Do you have a family member or loved one who is currently suffering from an eating disorder? Have you been in recovery from ED? When does the real change begin for the better? In this podcast episode, Dr. Cristina Castagnini speaks about going from full-blown ED to complete recovery and life beyond with Caroline Drummond-Smith.


Caroline is a 56-year-old mother of 3 who suffered from anorexia for over 30 years. She thought recovery was impossible for someone who had lived with an eating disorder for so long, but she’s now fully recovered and is using her lived experience, along with specialist eating disorder training, to help others to live and thrive.

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  • Caroline’s experience with ED
  • ED is an illness, not a choice
  • Having an eating disorder during pregnancy
  • The prospect of recovery can feel like abandonment
  • The process of recovery

Caroline’s experience with ED

For a long time, Caroline thought that her experience with an eating disorder started when she was 16. That was when she was sent to boarding school in a new country. However, she came to discover that it actually started earlier for her, when she was younger.
At 15/ 16, I started using food and restricting as a way of, one; controlling my situation, and secondly; coping with my situation. (Caroline Drummond-Smith)
Caroline was more introverted, had a smaller group of friends, and often felt a little separate. She then found safety in restricting her food at a young age. Then, when she had her life changed by being moved abroad to attend boarding school by herself, she used her restrictive behaviors as a coping mechanism again.
It was a big change, and that was definitely about control. I remember thinking, “I do feel out of control in this situation” … everything was new and unknown, and it was a conscious decision that I could control my food. It had started already, so it just got more severe. (Caroline Drummond-Smith)
Ultimately, control and coping were the feelings that restricting food gave Caroline.

ED is an illness, not a choice

An eating disorder is an illness. It is not something that someone picks up randomly, it is a maladaptive coping mechanism that has become more extreme that, if left untreated, can be fatal. Additionally, you cannot tell whether somebody has an eating disorder or not.
Even once somebody maybe does seek treatment and they are not engaging in the behaviors anymore, it’s the thoughts, it’s other part[s] that are going on internally for people. (Caroline Drummond-Smith)
An eating disorder is not only about the obsession with the physical because it also creates a harmful, self-destructive, and endless cycle of negative thoughts in someone's mind.

Having an eating disorder during pregnancy

Caroline took fertility drugs to help her get pregnant, and she had a son and a set of twins within 20 months of each other. However, her eating disorder was present right through her pregnancies, and she had to be hospitalized twice before each birth because the babies weren’t growing properly. Luckily, they were all born healthy, except her body had suffered tremendously.
I remember being really proud of my bump, and loving it and wanting to show and to look pregnant but only from the front, anything else, absolutely not. (Caroline Drummond-Smith)
Even though Caroline and her body had suffered after her births, her anorexia loved it. Unfortunately, many doctors and people in her community complimented her on her weight loss.

The prospect of recovery can feel like abandonment

When you have been struggling with an eating disorder for many years, or it was grown to feel like another “part” of you, the idea of going to recovery, healing it, and letting the ED go can feel terrifying. It can feel like you’re cutting off and abandoning a part of yourself, especially when you’ve been using it as an attempt to feel safe and secure, even though it was never safe in the first place.
It was my identity … who on earth would I be? I had this for 35 years, who would I be without my eating disorder? I didn’t know how to live as an adult because it started when I was 15, I didn’t know how to be without it. I didn’t know who I’d be without it. (Caroline Drummond-Smith)
Although, as soon as you start taking the eating disorder apart and separating it from you, so many good things that are real and true will rush in to take its place. You have to trust that that’s what’s going to happen. You have to trust to let the eating disorder go, for the sake of your future.

The process of recovery

Caroline experienced a few bad relapses. Her husband once stood up to her, and made her seek help – which she did – and it began again the process of her recovery.
I looked in the mirror and I said to myself, “I’m done with this.” And from that moment, I decided that I wanted to recover, and that was the first time in my life that I had decided for myself … it wasn’t anybody else telling me to … and I did it on my own. (Caroline Drummond-Smith)
Because she had the right intention, of recovering with love for herself and for wanting a truly better life, she was able to recover on her own. It was difficult, and Caroline recommends that people get support for their journeys, but it will make it much more manageable. Don’t give up hope, and know this: full recovery is possible. You have to want it and you have to commit to yourself. It really is possible to recover fully from your ED.
It has to come from within you. It has to come from within you, you can have all the people around you in the world [telling you but it has to start with you]. (Caroline Drummond-Smith)



