When a 23-year-old tells you they’ve spent around £2,000 over the course of a year, you might assume it was on nights out, clothes shopping, and online splurges.
But for Abbie Jackson, those weren’t on her list. In fact, they are all the things she’s had to sacrifice to fund her eating disorder treatment, which has been a major struggle amid the cost of living crisis.
She tells Metro.co.uk that the last year has made recovery tougher than ever, with prices soaring and her food guilt intensifying.
‘I’m just so anxious, especially for what could happen if I relapse,’ she explains. ‘Keeping warm and paying my bills is difficult enough without added costs.’
Abbie’s plight – and that of the thousands of others like her – follows the height of the Covid-19 pandemic, which saw record numbers of calls to eating disorder helplines from many due to panic buying, self-isolation, heightened stress levels and disrupted routines.
The Resolution Foundation, a think tank aiming to improve standards of living, found that, in November 2022, nearly a third of adults say that they could not afford to eat balanced meals, with 11% reported being hungry in the past month because they lacked enough money to buy food. On top of that, food and non-alcoholic beverage prices have been steadily rising – by last August, they’d increased by over 13% in just a year.
What’s more, The Food Foundation said that food bank users are increasingly asking for products that do not need cooking due to concerns about rising energy bills.
Abbie, from Brighton, has been grappling with her eating disorder and recovery since she was a teen. She was diagnosed with anorexia at 17 and initially spent three months in a specialist unit.
She’s since dealt with ‘multiple relapses’ and has received treatment from a range of professionals. She’s currently receiving support from both private services and NHS services.
However, the cost of living crisis is making it more difficult by the day for her to stay on top of things.
‘Food is more expensive, I feel guilty for spending “too much” money on anything that isn’t bills, but especially food. Plus, trying new food feels like even more of a waste of money than before,’ she shares, given that recovery from an eating disorder tends to mean challenging fears and trying unfamiliar foods can be vital to break harmful cycles of restriction.
‘I pay for private treatment on top of the NHS care I’m provided, and struggle to afford it. I’m also a full-time student, so money was already a struggle.’
Abbie pays £95 per session, which adds up throughout the year, especially as she lives away from home and is juggling her studies with a job to pay her way, and student loans only go so far.
As the cost of living crisis continues, her worries are mounting. Abbie is well aware that she could save money by eating less, which is a frightening thought that could well result in a life-threatening relapse.
Fortunately, she’s aware of her triggers and is prioritising her recovery by reducing her spending on other things – such as fun outings with friends or shopping trips – to make sure she has the funds to pay for both food and treatment – but she admits it shouldn’t have to be a compromise.
Abbie adds that she no longer eats out to make sure she can afford adequate food, travel, rent and bills, which harms her recovery by preventing her from challenging her fears.
She’s desperate for others to understand how ‘complex’ eating disorders are and why ‘external factors’ can make recovery such a challenge.
‘People who are struggling with an eating disorder will likely be impacted by the cost of living crisis, even though, to people who have never struggled with an eating disorder, it may not be immediately clear why.’
Beat, the UK’s leading eating disorder charity, echoes that the cost of living crisis is putting people with eating disorders at great risk, having witnessed first hand them reaching crisis point.
‘Research has indicated that food insecurity can make eating disorder behaviours worse in those who are already unwell or vulnerable, or contribute to a relapse in those in recovery,’ says Director of External Affairs, Tom Quinn.
‘We also know that periods of stress and uncertainty can be a trigger, as we saw during the pandemic.’
When Shannon Richards* describes how the cost of living crisis has affected her anorexia, she calls it ‘a nightmare’, adding that it’s ‘terrifying. Impossible.’
The 23-year-old from South Wales tells us that she has to fight to get through every day, sometimes unable to justify spending.
‘The pandemic caused a fear like no other for myself and others with eating disorders about not being able to access certain safe foods,’ explains Shannon.
‘Now, these “safe foods” are inflated at sometimes an unaffordable cost.’
Shannon was first diagnosed with anorexia at the age of 15, brought on by ‘severe exam stress’, and admits she’s still living with her eating disorder eight years on.
She explains that her eating disorder thoughts are ‘ingrained’ and, amid the cost of living crisis, it’s becoming increasingly hard to stay on track with recovery.
‘Having an eating disorder already makes it incredibly difficult to justify spending what little money I have on food, because of how selfish and awful eating makes me feel,’ she explains, saying she developed a massive ‘fear’ of food and eating disorder thoughts are now things she has to challenge daily.
‘Now, buying when prices are so inflated makes me feel greedy – despite knowing it keeps me alive.
‘The cost of living crisis has really complicated things, especially for those with a very limited number of foods they feel comfortable with or those in the early stages of recovery. Food just costs too much and I look at their prices in disbelief, because I can recall the cost of things with the same skill I can recall the calories and each time I visit the supermarket, they seem to have leapt up again.’
Shannon adds that it’s a struggle for the ‘rational’ side of her brain to prevail at the moment, sharing that having a mental illness like an eating disorder can be expensive in itself.
