutes of a training session. 
  • Reduce stress in other areas of your life where possible.

If you are unable to get your period back by yourself, after reducing exercise intensity and improving recovery, it is recommended to seek professional help as soon as possible. A specialist sports dietician should be able to help if you’re concerned or not sure if you need pointing in the right direction. 

Conclusions

With the increase in uptake of sports, and higher stakes especially in competitive sports, it is unlikely that conditions such as FHA and RED-s are going away any time soon, especially among young women. While we place pressure on men and women both to perform and look a certain way, regardless of actual health, it is vital to continue to educate athletes and coaches on the consequences of not treating our bodies well and with respect. 

Unless you’re actively trying to get pregnant, it can be easy to push issues such as FHA to the back of your mind, especially if the perceived immediate benefits are greater the perceived long-term risks. Ironically, if your primary concern is performance rather than long-term health, it will be difficult to become healthy and thus perform optimally. I’m hoping that by talking about it more and improving public awareness, we can start to encourage people to seek help when they need it, and hopefully reduce stigma while we’re at it! 

If you’d like to learn more about this topic, these podcasts were particularly helpful for me:

If you found this blog post helpful, please do share with anyone who might find it useful or share and tag me on Instagram! Many thanks to specialist Renee Mcgregor for talking me thorough these complex issues too. If you enjoy my posts regularly, please consider contributing so I can keep this page up and running (no pun intended).

Common Running Nutrition Mistakes

This is a guest blog post by Renee McGregor, a dietitian who I look up to for evidence-based information, especially in regards to running and nutrition. 

Renee is a leading Sports and Eating disorder specialist dietitian with 20 years of experience working in clinical and performance nutrition. She’s worked with athletes across the globe including supporting Olympic (London, 2012), Paralympic (Rio, 2016) and Commonwealth (Queensland, 2018) teams. She is regularly asked to work directly with high performing and professional athletes that have developed a dysfunctional relationship with food that is impacting their performance, health and career. On top of this Renee is the founder of Enspire clinic, a centre specialising in supporting individuals and athletes of all levels and ages, coaches and sports science teams to provide nutritional strategies to enhance sports performance and manage eating disorders. This is reflected in her work on social media too, priding herself on proving an educational hub for both the professional and everyday athlete. When not inspiring others with her incredible work, Renee can be found running the mountains and chasing the trails, most likely training for a crazy ultra-marathon!

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Everyone has an opinion about nutrition – why shouldn’t they? After all, we all need food to survive. However, there is a difference between anecdotal nutrition advice and actual nutritional science. On social media we are exposed to the former a lot more than the latter. What works for one person in a sample of n=1, may not work for another. Just the other day I was on a group chat where someone very boldly stated that their new vegan regime was the cause of their newly found energy and improved recovery. However, this was based on subjective information, which they had collected over a few weeks. Is this science? No – this is one individual’s personal experience with no information of what her diet had been like previously or even if any other aspect of her life had also changed which may have resulted in how she was feeling. Presently there is no evidence in the literature to suggest that a plant-based diet can improve an individual’s performance – such anecdotal evidence could cause more harm than good.

Nutritional science, and particularly sports specific nutrition, is actually quite complex. While many simply look at the impact of one particular nutrient or process on performance, this completely ignores the fact that the human body is run on an intricate system of endocrine, biochemical, immunological, physiological and psychological pathways that all work collectively.

Let’s take the keto diet as an example. This was a huge trend a few years ago and many still promote it with the idea that if we remove carbohydrate from our diet, then our body will use more fat for fuel and improve our performance but also our body composition. While on the surface this may seem to have some gravitas – take out carbohydrate and the body will have to find another fuel source to provide the body with energy – what has been completely ignored is the importance of carbohydrate intake on the hypothalamic pituitary axis, which is necessary to get adaptation from a training response. In addition, carbohydrate has a critical role in optimising immune function in those who are physically very active.

So, with this all in mind, here are some of the common mistakes often made…

 

Carbohydrates

Numerous studies have demonstrated that carbohydrate is the preferred fuel used by the body and is definitely the key to optimal performance. That said, many runners still have little understanding of how much they actually need in order to meet their requirements with many under fuelling.