  I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


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Podcast Transcription

[DR. CRISTINA] Behind the Bite Podcast is part of a network of podcasts that are good for the world. Check out podcasts like the Full of Shift podcast, After the First Marriage podcast and Eating Recovery Academy over at Welcome to Behind the Bite Podcast. This podcast is about the real-life struggles women face with food, body image and weight. We're here to help you inspire and create better healthier lives. Welcome. Well, hello everyone. Welcome to the show. So today is a show where we have somebody here who is going to share their personal journey with their eating disorder. As many of who have listened before, I absolutely value and appreciate when someone is willing to come on and share their journey. I think it is so powerful when someone comes on and someone out there listening can relate to what someone else is saying or may hear what someone else says and maybe they get that final push to go into recovery themselves. Or maybe they hear something that's just what they need to hear for them to realize that they haven't eating disorder when maybe they never really thought they did, or maybe they wondered if they did. Hearing someone else's journey and some of the things that they describe about their life and what they've been thinking and feeling or what they went through gives them that that final thing they need to hear to realize, okay, I need help. People have all sorts of reactions to hearing other people's stories. If nothing else, maybe you just don't feel so alone in what you're experiencing out there. Or for any of you out there who are struggling with disordered eating or an eating disorder, and even for those who don't have an eating disorder, maybe you're a loved one of someone who you see struggling, hearing someone else's story maybe it can give you some insight or help you more further understand more about what your loved one's going through and also give you, I guess maybe a sense of relief and knowing that there's really nothing that's personal to you about why your loved one is not responding to your police for them to get help or it's really not about how much they love you or not, whether or not they seek treatment or get better. So you'll hear so much about what this next guest is about to say that I think will help many of you listening and if you have questions after you hear this, please again, reach out to me, reach out to our guest. She's willing to communicate with you. She's going to leave her contact information, which I think is wonderful. That being said, probably wondering who this guest is, Caroline Drummond-Smith is our guest today. She's a 56-year-old mother of three who suffered with anorexia for over 30 years and she thought recovery was impossible for someone who had lived with an eating disorder for so long. And that's a lot of people. They think, oh gosh, if I've had this for so long, I'm never going to reach recovery. But now she's fully of recovered and she's using her lived experience along with specialist eating disorder training to help others to live and thrive. I'm really excited to have her on and for you to hear her story. [DR. CRISTINA] Caroline, welcome to the show. I'm very excited to have you here. [CAROLINE DRUMMOND-SMITH] Thank you for having me. It's great to be on your podcast. Thank you. [DR. CRISTINA] Well, and I always love having people who are willing to share their stories because as I've shared with listeners on previous shows, I think that that is so powerful to listen to somebody else's story so they can relate because I oftentimes think people don't realize that they actually have an eating disorder. It's in listening to someone else sharing what they're going through that they get a light bulb moment and go, wait a minute, maybe this isn't just me failing a dieting, or maybe this is something I can overcome, or maybe I don't have to live my life this way. So I really appreciate your willingness to come on and speak about your life, your journey, and where you're at now. So thank you so much. Given that I know you're in a different space now in your life, but how, what do you want to share with us in terms of like, where, I guess, how did you realize you had an eating disorder or maybe a struggle with food? [CAROLINE] I think it all started when I was about 15. I think for a long time I thought it started when I was 16 because there was a particular event. I was sent to boarding school in a different country and that was my story for a long time. That's when my eating disorder started. But actually, the more I've looked into it, the more I realized it started about a year before that. It took me a while to sort of readjust my story because you're living with a story and then you think, actually no, that's not true. So that made me think, well, maybe the reason for my eating disorder was different to what I originally thought. But I think there are so many reasons as there's not just one reason, but, so 15, 16, I started using food restricting as a way of one, controlling my situation and secondly, coping with my situation. I think the coping part was because I was an introvert, I was, I wasn't, I mean, I had friends, but a very small group of friends. I always felt slightly separate and just not quite part of the group. So I think I found that safety in