Categories
Dieting Eating Disorders History

It’s Not Just Us! A Brief History of Restrictive Eating

Eating disorders are now a widespread problem. Between 1.25 and 3.4 million people in the UK are affected: around 10% of these suffer from anorexia nervosa.1

The current Diagnostic and Statistical Manual of Mental Disorders (DSMV) defines anorexia as:

  • restriction of energy intake relative to requirements leading to a significantly low body weight
  • intense fear of gaining weight
  • persistent behaviour that interferes with weight gain.2

Restrictive eating practices are not new, however. Self-starvation has a long history, dating right back to the fifth century.

The first evidence of self-starvation comes from the Middle Ages. During this time, food restriction was commonly practiced a form of religious observance. This occurred particularly during Lent, where the control and reduction of food intake was culturally institutionalised. This provided women with the means of experiencing bodily suffering through spiritual fasting.

In her book Holy Feast and Holy Fast, Caroline Walker Bynum explores the role of women role in divine practices that involved abstaining from bodily desire. This included renouncing their appetite for food.3

These women would fast in order to prepare themselves for Christ’s body and blood. They derived nourishment from prayer and the Eucharist, rather than from real food items.

In England this practice lasted until 1534. With the advent of the Protestant Reformation, worship of saints was abolished and ‘[t]he renunciation of food, once experienced and explained as a form of female holiness, was increasingly cast as demonical, heretical, and even insane.’4

A century later, however, the development of scientific and medical understanding shed new light on restrictive eating behaviours.

Rejection of food was thought to result from a lack of appetite caused by other illnesses

The first medical account of self-starvation is credited to the seventeenth century physician Richard Morton. He observed that rejection of food that resulted from a lack of appetite was the symptom of other illnesses, including tuberculosis and chlorosis (anaemia). Morton named chlorosis the ‘Green-Sickness’ and in 1694 described the case of an eighteen year old girl, ‘who resembled ‘“a skeleton only clad with skin.”’5

He writes that she: ‘fell into a total Suppression of her Monthly causes … her Appetite began to abate, and her Digestion to be bad; her flesh also began to be flaccid and loose, and her looks pale.’6

Further evidence of this green sickness came 150 years later in 1838. A medical adviser in The Penny Satirist described a common disease ‘to which the tender sex is subjected, particularly in the large towns of over-refined countries’, which was identified as ‘chlorosis or green sickness.’7

The medical establishment responded by perceiving this susceptibility as a female trait and as further evidence that women were the ‘tender sex’. The advisor continues to observe that: ‘in the streets of large towns there are young ladies with a pale yellow complexion, mixed with a peculiar greenish tinge, a bluish circle around the eyes, an air of languor and debility.’8

They had cravings for strange substances such as chalk, dirt, ashes, or vinegar

These symptoms were thought to result from the patient’s ‘capricious’ appetite. Sometimes they exhibited symptoms of pica, cravings for ‘strange substances such as chalk, dirt, ashes, or vinegar’. At other times they lost their appetite altogether, sometimes refusing to eat.9

Chlorosis was diagnosed in psychosomatic terms. It was thought to arise from ‘bad physical and moral education’, which was the result of ‘[w]ant of proper exercise, improper dress, tight lacing, too much sitting, improper development of the imagination at the expense of the reasoning faculties, boarding-school education, play-going, and novel-reading’ (!)10

At this time, other ‘morbid mortifications of the appetite’ began to be diagnosed alongside chlorosis. In 1840 physician Thomas Laycock added ‘“[b]ulimia and pica’ to the list and claimed that these conditions were all characteristic of the pregnant, chlorotic, and hysterical female.”’11

Even though Morton and Laycock established a specific pathology of self-starvation, however, anorexia would not be formally named for almost two hundred years.

In 1873, anorexia nervosa was simultaneously diagnosed in England and France

By the nineteenth century, the physicians’ social status and power increased as medical authorities grew secure in the scientific validity of their own assumptions. This coincided with the official medicalisation of appetite in 1873. This was when anorexia nervosa was simultaneously diagnosed in England and France by Sir William Gull and Ernest Lasèque.