As stated above, carbohydrate availability is particularly key for the hormonal cascade needed in order to see adaptation and thus progression. This means ensuring sufficient carbohydrate before, during if your runs are over 90 minutes and within 30 minutes of completing your session. While everyone’s physiology is slightly different, as a rule of thumb the requirements set are 5g/Kg BW of carbohydrate if you are running for 60 minutes a day, with this figure increasing for longer or multiple training sessions. In general, I do not encourage fasted sessions and the recommendations state that if you are going to include these, you should not do more than 2 a week and they should be no longer thank 60 minutes, at an effort of no more than 6/10. More than this and at higher efforts, potentially can result in chromic stress on your body leading to a depressed immune system, higher risk of injury and down regulation of your hormones, particularly your thyroid gland, oestrogen and testosterone, leading to further negative health consequences.

In practise, if you are training regularly, it is unlikely that you will ever have full glycogen stores and so it is essential to ensure that you consume carbohydrate at meals and snacks throughout the day. Aim to include nutrient dense carbohydrates such as oats, potatoes, whole grains, fruit and yoghurts at 3 meals (about a 1/3 of your plate) as well as including 2-3 smaller carbohydrate based snacks such as bananas, cereal bars, 2 slices malt loaf or 2-3 oatcakes with peanut butter.

One common observation I have seen is that many people view vegetables as carbohydrate, often displacing these for pasta, grains, bread and potatoes. While vegetables play a role within our diet and should be included, they are predominantly fibre which means they add bulk to the diet but not essential carbohydrate fuel.

 

Protein

There is a lot of hype around protein in the recovery phase, with many runners stressing about not getting enough to enhance recovery. Protein does play a role in the response to training and should be included in addition to carbohydrate, particularly immediately after. The general recommendations are that a recovery meal/snack/choice should provide 1.2g/Kg BW carbohydrate and 0.4g/Kg BW protein. So for someone who is 55Kg this would be 66g of carbohydrate and 22g protein and looks like a medium size baked potato with a small tin of tuna.

It is important to appreciate that the body will struggle to utilise more than 0.4g/Kg BW post training for muscle protein synthesis and adaptation. Any additional protein consumed will be used as fuel or stored as excess. Therefore, it is actually really important to spread your protein requirements out throughout the day. Aim for palm size portion of protein at 3 meals and then half this amount for snacks. This will ensure that your body always has an amino acid pool to draw from in order to repair and rebuild muscles, throughout the day, as well as preventing blood sugar fluctuations.

 

Sugar

With so much negativity around sugar, it is hardly surprising that many runners are equally concerned about their intake. While I would never advocate a high sugar diet, there are definitely times during training and competing, where sugar is the only option. During endurance events, such as a half or full marathon, the body will need an easily digestible source of carbohydrate to keep stores topped up so that running pace can be maintained beyond 60-90 minutes. Gels, jelly babies, sports drinks are all suitable options and they all contain sugar. So in this case, sugar actually enables and potentially enhances your performance.

 

5 Nutrition Staples:

  • Don’t be drawn to the latest fad – many runners will try almost anything to improve their performance. Focus on training and getting the building blocks of your diet correct first – this is going to have more impact than whether you are gluten free or not.
  • After a very hard training session and especially when you will be training again within 12 hours, taking on something like flavoured milk is an ideal choice to start recovery as quickly as possible. The combination of added sugar to the natural milk sugar causes insulin to increase in the blood. Contrary to what you might think, this is actually really important. Only when our insulin levels are raised, can we draw carbohydrates and protein into the muscles to start the recovery process.
  • Always practise your race day nutrition – the worst mistake you can make is to use what is available on race day without previously having tried it –this could have real negative effects on your performance.
  • Work out what is right for you – just because your training partner swears by a bowl of porridge every morning, this does not necessarily mean this is the right fuel choice for you.
  • You don’t have to eat less on your rest day – for most this will fall between two training days so it is the perfect opportunity to recover and then refuel. By being consistent with your nutrition, you will also allow for consistency with your training which allows for progression.

 

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Overtraining

Fitness undoubtedly has a myriad of benefits, from the mood-boosting to the life-improving. However, it is possible to have too much of a good thing, and over-training is an issue that can affect even amateur athletes in pursuit of their next PB or particular aesthetic goals.

When I first started training I felt invincible. Increasing my sessions per week left me exhausted but happy and no matter how much I trained, I always had the desire for more. However, long story short, recurring injuries and losing my period aged 17 left me questioning whether I really was helping my body, or whether my intense training regime was actually causing more harm than good.