restricting my food because I thought, okay, this, I can do this, this is okay. Things felt okay when I did that. Then at 16 I was sent to boarding school in England, I'd been living abroad and I'd never lived in England or since, before I hadn't been in England so it was a big change. That was definitely about control. I remember thinking, I really do feel out of control in this situation. Everything was new and unknown and it was a conscious decision then I can control my food. I think I'd started already so it just got more severe. So it was really, it was control and coping. It was those two things that that restriction gave me. [DR. CRISTINA] That's so interesting that you, you say you knew that that's what you were doing at this time. I oftentimes here, oh, I didn't know that that's what that was about until much later. So to even have that awareness, so young ... [CAROLINE] I think yeah, the control, I definitely had the awareness, the coping before I didn't. It's only now looking back I can see what I was doing and see what was happening. But yes, the control, and then of course that carried on. So there were times through my late teenage years, early 20s where, where things were okay and I didn't need it so much, but it was always there as a crutch. Like I knew it was in my back pocket to bring out when I needed it. So there were times when it was much worse than others. [DR. CRISTINA] So was anyone aware of what you were doing or was this something that you kept to yourself? [CAROLINE] Do you know, it's funny, isn't it, because I think, I think when we're in an eating disorder, we think nobody knows. We think we're being really clever. Of course, an eating disorder is so secretive. And because I was at boarding school and then I never really, I used to go home in the holidays, so, but I can't, it's funny, isn't it, you can't really remember. But bearing in mind that I wasn't at home 24/7 every day of the year and also, this was 40 years ago, eating disorders were not really talked about or recognized then. So, although I do remember arguments particularly with my father about it, so yes, in answer to your question, yes, people clearly did notice, but I don't think they knew how to approach me about it. I didn't get any help or support because there wasn't a help or support then. It just wasn't there. I mean, I think if you were severely ill you went into hospital, but there wasn't all the awareness that there is now. [DR. CRISTINA] Oh, absolutely. [CAROLINE] I think probably my friends, actually, I was talking to my best friend the other day who I've been best friends with since the age of 10. We were at school together in Paris. She said, "Oh yeah, teachers used to come up to me and say what's wrong with Caroline?" And I never knew that. I only found that about six months ago, I found that out. So yes, I was there blissfully thinking, oh, nobody knows what's going on, but, and this is the trouble, isn't it? People won't approach the person with the eating disorder because they're scared of what to say. They're scared to say the wrong thing. [DR. CRISTINA] Yeah, that's absolutely true. I'm wondering, I know that's hard for you to probably answer this, but do you think if your friend had said something to you back then do you think that anything would be different? [CAROLINE] It's so hard, isn't it? I think it could have been that, whether she had said something, if my parents had said more, if they'd been a support networker, I mean they'd really got on it straight away. Because we all know, the research says if you catch it early recovery is more successful and more likely. So whether that would've helped, but looking at my personality, I think even if I hadn't gone to boarding school, I think it would've happened. There'd have been something else that triggered it. [DR. CRISTINA] So, it's so interesting too, because I'm wondering, did, was there any influence you had in your life that you like, looking back, you think, well, this is why I turned to food, to cope and to control? Was there anybody in your life that was also doing that? Like how do you make sense of why you had the eating disorder versus maybe coping with something else? [CAROLINE] Yeah, I believe that there's a genetic element to it. If I look back in my family, I can see a genetic, I can see a pattern. Obviously, it was, it manifested in different ways because it was back several generations but I think that, I've forgotten your question now. [DR. CRISTINA] Just looking at back and --- [CAROLINE] Oh, was there anybody who I knew and sort of copying or, no. Isn't that the extraordinary thing about eating disorders? We don't need it. Just, they have so many common elements. That's why I think when I finally talked to somebody else about it years down the line, because I'd never talked to anybody about it and they said, I feel like that. I thought, whoa, I'm not on my own here. I went for 25, 30 years without ever talking to anybody about it, as in somebody else who'd suffered with it. [DR. CRISTINA] Wow. [CAROLINE] So that's really lonely. It made, yes, it made me think, well, maybe I don't have such a problem. Like you said at the beginning, people might think, oh, I don't have such an issue, I had a big problem. They would, and it's not like we know, it's not just about weight because there were times when my weight was just about okay, where people would say, oh, you're so lucky, you're