‘How does anyone with an eating disorder get better in this situation?’ she asks.
‘I don’t think many people realise how ridiculously expensive having anorexia can be. Sometimes, because of the restrictive mindset, you can hoard food that you’ll never eat – but can’t help but buy “just in case” it ends up being the one thing you’ll actually manage to eat. Other times, you’ll struggle to buy anything.
‘For me, before it was that I felt “scared” of food, now I’m just frightened by how much it’s going up.’
I’m worried about the cost of living crisis for so many reasons but, for sufferers of eating disorders, it really is a matter of life or death
Shannon also explains that recovery is expensive, as she needs to meet a certain calorie count, with the slightest drop threatening to topple her progress. She must stick to meal plans, ensuring she’s including vital food groups, such as carbohydrates and dairy, to stay nourished. She was spending around £85 a week previously, but this has increased to £120.
‘I’m worried about the cost of living crisis for so many reasons but, for sufferers of eating disorders, it really is a matter of life or death.’
When it comes to who is affected by eating disorders, these illnesses have a ripple effect as they also impact the lives of those close to those who are unwell.
For parents, supporting a child with an eating disorder isn’t easy. It requires love, patience, understanding, but also access to resources, which isn’t so straightforward in the current climate and can result in young people’s conditions deteriorating.
In fact, hospital admissions for people with eating disorders in England have risen 84% in the last five years and in March 2022, the NHS revealed that more young people than ever before were receiving treatment for eating disorders.
Fran Smith’s* daughter Paula was 13 when her eating disorder began around the time she got involved in athletics at school and began to experience anxiety.
Using exercise as an outlet for her feelings, the teenager turned to the MyFitnessPal app to monitor her calorie intake.
‘Paula often kept a lid on her emotions or worries, but used running both to process anxiety and secure an identity as the “sporty one.” Running became the main focus, to the detriment to her social life,’ says Fran.
However, during the second lockdown, when Paula was 16, she became injured and was advised not to run. Instead she was given bike sessions by her coach who, in order to comply with rules, allowed her to use an outside space by herself to train.
‘She would complete online lessons, then go and cycle on a static bike by herself,’ recalls Fran. ‘On reflection, this was pretty depressing and isolating. Her spirits dipped.’
The family originally failed to spot signs of Paula’s eating disorder, such as weight loss, not thinking much of it when she cut out foods such as crisps and cake. She also didn’t express her worries surrounding food to her parents, confiding in a school counsellor instead who later informed the parents.
But, when it came to seeking specialist support, Fran admits they were ‘totally lost’ with where to turn.
What’s more, the teenager was often turned away from services.
‘Paula was told that her weight was not dangerously low,’ Fran says. But, by 17, her daughter’s coaches also had concerns. ‘That is when our world fell apart.’
With Paula refusing most foods, she needed ‘warm words of encouragement’ after her parents were given instructions on how to prepare her meals by a nutritionist.
The whole process took a toll on the household, with both parents having to balance her care and their jobs, and friction arising in their marriage as a result. Younger sibling Ellie was ‘traumatised’ after witnessing her sister’s illness in full force.
Now, the cost of living crisis has also impacted the family and Paula’s recovery, says Fran.
‘She needed, and still needs individualised care, as well as support for us as a family. I could afford neither,’ she explains.
‘By the time enough weight had been restored to make a dietician worthwhile, we had used our funds on nutritionists and psychologists. We still really need specialist dietician support, but at £250 an hour with a recommended course of 12 sessions – who can afford this?
‘We also wanted to be flexible with meals out. It was an easier way to consume calories as they were unknown. This can be expensive, but often has felt necessary.’
Meanwhile, as a parent, Fran believes that treatment is still totally ‘unachievable’ for her daughter.
I can’t afford to become unwell again
They’ve tried accessing Family Eating Disorder Services (FEDS), Children and Adolescent Mental Health Services (CAMHS), and now the adult services within the NHS, as well as private treatments.
While Fran was ‘relieved’ when services did open their doors for Paula, it’s been an exhausting battle. She says it’s vital we have better resources and training for schools to help take the burden off families and provide children support for mental health problems. She also calls for more thorough training for GPs and NHS professionals, to prevent families from feeling a need to go private.
However if they do go private, Fran says wants specialist help to be available at an affordable price, so no person with an eating disorder misses out on a chance for full recovery.
‘It seems only wealthy families are now able to get the care necessary to treat EDs effectively and for the time required.’
Meanwhile, Beat urges anyone struggling with new or existing eating disorder symptoms to contact their GP without delay, as the sooner someone gets the help they need, the better their chances of making a full recovery or preventing relapse.
‘My heart breaks for those trying to recover who are having the increasing barrier of the cost of living to contend with now,’ adds Shannon.
‘Cutting back too much on food isn’t an option for me, because I can’t afford to become unwell again. Most of us are merely trying to keep our heads above water and hope these tough times pass soon.’
If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, 365 days a year on 0808 801 0677 or beateatingdisorders.org.uk.
*names changed
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