Sir William Withey Gull

While Lasèque named the condition anorexie hystérique, the term anorexia nervosa was coined by Gull, whose description of the malady first appeared in Transactions of the Clinical Society of London (1874). In an 1888 issue of the Lancet, Gull credited his patients’ refusal to eat to a psychological, rather than a physical affliction. He stated:

That mental states may destroy appetite is notorious, and it will be admitted that young women at of sixteen to twenty-three are specially obnoxious to mental perversity.12

Yet, while Gull noted the psychological cause of anorexia, he chose not to engage with his patients’ subjective mental states. By concentrating upon the physical effects of the condition, rather than psychological causes, Gull thereby dismissed the emotional states of his female patients.

In 1883, anorexia was divided into two sub-conditions: anorexie gastrique and anorexie mentale. Anorexie gastrique applied to patients with digestive complaints. ‘Hysteria was believed to cause a physiological disturbance leading to impaired gastrointestinal absorption.’ Anorexie mental, on the other hand, occurred in patients with ‘“pure” psychiatric conditions and involved mental rather than digestive problems.’13

Despite a more detailed definition of anorexia, however, this did not significantly alter methods of treatment, or the way in which female mental health was regarded. Patients diagnosed with anorexie mentale were still treated by controlled or forced feeding in order to overcome the physiological effects, rather than by engaging with the underlying causes.

In conclusion, from this brief history of restrictive eating it evident that it’s not just us. Self-starvation and other similar eating practices have occurred throughout history in various guises.

For more information on how theories of anorexia continued to develop into the 20th century, please click here. {link to why women theories of anorexia when its published!}


  1. https://www.beateatingdisorders.org.uk/how-many-people-eating-disorder-uk
  2. Abraham M. Nussbaum, M.D., The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  3. Walker Bynum, Caroline, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Berkeley, 1986)
  4. ibid
  5. R. Morton Phthisiologica: Or a Treatise of Consumptions 2nd edition (London, 1720), pp.8-9, in R. M. Bell, Holy Anorexia (London: University of Chicago Press, 1985)
  6. ibid
  7. Anon., ‘The Medical Adviser’, The Penny Satirist, iss.43 (London, 1838)
  8. ibid
  9. Victorian Literature and the Anorexic Body, p.2, Noted by Samuel Ashwell, in A Practical Treatise on the Diseases Peculiar to Women (Philadelphia, PA: Lea and Blanchard, 1845)
  10. Anon., ‘The Medical Adviser’, The Penny Satirist, iss.43 (London, 1838)
  11. T. Laycock, A Treatise on the Nervous Diseases of Women (London: Longman, Orme, Brown, Green and Longmans 1840), p.73, in A. Krugovoy Silver, Victorian Literature and the Anorexic Body (Cambridge: Cambridge University Press, 2002)
  12. W. Gull, ‘Anorexia Nervosa’ (apepsia hysterica, anorexia hysterica), Transactions of the Clinical Society of the London 7 (1874)
  13. E.L. Bliss and C.H. Hardin Branch, Anorexia Nervosa: Its History, Psychology, and Biology (New York: Paul B. Hoeber, 1960)
Categories
Body Image Eating Disorders Exercise Men Recovery

Freddie Flintoff: Men and Eating Disorders

CW: details of purging behaviours.

In the BBC One documentary ‘Living with Bulimia,’ former England Cricket Captain Andrew ‘Freddie’ Flintoff speaks openly for the first time about his 20 year struggle with the eating disorder bulimia nervosa. In the programme, he gives an honest account of his experiences with body dysmorphia, self-induced vomiting and compulsive exercise, which began during his cricketing career when his weight came under scrutiny from the British media.

Today 1.5million people in the UK are reported to have bulimia, 25% of which are men. The actual number of male sufferers, however, is likely to be much higher: a 2007 study suggests that it is closer to 40%.1

Eating disorders are often considered to be female illnesses

The reason why this condition often goes unreported is owing to sex-related stigma. Eating disorders are often considered to be female illnesses, meaning that only 10% of men pursue treatment. Flintoff himself was prevented from disclosing his bulimia owing to his dietician’s discriminatory attitude towards men and eating disorders.

Until being interviewed for this documentary, Flintoff kept his eating disorder secret for 2 decades. Ashamed of his condition, he still finds it difficult to even say the word, ‘bulimia.’ Instead, he refers to it as ‘being sick’.