so slim. But they weren't, they didn't look at me and say, oh my goodness, she's underweight. It is the behaviors and the thought patterns. That was what was engulfing me and dominating my life so much. But no, I didn't have anybody, it wasn't like a rule, but a manual. I didn't read a manual on how to be anorexic, didn't copy somebody else. It's extraordinary, isn't it, how we just seem to pick these. Well, it's an illness, isn't it? It has these common traits [DR. CRISTINA] I thank you for saying that because I think there is that myth out there still, that if someone has an eating disorder, you can look at them and know, especially anorexia nervosa, everyone thinks, oh, if I can tell if somebody has that illness. You can look at somebody and know. Much to your point, that's not it. Even once somebody maybe does seek treatment and they are, let's say, not even engaging in the behaviors anymore, it's the thoughts, it's other part that's going on internally for people. So for you, when you were saying that, for anyone listening, going, what do you mean, what are these other things that nobody sees? What's going, what was going on for you that nobody saw? What were you struggling and suffering with? [CAROLINE] I suppose it's the continual, on a practical level, practical level. It's that continual negotiating in your head. Can I eat that today? If I eat that, do I need to go on a run? That was my drug of choice, my eating disorder. If I'm eating out tonight, what can I eat during the day or what can I not eat during the day because we're eating out this evening in a restaurant, and then what do I have to do tomorrow? It's all those sorts and it's a continual chatter. It's exhausting. It really is. And that's what people don't see on the outside. You can seem so together and with it. [DR. CRISTINA] Very true. You did a lot of pretending and --- [CAROLINE] Yeah. Oh, totally, totally. I think when you've, I'm sure we'll talk about with a family, you have to really, unless you're very sick as a mother, it's our role to keep going. You're not allowed to be ill because you have to keep going. It's just what you do. [DR. CRISTINA] Well, so now that's interesting. So you were talking about boarding school and late teens, early 20s. So it sounds like you're eating disorder and behaviors and all of this like you engaged in all this and had your eating disorder throughout from 15 on. So what happened? Because obviously you're, you're talking about motherhood and things like that? Yeah, what happened here? Because a lot of people are scared oh, I won't be able to have kids. This eating disorder's going to like hurt my body. Or oh if I, what happens? Does the eating disorder need to be gone before you have children? Like let's talk about all this because you went through all of these things that people probably have questions about and are worried about. [CAROLINE] So for a start, I think I was told when I had an eating disorder as a teenager, I was told by somebody, probably my father, if you keep going like this, you won't be able to get pregnant. My big thing, when you're asked as a child, what do you want to be when you're older, apparently, I always said I want to be a mommy. So that was my thing. I did, I knew I wanted to have children, but being told I might not be able to, that wasn't enough. That was not enough. This is how powerful an eating disorder is. My biggest desire in life, I was being told I might not reach it might not achieve it, but eating disorder was stronger. But I got married young at 23. My husband was a workaholic and he wouldn't mind me talking about this openly. Our marriage actually, it starts, it's changed so much over the years and thank goodness we've grown closer, not further apart because I think things like this can either separate you or bring you closer. We got married, he was a workaholic, I was an anorexic, it was perfect. The extraordinary thing is, looking back, we didn't even talk about my anorexia. It was never talked about. This guy I was marrying, it was never acknowledged between us, which now you think, whoa, that's crazy. But it suited us that he went off to work at some crazy hour in the morning, didn't get back till after supper in the evening. Well, how perfect was that for me that I could start myself all day without him knowing and without him confronting or noticing. So that went on for a while and then tried to get pregnant and funny enough I couldn't. But the gynecologist I went to, he put me on fertility drugs. So I suppose somehow I thought, well this is fine because I can still carry on being anorexic and I've got this medicine that's going to help me get pregnant. So yes, on the one hand that was great. Isn't modern medicine amazing? But it didn't help me get better. But I think what it does is give hope to people that yes, I wasn't emaciated but my body was not functioning properly. I wasn't ovulating. So ideally of course, I would've wanted to do it without getting, being on treatment. But I was really fortunate. I managed to fall pregnant. I had my son and then 20 months later I had twins. So yeah, that was pretty full on three under 20 months. But there was that, people said to me, well, how was it being pregnant when you had an eating disorder? I know everybody is different. For me, I was okay with my changing body to a certain degree and the bump was fine and anything else wasn't. I was put in hospital five