It wasn’t until later that I discovered RED-S, or Relative Energy Deficiency in sport, previously known as Female Athlete Triad, which is now known to affect both men and women. If not enough food is consumed to cover the energy demands of your workouts, and the rest thereafter, chronic energy deficiency can occur – you basically run out of fuel in your body, and your body does what it can to make it up. This may mean fuelling from fat, muscle, brain and even the heart.

It is possible to be overtraining without all the symptoms of RED-S, and this can lead to a range of problems.

First, it’s important to bear in mind that overtraining is possible by:

a) Doing too much exercise (for your current level of fitness) or

b) not having enough recovery between workouts or

c) chronically underfuelling

It is possible to accidentally overtrain if you increase your training load without increasing food intake, decrease your rest times and/or reduce food intake.

Symptoms:

Decrease in training ‘gains’

We all want to make progress when we workout, but overtraining could hinder exactly that. Overtraining can lead to an increase in recovery times and decrease in performance, meaning that training sessions don’t provide the benefits that they should, so little to no improvement is seen.

Increased risk of injury

While most of us suffer from aches, pains and niggles at some point during a training regime, having recurring issues could be a sign of something more serious. When fatigue accumulates from lack of recovery, small injuries don’t have the chance to heal, and form can suffer, leaving the athlete at a greater chance of acute injuries, too. In addition, lack of food can lead to decreased bone density, especially in women, linked to fractures and osteoporosis, especially in athletes who don’t do weight-bearing exercises.

Insomnia/agitation/low mood

A good intake of food and sufficient rest are both important for our endocrine (hormone) system. When the body is under stress however, the overproduction of cortisol and disruption of other hormones can make it harder to wind down and fall asleep. This in turn can lead to low mood and agitation and, of course, less progress in training.

Recurrent illness

Training puts the body under a lot of stress, which when paired with rest can make it stronger. However, without sufficient food or rest, the body does not have enough energy to warn of viruses and other infections, making illnesses and infections more likely and more frequent.

Loss of period

When women train too hard, hormones can become unbalanced. Paired with a lack of energy availability, the body does not have the energy to support itself, let alone another life. Therefore many athletes lose their periods – whilst this is seen as ‘common’ and perhaps even ‘normal’ within the running community, it could be symptomatic of bigger issues and should never be ignored.

Often, overtraining is the result of a lack of education or an overabundance of enthusiasm for a particular sport. In these cases, recognising and resolving the problem can be quite simple. Eating more, ensuring rest days are adhered to and taking a step back from frequent intense sessions can resolve the above issues relatively quickly.

For some people however, the issues are more psychologically rooted, and may require professional help to deal with.  The paradox with RED-s and over overtraining, is that the result is reduced performance, exactly the opposite of what the athlete is aiming for. If you believe you might be suffering from overtraining, seek help from a health professional – not only will your training suffer if you don’t, but you could be putting your lifelong health at serious risk.

If you are unsure if you are suffering from overtraining, it is possible to measure bone density and hormone levels to ensure everything is in check. First, however, try reducing training intensity and/or increasing food consumption to see if any of the issues resolve themselves. A new PB is not worth the damage done from overtraining.

I hope this helps! I would love to hear your thoughts on the subject 🙂 Come and find me on Instagram and YouTube for more fitness and food content!

Anon II

This piece is part of #mentallywealthy, a series of blog posts written by men and women who have suffered, or are suffering from mental health problems. The aim is to open up the conversation around mental health and give a voice to those suffering. To see more from this series head to the ‘Mental Health’ tab on my blog. 

It’s not about getting skinny; it’s not about looking a certain way. It’s about not being able to control the external world that surrounds me and so instead I control my internal world, or at least I think I am. Imagine waking up and taking 20 minutes to get out of bed because you feel too faint, too weak, too drained to carry yourself. Imagine having to start your day with the agonising thought of how much weight you’ve lost and having that determine your actions and self-worth for the day. Imagine having your twin sister have to bathe you at your worst point, witnessing your skeletal frame. Imagine having your little sister have to monitor your snacks and meals at school. Imagine having your parents and grandma cry at the sight of you and the thought that you may die in your sleep.