The secrecy and shame associated with bulimia gave him the sense of having a duel identity. Publicly, Freddie Flintoff is a famous TV presenter and international sportsperson; but privately, he suffers from such low self-esteem that he is compelled to vomit after every meal.

When he began his sporting career age 16, Flintoff had what he describes as a ‘skinny’ physique.2 At this time he became aware of the difference between his own teenage body and those of his teammates, who, in comparison, were more muscular.

The British press christened him ‘The Fat Cricketer’

Over the next few years, Flintoff consequently attempted to increase his size in order to have ‘more presence’.3 Yet, he was not fully aware of how much weight he had gained until his appearance caught the attention of the British press who christened him ‘The Fat Cricketer.’ It was this weight shaming that was the trigger for his 20 year long struggle with bulimia.

By shaming Flintoff for his weight gain, the media reinforced the idea that a professional sportsperson should have a certain type of body, i.e. lean and athletic. Because he did not accord with their aesthetic ideal, Flintoff was publicly humiliated.

This type of discrimination has been documented as posing a significant threat to psychological and physical health; and is also a risk factor for depression, low self-esteem, and body dissatisfaction.4

It is often weight stigma that causes eating disorders

As in Flintoff’s case, it is often weight stigma that causes eating disorders. It was only after the press commented on his appearance that he became concerned about his size. Constantly under the scrutiny of the public eye and known as ‘Fat Flintoff’, Freddie consequently began engaging in destructive behaviours in order to lose weight, making himself sick after every meal.

This behaviour was reinforced by a subsequent improvement in his cricket performance and positive attention from the previously critical British media. This, therefore, confirmed his idea that a trimmer physique was his ticket to increased sporting performance and social approval.

Flintoff also admits that he derived a ‘perverse’ enjoyment from the act of purging itself. He describes it as being addictive, a descriptor commonly used by patients with bulimia since purging activates the opioid (or addictive) part of the brain.5 For many individuals, being sick often provides feelings of comfort, euphoria or instant relief, which makes it difficult to stop.6

Although Flintoff states that he currently has his vomiting under control, he still purges via excessive exercise by carrying out an hour of fasted cardio every morning, becoming anxious if he is unable to train.

Amongst male athletes like Flintoff, purging can lead to serious outcomes that may affect their particular sport. These include ‘increased susceptibility to injury, inconsistent performance, problematic recovery [and] muscle deficiencies.’7

He still experiences guilt and an urge to make himself sick

Although his eating disorder is now functional, in addition to carrying out compulsive exercise, he still experiences guilt and an urge to make himself sick after eating.

Despite these symptoms, however, Flintoff questions whether he is in need of treatment. His claims that he is in control of his eating disorder and can stop whenever he wants, however, are inconsistent with his previous comments that he feels out of control and isn’t able to stop.

Despite bulimia’s medical diagnosis, Flintoff continues to perceive the condition, not as an illness, but part of who he is. It is perhaps owing to his strong identification with his eating disorder that he has not yet made a full recovery. Believing that it is an inherent aspect of his personality means that he will not be open to change.

 ‘Gaining weight would be his worst nightmare’

Flintoff’s reluctance to seek help also seems to be driven by the fear of renouncing his purging behaviours since, as he states, ‘gaining weight would be [his] worst nightmare’.8 Yet, this help can be vital, since ‘almost half of all people with bulimia will not recover without treatment’.9

The importance of Freddie Flintoff sharing his story is that not only is it a stepping stone towards his own recovery; but it will also help to break the stigma surrounding gender stereotypes and eating disorders, and encourage more men to seek the help that they need.


  1. https://www.nationaleatingdisorders.org/blog/males-dont-present-females-eating-disorders [accessed 30 September 2020]
  2. Freddie Flintoff: Living With Bulimia, BBC Television, 28 September 2020
  3. Freddie Flintoff: Living With Bulimia, BBC Television, 28 September 2020
  4.  Andreyeva, T., Puhl, R. M. and Brownell, K. D. (2008), Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006. Obesity, 16: 1129–1134. doi:10.1038/oby.2008.35
  5. https://eating-disorders.org.uk/information/bulimia-nervosa-a-contemporary-analysis [accessed 30 September 2020]
  6. https://mirror-mirror.org/eating-disorders-2-2/bulimia-nervosa [accessed 30 September 2020]
  7. https://journals.sagepub.com/doi/full/10.1177/1941738120928991 [accessed 30 September 2020]
  8. Freddie Flintoff: Living With Bulimia, BBC Television, 28 September 2020
  9. https://eating-disorders.org.uk/information/bulimia-nervosa-a-contemporary-analysis/ [accessed 30 September 2020]

Categories
Dieting Eating Disorders

Naughty But Nice: The Implications of Eating ‘Clean’

In the current pandemic, ‘clean eating’ involves spraying your Tesco delivery with Dettol.