weeks before my eldest was born and 10 weeks before the twins were born because they weren't growing properly, not surprisingly. And do you know for me, although I hated every minute of being in hospital, the eating disorder loved it because the food was disgusting. So I didn't eat it. Is it an amazing, the human body? had three healthy children because they take everything from you. So I was just completely depleted by the end. But the children, the babies were fine. So it was a very mixed feeling. I mean I didn't enjoy being pregnant because I felt very sick right the way through but actually the growing bump, I remember being really proud of my bump and loving it and wanting to show, to look pregnant, but only at the front. Anything else, absolutely not. Then afterwards, I mean I think because I'd basically not eaten properly in hospital, so it was just, I naturally just did what is so awful in the media, oh, get back to your pre body shape, which I hate. Because that's not normal and that's not what the human body should be doing. We've just grown a baby or I've grown two babies. So, but I, my anorexia loved that. It was pinging back and back in jeans, which is so sad. I look back and I think that's so sad, so sad. [DR. CRISTINA] So I'm curious, like during your pregnancy, so you were full on engaged in your eating disorder throughout both pregnancies sounds like, and were you aware of this? Were any doctors aware of this? Was anyone aware, was this, because you said too, this is the nature of the illness. It's so secret. Like how are you able to hide this? This sounds so --- [CAROLINE] I suppose because, yeah, I mean it's looking back, I remember when I, because I had cesarean and I remember having my epidural, it was either just poor, just after. Then I think I must have had the epidural and then they put me on the operating theater and the gynecologist who did the surgery, he helped carry me. He said, oh, I only help lift the light ones. I mean, what a shocking thing to say. So that endorsed my size. I thought, this is great, this is a really good thing. Then when I went for a checkup, I remember went, I can't remember, is it six-week checkup or something you go for? So long ago now. The nurse was there and he said, wow, look at this, look at that shape, pinged back. I just think, no. But at the time this was fantastic for me. [DR. CRISTINA] So for anyone listening, like they might not be picking up on like when you have an eating disorder and somebody says things like, oh, I only pick up the light ones, what's going on in someone's mind with an eating disorder is, yes, I've reached the goal. I'm the light one. It's like a victorious, like --- [CAROLINE] Oh, I've made it, I've succeeded. [DR. CRISTINA] I'm hearing things like, oh, look at that shape. It's validating, the eating disorder's like getting all this fuel and like just, it's solidifying everything you've been doing and perpetuating this like horrible message of this, keep going. This is it. You're doing the right thing. You're getting this. It's horrible. [CAROLINE] Yep. Oh, it's shocking. I mean really shocking. [DR. CRISTINA] So for anyone who doesn't have an eating disorder, I do understand people think it's very nice to compliment people on certain things and they don't mean anything negative by it when they're like, oh, you look great. Or I hear all the time on everywhere it's like, oh, they've lost weight, they look great. But if someone has an eating disorder, all you're saying to them is keep up the eating disorder behavior. You're doing a great job. [CAROLINE] Keep killing yourself. So that was hard. That was, I mean it was great but it was it, yeah, it didn't do me any good obviously, at all for the eating disorder because it just encouraged it. So when the children were little, I think again, it was my way. I didn't have any help with the children and everyone seemed to me get some help. If you have it in the States au pairs, do you have au pairs? So just get an au pair to be there or get somebody in at least a couple of days a week to help. I think this is part of an eating disorder person's personality. They have to do everything perfectly. Is that perfectionist? I was, no, I'm going to bring up these three babies under 20 months, breastfeeding two of them, a toddler still in nappies, all on my own. I'll do it perfectly. Well, none of them slept. My husband was at work most of the time. I think I look back now, I think what, I couldn't even go to the supermarket. I had the double trolley that you could put the two babies in and then my toddler had to sit in the main bit of the trolley. I could fit about one bunch of bananas in one shop. That was about all I could do at a time. I think at least I should have got somebody to come and look after them for two hours so I could go to the supermarket on my own. But no, I had to do everything perfectly on my own, in my eyes and it was, I was exhausted. So I was giving, giving, giving all the time, so for me, that eating disorder was my thing. It was my secret I suppose, my gift to myself that yes, I was exhausted. Yes, I was just so run down, but it was okay because I had that little thing of my own. I was giving to everybody else but I had that little thing of my own that I could retreat into and it just felt good. [DR. CRISTINA] So as you're talking, I'm just wondering my gosh, how was this affecting your other relationships too, like