The worst point of my anorexia left me bound to a wheelchair and hooked to an NG tube. I became so frail I couldn’t walk, and I’d abused my body to the point where it couldn’t digest ‘normal food’ anymore. The internet glorifies anorexia in some way and the recovery alongside it. It doesn’t show you the god-awful side effects that come alongside it. An eating disorder is not skipping one meal, thinking you are fat or wanting to lose a few kilograms. It is a mental disease, one that controls your life and overpowers everything else that you once cared about. It transforms you into a different person, stealing your personality, happiness, friends and family and replaces them with fear, anxiety and loneliness. I have had so many occasions where I know I have an abundance of support around me but that voice in my head convinces me that I don’t need help and that it’s better to keep my struggles to myself. It doesn’t appear out of nowhere, it grows from so many different sources; for me personally being perfectionism, a fear of growing up and change, and living up to expectations. It drains your body, mentally and physically, and slowly but surely kills you … literally. Anorexia is the rotting away of your body, the emaciated skeleton you become, the complete withdrawal from life, the numbness of all feeling apart from guilt and crying. It is your fingers turning blue, your legs giving in whilst you walk, the endless hours of body checking and exercising, and nothing but emptiness seen in your eyes.

I have been suffering from anorexia nervosa for almost 7 years, in and out of hospitals, transferred multiple times between treatment teams and consultants. It terrifies me to think that all of my teenage years have been lost to this illness. I was diagnosed when I was 13 years old, and this year, I’ve turned 20. I never thought I’d reach this age and still have my eating disorder. Two seconds ago I was a teenager, just falling into the depths of anorexia, thinking I’d magically get better and be successful in life. Yet here I stand, 7 years later, still suffering, still counting every calorie, weighing myself multiple times a day and still consumed by my eating disorder.

I don’t know if I will ever recover, and if I do then when that’ll be. To anyone else suffering, You don’t have to be alone, find someone, anyone who will listen to you. Sure, there will be nights when you feel alone, some nights where you actually need to be alone but don’t leave yourself with no option but to be alone. Having someone there for you doesn’t mean they’ll understand what you’re going through, but just having someone to listen, to hold you whilst you cry, will give a sense of longing security. Don’t fall victim to your anorexia, don’t become part of the 1 in 5 who die from anorexia.

Read another post here.

Jemima

This post was written by Jemima, who has suffered from anorexia for the past four years. Whilst she has not been vocal about her story in the past, I love that she is using this opportunity to open up about her struggles and share the realities of living with anorexia, what is often ‘glamourised’ on social media. You can find Jemima on Instagram

“Loss of appetite for food, an emotional disorder characterized by an obsessive desire to lose weight by refusing to eat”. That is the online definition given for Anorexia Nervosa. However, the reality of it is a million times more complex than that. I mean, if you’re ill surely you want to get better? Whilst that’s true imagine having your mind in two parts, the rational side and the irrational side. Every second of the day is a battle between the two, the rational side yearns for nutrition to get well again, whilst the irrational side is telling you “you’re not really that sick” “that’s far too much” “the guilt of eating that won’t be worth it” “everyone’s over exaggerating” “just lose a little more”. This fight is what presents itself from the moment I wake to the moment I sleep. That’s why the above definition is so inaccurate, it’s never as simple as “just eat!” – if it were I can assure you that I would have beaten this four years ago.

I’ve never said anything publically about my battle with Anorexia Nervosa, but thinking about it recently I’ve realised that I’m only fuelling the stigma by staying quiet. Last week was Mental Health Awareness Week. Kevin Breel vocalised the issue with the stigma surrounding mental illness saying, “We live in a world where if you break your arm, everyone runs over to sign your cast. But if you tell people you’re depressed, everyone runs the other way… We are so, so, so accepting of any body part breaking down other than our brains, and that’s ignorance, pure ignorance. That ignorance has created a world that doesn’t understand depression, that doesn’t understand mental health.”

Two years ago Anorexia landed me a hospital admission robbing me of my dream gap year job, last year it robbed me of my university dream at St Andrews. In January 2017 I was told that if I carry on as I am I will soon be dead. That’s the reality of it, despite the fact that Anorexia has the highest mortality rate of all mental illnesses, people still don’t seem to recognise it can be fatal.

Anorexia does not only kill the sufferer, it also destroys those around them having to sit and watch helplessly. Anorexia is not simply wanting to be thin or the desire to get attention or any of the other misconceptions. My Anorexia is a yearning for control, when paradoxically it’s taking all my control. It’s seeing people being restrained and tubed, people crawling down corridors crying in pain as their bones have got too weak, its being physically present but mentally consumed 24/7 by food and weight thoughts, it’s having your entire mood and worth dictated by the number on a scale, it’s hot water bottle burns all over your body. It’s appointments, weekly blood tests & ECGs. It’s seeing your parents and siblings bursting into tears of despair and fear, your twin sister who came into this world with you watching you kill yourself unable to stop you. Anorexia is the most isolating, deceiving and manipulative disease. That is the reality of it… and the toughest part is, only the one suffering with it can change things.