This phrase, however, does not ordinarily mean disinfecting groceries. When I first encountered the concept of clean eating in 2012, it was a nutritional lifestyle that existed predominantly within the fitness community. This diet was comprised of foods that were fresh, whole, unprocessed and unrefined. The mantra of the bodybuilding world was ‘eat clean, train dirty;’ and observing these principles was the standard way to reduce body fat. Day after day, I ate my sad looking turkey and greens from a sweating Tupperware tub, trusting in the magical powers of clean eating to grant me the lean physique of a successful bikini competitor.

‘Clean’ encompasses food that is organic, local, grass-fed, free from diary or gluten, ‘super,’ and raw

Since then, there has been a noticeable shift in diet culture towards ‘wellness.’ Contemporary advocates of clean eating base their meals around foods that provide optimum health. Nowadays, the term ‘clean’ is liberally applied and also encompasses food that is organic, local, grass-fed, free from diary or gluten, ‘super,’ and raw. These eating trends are now mainstream and items such as almond butter and apple cider vinegar have become familiar cupboard staples.

In 2020, plant-based diets are still in vogue, but their offerings are more glamorous than the dry Linda McCartney sausages of my teenage vegetarian phase. Now supermarkets stock exotic products such as sustainable seaweed puffs, coconut flour tortilla chips and spirulina chia pudding.

This eating trend has been perpetuated by a boom of social media bloggers. Despite most of them lacking nutritional qualifications, these foodstagrammers have armies of followers. Their focus is not usually on the health benefits of clean food, however, but rather on its aesthetic appeal. Clean eating has become part of an aspirational lifestyle portrayed by lean, wealthy young adults who swear by their Mason jar rainbow smoothies.

If taken to extremes, clean eating can develop into a condition known as orthorexia nervosa. Orthorexia was first defined in 1977 by Dr Steven Bratman as a pathological obsession with healthy food. While not currently recognized by the American Psychiatric Association, the condition does bear similarities to other clinical eating disorders. Like anorexia nervosa for instance, orthorexia involves strict dietary control and fear-driven ritualistic compulsions.

People with orthorexia fixate on the quality and purity of their food

Unlike anorexics, however, people with orthorexia fixate on the quality and purity of their food. This includes avoiding products that contain artificial preservatives, trans fats and pesticides. Echoing the principles of clean eating, this diet is limited to foods that support physical health. Yet, while clean eating is universally praised, orthorexia is deemed to be harmful and obsessive.

Ironically, such a strict ‘healthy’ eating regime can in fact lead to illness. Since many foods are omitted from an individual’s diet, there is often insufficient intake of the vitamins and minerals required for optimum health.

When part of a more balanced diet, healthy food is good for our physical wellbeing. Yet the language that surrounds our nutritional choices such as ‘organic,’ ‘detox’ and ‘natural’ infers that eating clean will also elevate us to a superior level of virtue. In this way, health food evangelists assert that those who conform to the values of clean eating will not only become physically well, but also morally pure.

This judgment and morality are an everyday part of our eating lexicon. ‘Clean’ food items are even branded with virtuous names. These include Halo Top Ice Cream, Innocent Smoothies, Perfect Snacks and Right Rice. The ‘guilt free’ slogan of these products echoes the idea that we are ‘good’ when we eat clean; and conversely ‘bad’ if we are tempted by ‘dirtier’ foods.

‘Junk’ or ‘cheat’ foods suggest decadence and depravity

Using the language of morality to define our nutritional choices thereby demonizes food items, or whole food groups. Calorie-laden, low nutritional value foods are often described as ‘junk’ or ‘cheat’ foods, terms which suggest decadence and depravity. In the 1980s, Lyons marketed their products by associating ‘forbidden’ types of food with pleasure, coining the ubiquitous phrase ‘naughty but nice.’ Their successful advertising campaign endorsed the concept that highly palatable foods such as cream cakes are bad for the soul.