your marriage relationships with friends, family? It sounds like you were just not really even giving yourself enough to be present, I mean energy for anything. Like how did this affect the everything in your life? [CAROLINE] I think at the time I was too tired to even notice what was going on. My husband was exhausted. I think as a couple, I think it's very common, whether you got an eating disorder or not. When you've got young children, you just get through each day basically. So that the marriage was, yeah, it was tough actually, I think because he was working so hard and I was doing everything with the children. And he's admitted now. He said you were like a single mother. He said, I didn't do much, did I? Mmh, no, not really. But he's a great dad and he's got a great relationship with them now. With the rest of my family, it was difficult. I remember at one point my sister didn't force me, but really, really encouraged me to go and get help. Now I thought, I haven't even got a problem. But I went along to this place to have therapy just to keep her quiet. Of course, it didn't no good at all because I'd sit there, talk the talk and go away and do my own thing because I had no intention of changing because I didn't really think I had a problem anyway. But I do remember Christmases, Easter time times when we were together as a family, it was tense. If I look back, there were times when I'd go to my parents with the children and I remember one occasion pretending I had a migraine so I could avoid eating with them. So I obviously, there were tactics I used. And you sort of forget, don't you, but then suddenly these memories come u. Yeah, I remember that. I suppose I panicked. I think what happened, I arrived at my parents' house, put the children to bed, saw what my mother was cooking. I thought, I cannot eat that because obviously I wasn't in control. So I think I obviously conjured up this migraine, which I do get anyway. So it wasn't totally impossible, but it was a lie at that time. That's the thing, isn't it? I am, I would hope a very honest person, the eating disorder turns you into somebody. You're just not I would lie to my husband about what I'd eaten and it was becoming more obvious that there was a problem. I would lie to him, I would lie to family, I would lie to friends. I would make excuses, "Oh, I've eaten already." All of the things that people listening who've had or have an eating disorder. You know what I'm talking about. But it can be very credible because if you are a sort of person who doesn't lie, which I absolutely wasn't, but eating disorder just makes you. It just, it's like it takes over, possess, possesses you. [DR. CRISTINA] Oh, it's scary to think about not having it too. Like you said, it was your little thing, your little secret that was yours and don't want anyone to find out. [CAROLINE] Oh, don't you come close to that. It was my identity, which I think again is a very common thing. Who on earth would I be? By the end I've had this for 35 years, who would I be without my eating disorder? I didn't know how to live as an adult because it had started when I was 15. I didn't know how to be without it. I didn't know who I'd be without it and I think that's a really scary thing. The longer you have it for, it just becomes so much part of you. I always liken it to a sort of a ball around you and that's your world. When you have an eating disorder, that's all that's in this ball. That's all there is. So you can't see that there's any space for anything else. So why would you get rid of it? Because there's nothing else in your world. But actually, as soon as you start taking bits of the eating disorder out of this ball, suddenly the space opens up to put other far more interesting things in it. But it's trusting that that's going to happen. [DR. CRISTINA] The one thing I hear the most, and I don't know what your experience was, the fear of not being in control, I guess the perceived notion that you're in control of even your body. I mean, you're, you're really not, you feel like you are, but the fear of what happens if I don't have this? Like not just who are you going to be, but what are you going to look like? I know it's extremely scared to go to treatment and go, if I don't have this, then my body's going to be out of control. Everything will be out of control, not just that. I don't know if that was part of that for you as well. [CAROLINE] It was totally because I'd lived my whole adult life counting calories, monitoring my exercise and that's how I'd maintained my body. So I thought, well, if I don't have that, what on earth is going to happen to my body? It's going to go completely out of control. I need, I thought I need, how do people just, I used to look at people in restaurants and think, but they just seem to be ordering food that they want and eating it and they look quite normal. How do they do it? Amazingly, your body is actually a lot cleverer than your head, your head being your eating disorder. Your body knows what to do. That's what I just could not trust my body to do what it needed to do. [DR. CRISTINA] Yes. I mean, I've shared on here with the show, I also had my eating disorder. I remember thinking that too, like I have a magical body. Like mine's not like everyone. [CAROLINE] Exactly. It's fine for everybody else, but mine won't do that. Mine will go completely haywire and yeah, it won't know what to do. [DR. CRISTINA] So