BMJ  2008;336:892 (19 April), doi:10.1136/bmj.39546.715347.94

Views & Reviews

The tale of an anorexic male medical student

"I need to go on a diet." "Does my bum look big in this?" These are not the typical statements you hear in the men’s changing room of the local gym. But to the one in 10 people with anorexia who are male these statements are too close for comfort, as I found out personally during my four year battle with anorexia nervosa.

I had always been a fat child, and I was also born with a congenital deformity of my lower right leg. As these together made me stand out like a sore thumb, I decided as a teenager that the least I could do was to lose some weight. My looking slim and trim would not only benefit my leg but also attract attention from girls, something most teenage boys crave. Unfortunately the health regimen slowly turned into a battle against food and eating, as well as a battle with my self image and body.

Hatred of your own body takes you over. My constant fear of gaining weight turned my life into a mere existence dominated by exercise (excessive and obsessive), calorie counting, and work. The perfectionism associated with anorexia nervosa made me focus on my work more and more, and the drive to succeed in medical school isolated me: medical books and patients were my only friends.

But then it was these very things that opened my eyes to the damage I was inflicting on my own body. I was undertaking my psychiatry attachment at the local hospital when I was asked to attend a clinic for eating disorders. I entered a room full of human mirrors of my bony form. I felt the pain they were suffering—the pain I was suffering.

I admitted that I had a problem. I had anorexia. The physical effects were obvious: cold peripheries, heavy, tired legs, bradycardia, and sluggish bowel habits. The mental effects were all too clear: irritability, poor sleep patterns, poor concentration, and lack of interest in social activities. My bubbly personality had gone, and my relationships with members of my family were shattered through their anguish at seeing me starve.

Admitting that I had a mental illness was the hardest part; but that morning in clinic, speaking to those patients, made me realise that I was stuck on a rollercoaster and that, in the end, anorexia would cost me my lifetime dream of becoming a doctor and even my life. People who are "successful" anorexics die: their drive to lose weight and their perfectionism mean that they lose too much weight to survive. I did not want to turn into one of the 20% of people with anorexia who die.

The next months were a challenge. Weekly sessions of counselling and cognitive behaviour therapy and continuing my medical studies helped me to overcome the illness, focusing my mind and opening up new opportunities. My university was very supportive, and my family’s love and attention were indispensable.

I now thrive on life on the wards and enjoy engaging with patients. I’ve become an active member of the BMA and enjoy socialising again, having a life beyond work and anorexia. I have also been signed off from my clinic, so I am no longer a medical student "living with anorexia"—I am now a recovered anorexic.

I hope to qualify as a doctor in 10 weeks’ time. One thing is certain: the experience of anorexia has made me appreciate the torment that patients endure when they have a serious illness. Hopefully, I will be able to empathise with my patients and offer them support and advice, gleaned from my own experiences.

My time as an anorexic has made me realise that as doctors we can learn so much about ourselves and our own illnesses just by looking at our patients and also to use our own experiences to benefit our patients and improve outcomes. For years to come I will look back on that day at the psychiatry outpatient clinic and thank each and every one of those patients for opening my eyes to the skeleton and shadow I had become and for saving my medical career. Being a patient is a humbling experience and one to which no doctor is immune.

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