When we consume foods that have been designated as ‘good’ or ‘bad,’ this morality becomes transferred to ourselves. Restricting our diet to good, clean products can therefore provide us with a sense of achievement and virtue. Within modern culture, praise and respect are awarded to those who eat healthily since they are perceived to possess superior levels of willpower and self-control.

This external commendation, however, only serves to reinforce the mind-set that clean is better. As a result, we are left constantly questioning whether our food choices are ‘good enough.’ Eating foods that we have labelled as ‘bad’ can lead to feelings of guilt and shame; and even physically damaging behaviours such as restriction or purging.

Food does not possess intrinsic moral value

The fetishization of clean eating and its more extreme manifestation as orthorexia can therefore challenge our mental wellbeing. Ultimately, using the phrase ‘clean’ to describe certain types of food grants power to these items and their promise of health and self-worth. In order to disable this power, we need to remind ourselves that the moral lexicon surrounding food is merely a linguistic construct that is culturally promoted and self-imposed.

We may feel virtuous if we eat cauliflower instead of bread, but this is just an idea: food does not possess intrinsic moral value. Health is about balance: eat the kale AND the cake.

Categories
Dieting Eating Disorders Fitness Competitions

How Dieting Leads To Eating Disorders

Fitness Competitions and The Minnesota Starvation Experiment

CW: details of eating disordered behaviours.

Restricting food intake is the number one cause of eating disorders. NEDA reports that ‘35% of “normal dieters” progress to pathological dieting and that 20-25% of those individuals develop eating disorders.1

But why is this the case?

In 1944, a study was conducted that documented the effects of following a restrictive diet. This was the Minnesota Starvation Experiment. Led by Dr Ancel Keys, a team of researchers set out to find the most effective methods of rehabilitation for the millions of people who experienced starvation during the Second World War.

They did this by restricting the diets of 36 young, healthy, male volunteers for a period of 6 months.

The study found that externally induced starvation led to various psychological and physiological changes. These changes are typical of what might occur when we engage in extreme or chronic dieting.

As a former Pro Bikini Competitor, I experienced similar effects when severely reducing my calorie intake in preparation for the stage. This eventually led to a full blown relapse into anorexia nervosa.

The Minnesota Starvation Experiment was in three parts:

  1. 3 month control phase, during which the men ate normally
  2. 6 months of semi-starvation
  3. 3 months of re-feeding

During the first stage, the daily calorie intake was approximately 3500kcal. This was then halved to 1570kcal in the second, semi-starvation phase.

Likewise, achieving the lean competition physique involves being in a calorie deficit for a long period of time. For the average woman, the recommended daily intake is 2000kcal.2 When preparing for a competition, however, this can drop almost to 1000kcal. This is the figure established by The World Health Organization as ‘the border of semi-starvation.’3

The Minnesota Experiment’s protocol required participants to lose 25% of their body weight during the process (an average of 37lbs.)4 This meant sustaining a weekly weight loss of approximately 2.5lb.

Aside from obvious external indicators such as sunken faces and protruding ribs, the men experienced:

  • decreases in body temperature
  • low blood pressure
  • anaemia
  • dizziness
  • fatigue
  • decreased heart rate
  • decreased metabolic functioning.

The lean stage physique is essentially in a state of chronic malnutrition

These symptoms can also arise when preparing for a fitness competition. Striving to attain the extreme aesthetic requirements causes various physical afflictions. These closely resemble the symptoms of starvation since the lean stage physique is essentially in a state of chronic malnutrition.

This produces dysfunctions that affect multiple organs within the cardiovascular, gastro intestinal, endocrine, skeletal, and central nervous systems.5

As well as causing physical illness, reduced caloric intake also leads to psychological depletion. The Minnesota men experienced various neurological deficits: lack of concentration anxiety, irritability and depression. Depressive episodes are both a physiological result of reduced dietary energy intake, and a psychological response to constantly fighting hunger.

Participants were also fanatically preoccupied with food: it was the principal topic of conversation and the subject of their dreams. They collected menus and cookery books; and some even expressed a desire to become chefs after the experiment had ended.