was there like a certain point or like event or what finally got you to the point where things started to turn around for you? [CAROLINE] So I had a couple of bad relapses, so it was always there right the way through. There were a couple of events, when I was 35, I had a skiing accident and I was told I couldn't exercise for nine months. I had to have surgery on my knee. I walked out of the clinic and thought, can't exercise, can't eat. So that was a real dip. At that point my husband said, "You've got to get help." He said, "You need to go to the hospital." My children were 10 and 11 and I said, "Well, I'm not. I said, "If you put me in hospital or if they put me in hospital, I'm escaping." I literally, I would've climbed out of the window. I know I wouldn't have done it. I said, I'm not going into hospital. He said, "Okay, I'll give you a week to find an alternative." I mean he was, he really stood up to me there. Luckily near where we lived in England, there was this woman who just set up this sort of center for about four or five people, very small. I remember going to her because I'd heard about her and I remember knocking at the door and I felt so embarrassed because I thought, she's going to think I'm a complete fraud. Now, looking back, I was so ill, I mean I had had a major relapse. You didn't have to be a doctor or anybody to just look at me and think she's got real problems. Anyway, so I said to her, oh, you might not know why I'm here. I mean it's laughable really. Anyway, she agreed to take me. I said, I'm not staying the night because it was residential. I said, "The deal is I'll come in in the morning, I'll go in the evening so I can see my children." I did that for 18 months and it really helped and I came out thinking I was recovered. Then another four years passed, we moved to Madrid and I realized that, I still told people I was recovered. In my body I looked recovered but the behaviors and the thoughts were still there. I still hadn't got rid of them. It was really annoying me but I thought, well this is just the way I'm going to live. I think I got a point I accepted, I've had this for too long to ever recover. Then we moved back to England and I had another major relapse and it was at that point, it was one morning I got up and I was drying my hair. When you cross your legs, you're sitting in a chair, cross your legs. I remember looking down at my legs and it was like I was seeing them as they really were for the first time and I thought, oh my goodness, that's not a good look. I looked in the mirror and it was like I said to myself, I'm done with this. From that moment I decided I wanted to recover and that was the first time in my life I had decided for myself. It wasn't anybody else who told me to. I did it on my own. This is why I do the work I'm doing now because I had no support. I wish I had, because it took a lot longer doing it on my own, but I did it. It didn't mean it was easy because I'd decided to recover but because I had the right intention, I had the motivation or I'd made the decision. I didn't wake up every morning feeling motivated, but I woke up every morning deciding I was going to take the right steps towards recovery that day, however hard it was going to be. It was that, it was just, that moment, it's so hard because people say, well how can I want to recover? It has to come from in you. It has to come from within you. You can have all the people around you in the world. I mean, when I was in England in that last relapse, my daughter who was 16 at the time, she said to a friend of mine, "I'm really scared Mommy's going to die." This friend told me this. Now bearing in mind, my children are my world. I didn't work when they were growing up. I wanted to be at home. That was my choice. I was very fortunate I could do that. So that was how much they meant to me. Not the people who were, you know what I mean though, it was my world. They were my world. My friend said, "Your daughter is really scared you're going to die." It was like, went right over my head. That's how powerful and strong, like I said, the eating disorder is. Yes, of course, I'm, oh, but then it just put that to one side because the eating disorder is far more important, far more important to stay thin, not eating, in control. But it was at that point that I decided to get better that things really happened. [DR. CRISTINA] I really want people to hear that part because I get a lot of questions on my messages from people, loved ones asking, well what can I say to my wife, my friend, my whatever, sister to get them into treatment? What do I need to do? They're not listening to me. They're not listening to anyone else. So, just to your point, anyone out there who's ever asked me that question, hear what she's saying. There's nothing you can do or say. There's no magical words. It's not about them not loving you enough. It's nothing to do with you. It's the illness is so powerful. [CAROLINE] I hear so often loved ones saying, don't they love me? If they love me, they'd get better. It's not, that's not, like you said, that's not how it works. It's really not. I've had to luckily my relationship with my children, it's so close that I've talked to them about it, especially to my daughter because I affected her eating. My behaviors affected her. I feel immense guilt. I did, I've sort of forgiven myself for that because I know it wasn't my fault. I