I know that I am still far off recovered, but I felt that there was little point in me keeping quiet for the fourth year running. Social media is brilliant at helping us all create a façade to others that we feel great all the time and have everything together. But that is its unhealthy side; it’s the false pretence we all put on. So today, for the first time, I want to use social media to effect positive change, to show that despite all my photos etc. I don’t have it all together, I’m currently not okay. I hope that in posting this it may inspire others to speak out about mental health or to feel less alone.

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Thank you so much to Jemima for writing this! If you’d like to get in touch to write for this series please email florabeverley@gmail.com. Please hashtag #MentallyWealthy in any Instagram/twitter posts and spread the word!

Lauren

This post was written by Lauren as part of my #MentallyWealthy series for Mental Health Awareness Week 2018. Lauren is 18 months into her recovery from anorexia and shares her experience of the bumpy road of recovery. You can find Lauren on Instagram

Almost two years ago, I found myself in a toilet stall in Malaysia, on the phone to my parents back at home, verbalising for the first time that my mind no longer felt like my own. After a month away from home, the Anorexia that had been controlling me through much of my final school year had grown into spitting, skeletal monster that had wrapped itself around my brain, distorting my perception of everything around me. The relief I felt when I finally said the words out loud was unparalleled, and in the weeks following my return home I felt like progress was being made. I had accepted I had a problem. I was receiving the counselling and nutritional guidance I needed. University still seemed like a sensible goal come October. Surely, the gap from diagnosis to full recovery would be a matter of months?

Unfortunately, this was not the case. I spent large parts of my recovery being told that I was brave for talking about my illness, and that I had overcome the biggest hurdle by accepting that I was unwell. But for several months after my first counselling session, I continued to feel that surge of euphoria when I stepped on the scales and the number dropped. I continued to weigh out my food, count my steps and calories, continued to overexercise. Recovery is not the neat, brief process I had imagined it to be, and accepting I was unwell was not the most difficult part. In fact, it became a new tool for the Anorexia to use; if I had accomplished this step, there was no need to try new foods or gain the weight back. As long as I was talking to people about the fact that I was unwell, I didn’t actually need to do anything to address the problem. I ended up in a bizarre situation where I could openly discuss my plans for recovery whilst edging closer to hospitalisation; I took a twisted pride in my manipulation of the situation, kidding myself that I was fooling those around me into believing I was engaging in recovery even whilst I faded into a bruised and delusional skeleton.

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Recovery is not a smooth process, and it does not take mere months. I took an enforced gap year and when I finally reached university just over a year after my original diagnosis, it was not the experience I had been led expect from friends and the media. How to manage freshers’ week when you can’t bring yourself to drink alcohol for fear of ‘wasted’ calories? How to talk to someone you like when you are internally assessing every physical flaw you possess? How to deal with deadlines when you are too depressed to get out of bed? I made some fantastic friends, have a hugely supportive family and have medication to manage my depression, but first year has been a struggle. I have recently returned to counselling after verging on a relapse during exam season, and have been booked in for a bone density because I have not had a period in over two years. The fantasy of the rapid recovery I had talked about with my parents over the phone in Malaysia is laughable now, but not an uncommon perception. Mental health recovery is not smooth, it is not a journey of self discovery, it is not glamourous. I am still on antidepressants, still obsessed with food, still capable of spending hours at a time in front of a mirror dissecting my body. The body that may not be able to bear children because of what I have put it through, the body that I continue to berate and critique on a daily basis.

Recovery is the best thing I have ever done, but let no one tell you that it is not brutal. It is necessary. It is the only option, but it may take years and it will not be without struggle. Do not be cosseted by the notion that talking is enough; it is crucial, but you have to act on your words. I have to act every day to prevent the monster feeding on my hunger, and it is empowering, exhausting and exhilarating all at once. But it is a battle I am proud of and a battle that is happening in every country, city and home every day. You are more than your illness, more than your recovery and every action you take creates a new identity that is not defined by these things.

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A huge thanks to Lauren for sending me this post. Recovery, as Lauren mentions, is the only option following an Eating Disorder diagnosis, but unlike so many of the stories we hear, it’s not always the smooth road we (or our families) expect. 

If you’d like to get in touch to write for this series please email florabeverley@gmail.com. Please hashtag #MentallyWealthy in any Instagram/twitter posts and spread the word!