This obsession is also true of competitors. My fellow bikini models and I constantly talked of and thought about food: comparing our meals, watching food channels, and compulsively starring at ‘forbidden’ food items in the supermarket.

A common symptom of calorie restriction is heightened cravings


A common symptom of calorie restriction experienced by both study participants and competitors is heightened cravings. As with food obsession, cravings are survival mechanisms that ensure that the starving individual seeks out nutrition. In the fitness world, cravings are typically for carbohydrates such as doughnuts, chips and ice cream.

Following the semi-starvation phase, the men underwent 3 months of restricted rehabilitation where their daily rations were incrementally increased to 3200kcal. Their extreme hunger did not abate, however. According to Dr Keys, this was because the calorie increase was still not sufficient ‘to allow tissues destroyed during starvation to be rebuilt.’6

Finally, there was an eight-week period during which there were no limits on food intake, during which the men would often binge on 8000-10,000kcal a day. As a result, they frequently vomited after meals and one was admitted to hospital to have his stomach pumped.

Extreme hunger, known as hyperphagia, is typical of anorexia recovery


This extreme huger, known as hyperphagia, is also typical of anorexia recovery. It is the result of the body’s attempt not only to restore weight, but also to repair the physical damage that has occurred during starvation. Throughout my own recovery, I had frequent binges where I could easily consume a frightening 10,000kcal in one sitting and still not be satisfied. You can find a detailed account of my own experiences in Hanging Up The Bikini: Why I Quit Fitness Competitions.

Despite having no previous history of eating disorders, participants continued to be preoccupied with food, binge eating or restricting their calorie intake long after the study had ended.

Like the starvation imposed upon the men in this study, the extreme diet required for a competition can lead to obsessive and destructive food-related behaviours for women who have no previous histories of disorderly eating.

Eating disorders can be created just by dieting

The experiment revealed that malnutrition itself causes these symptoms: eating disorders can be created just by depriving the body of food through dieting.

This means that many, including myself, have hung up their sequinned bikinis. Like the Minnesota men, we have found starvation too damaging to our psychological and physical well-being.


  1. http://www.eatingdisorderhope.com/treatment-for-eating-disorders/special-issues/dieting
  2. http://www.nhs.uk/chq/pages/1126.aspx?categoryid=51
  3. Feminist Perspectives on Eating Disorders, ed. by Patricia Fallon, Melanie A. Katzman, Susan C. Wooley (The Guilford Press: London, 1994), p.8 ‘From Too “Close to the Bone”: The Historical Context for Women’s Obsession with Slenderness’, Roberta P. Seid
  4. http://www.seven-health.com/2013/08/controlling-weight-part-2/
  5. http://emedicine.medscape.com/article/89260-overview#a0101
  6. https://academic.oup.com/jn/article/135/6/1347/4663828

Categories
Body Image Dieting Eating Disorders Exercise Fitness Competitions Recovery

Hanging Up The Bikini: Why I Quit Competing

CW: details of eating disordered behaviours.

In October 2014, at age 31 I achieved the award that marked the pinnacle of my fitness competition career: the coveted Bikini Athlete Pro Card. Standing onstage in a Hertfordshire theatre, smiling for the winner’s photographs, I appeared the epitome of health and fitness. But, in reality, I was suffering from serious physical and mental damage.

Entering the world of fitness competitions triggered a major relapse

I have had a disordered relationship with food since I developed anorexia at the age of 11. Over the years, I have also suffered from body dysmorphia and bulimia. When I was in my late 20s, entering the world of fitness competitions triggered a major relapse into these destructive patterns of eating.

I am second from the left

Fitness competitions are a misnomer. The irony of these events lies in the very title itself: fitness is not necessarily synonymous with health. I was a fitness model, yet I was far from fit. I ignored my body’s appeals for food and rest, and instead rigidly adhered to punishing diet and training regimes in the hope that they would make me muscular and lean.

In the fitness world, disordered eating is extremely common

These types of strict routines mean that most competitors become disconnected from their bodies and what they truly need. Unsurprisingly, therefore, in the fitness world disordered eating is extremely common. Female athletes have the same risk factors as women in the general population, supplemented by the additional risk of reducing their body fat to dangerously low levels.

Body fat is decreased during the final stage of competition preparation, which is masochistically known as ‘cutting’. This typically begins eight to twelve weeks prior to a show, depending on the amount of fat that must be lost in order to create a winning physique.

This process increases the female competitor’s susceptibility to three inter-related disorders, known as the Female Athlete Triad. The components of the triad are osteoporosis, amenorrhea and disordered eating.

Osteoporosis occurs because limiting calorie intake leads to a decreased production of the hormone oestrogen. Since oestrogen plays a crucial role in calcium resorption and bone growth, reduced levels can lead to brittle bones.

Even though I was following an extremely restrictive diet, I naively thought that any damage would be offset by my strength training which typically increases bone density. After competing, however, I had a bone density (DEXA) scan, which revealed that my bone density was borderline abnormal.

This was the last time I lost my period before I learned that I was infertile


Not only does a low level of oestrogen lead to brittle bones, it also causes menstrual dysfunction where the cycle can be delayed, or can stop altogether (known as amenorrhea). Owing to my restrictive eating habit, I have lost my period on numerous occasions over the past two decades.

When I experienced amenorrhea during competition preparation, however, this was the last occasion before I learned that I was infertile. Three very costly and emotionally traumatic in vitro fertilization (IVF) cycles later, and I am still waiting for my miracle baby.


While osteoporosis and amenorrhea are widely experienced by female athletes, the most common aspect of the triad is disordered eating. This includes extreme calorie restriction, binge eating, and purging via excessive exercise or self-induced vomiting. These abnormal patterns of behaviour are caused by the strict nutritional regime required during competition prep.

My own insubstantial food plan exacerbated my pre-existing patterns of disorderly eating. I was so hungry that I couldn’t keep any ‘forbidden’ food items in the house since I had moments of ‘weakness’, where I would ‘give in’ and binge. A teaspoon of peanut butter could easily become a whole jar.

I unsuccessfully attempted to alleviate my troublesome appetite by drinking litres of cherry Pepsi max and chewing sugar free gum. The Pepsi, however, gave me headaches and heart palpitations; and I chewed so much gum that I eventually wore away my teeth and had to have most of them filled.

Hunger increases during the final weeks of preparation, when carbohydrates are drastically decreased in order to boost fat loss. Reducing carbohydrates to less than 20g per day releases ketones which the body can then use as fuel. This process produces various side effects, however, including nausea, headaches and fatigue.

This established a pattern of eating which would later turn into a vicious cycle of restriction and binging

In order to avoid these undesirable symptoms, competitors typically cycle carbohydrates. This involves enduring several consecutive low carbohydrate days, followed by a high carbohydrate ‘refeed’ day to aid metabolism and ensure continual fat loss. I didn’t know at the time, but this established a pattern of eating which would later turn into a vicious cycle of restriction and binging.

In the end, all my hard work paid off. I won. And I was awarded my Pro Card. But was it worth it? On show day, the audience admire and applaud your physique. But they don’t see behind the curtain. They don’t see what it takes to be that woman holding the trophy. And they don’t see what happens afterwards.


Stepping off stage was the beginning of a relapse into my most serious and dangerous anorexic phase to date.


Terrified of losing my stage physique, I continued to restrict my calorie intake over the next couple of years. I lost body fat, and I also lost the muscle that I worked so hard to gain. My body literally ate itself. My glutes, the prize aspect of every bikini competitor, became saggy and deflated. My coccyx was so bony that I had to sit on a cushion. I was constantly cold from the inside out and handfuls of my hair fell out in the shower. I couldn’t go to the gym; I couldn’t even walk 10 minutes to the shop without feeling faint.

Eventually, my internal organs began to shut down and my hormones stopped functioning. I developed bradycardia because the muscles in my heart had shrunk.

I lost over 2 stone (12.7kg) before I was admitted into an eating disorders hospital, where I spent 18 months as an outpatient. I was emaciated and mentally broken, a shadow of the woman who triumphantly raised the winning trophy.

In my experience, having your dream body does not make your life better. For me, it did exactly the opposite.

Whether you are preparing for a fitness competition, or just trying to manipulate your body through diet and exercise, I hope this has brought attention to the physical and emotional damage that can be caused by valuing aesthetics over mental health.

I am now working towards food freedom and body acceptance. I still have my competition bikini as a memento, but its time in the spotlight is over and it is resolutely HUNG UP.