mean, yes, it was my doing, but I didn't choose to do it. It was the illness. But we've talked a lot about it and she's absolutely fine now but she went through those teenage years, she struggled, luckily nowhere nearly as bad as I did. She came out of it. But all three of them, the two boys and my daughter I've talked to about it and I've apologized. There was a phase, a time when I controlled their food too much when they were just coming into their teenage years. My husband said to me, he was pretty harsh, but it was quite right, he said, "If you carry on like this, you're going to lose your relationship with your children." And he was right. I had to back off because I was trying to control their food. Well, they were coming into teenage years, they could decide, yes, of course I provided healthy food for them at home, but they had a choice in what they ate far more at that age and I had to let them do that. That was really difficult for me, really, really difficult not to micromanage their food as well as mine. I think that was a real indicator of how badly I was in or out of my eating disorder. You could see it by how much I was controlling their food. I think if you look back, it probably would've been quite a good indicator of how badly I was doing. When I was doing better, I'd ease off and I was much more relaxed. [DR. CRISTINA] So interesting. As you look back and think like the times you were doing better versus more in the illness, have you been able to identify for yourself, like why there were times you maybe weren't so in your eating disorders other times? [CAROLINE] I think maybe when there was more in my life when I felt more fulfilled in other things. But it's a catch because you need to let go of the eating disorder a bit to allow other things into your life. So I think when we moved to Madrid it was a bit better because although the thoughts, behaviors were there, I was eating better because it was exciting. It was a new start. It was all very, it was all new and fun. But then when we came back and I had my relapse, that was probably because the children were all a lot more independent and that was when I felt, well, what's my purpose now? I've been a mother all these years, now what? So that I think was a time when I thought, okay, I know what I need. I need to really get ahold of this again. This will make me feel I've got a purpose and something to get up for every day. [DR. CRISTINA] So, yeah because I even as I'm thinking about like you doing this on your own, when you had that moment, how did you even know what to do? Do you think part of it was because you had had 18 months of treatment that you knew what you needed to do? Because I'm just thinking if anyone's listening going, oh wait, I can just have that moment and do this on my own. Like you also did have 18 months of really intense --- [CAROLINE] I did. Exactly. I think that helps a lot. I knew what I needed to do. Now when I'd had the treatment, I went off and didn't do it. I did some of it, whereas when I decided to get better, yes, I sort of drew on what I'd been through and what we worked on. And to a certain extent I thought, do you know what, I've just got to eat more. That doesn't solve everything because it's not just about food. But I think once you are nutritionally nourished you can actually think more rationally. Then I was in a space to think, okay, what do I want to do with my life? Then you can start working on all the other stuff. And it took several years. I've been to therapy for other things to help me cope with general life because obviously the way I've done it for so long was through an eating disorder. So I've actually needed help to learn how to cope with things not using that eating disorder. So yeah, it's, you've got to get, get rid of some of the eating disorder to allow that space to put something else in. [DR. CRISTINA] Yes, to your point too, like I hear this, anyone listening, there is I think a lot of confusion about, okay, once I start eating more like the eating disorder is gone. But to your point, when you are starving yourself, literally your brain does atrophy. MRIs, people's brains, atrophy, you are not capable of thinking clearly. There's no rational. You're just not. So once you start eating and nourishing your body again, you're able to think clearly. You're able to focus, you're able to like really do some work and get really involved in therapy. I've worked with patients, it's really hard to do any intense work or really do the treatment of the eating disorder until somebody's body and brain are nourished. And that's --- [CAROLINE] Yeah, exactly. That's what I find. [DR. CRISTINA] Yeah, it's the eating disorder's not gone just because somebody's eating and their body's well-nourished. Again, that's the surface. I hate to say that it's a big step, it's huge. Don't get me wrong. [CAROLINE] But it's the first step. [DR. CRISTINA] Exactly. [CAROLINE] And I think people find it difficult because they come to me and they say, well, I've been into hospital and they fed me, put weight on, I came out and I lost it again. So looks like we are doing just the same thing. I say no, the difference is this is just the first step, but we cannot do anything. Like you said, you cannot do anything when they're so starved. You can't have a conversation with them. Some of my clients I have to do, I split into two sessions because I think they can't focus for that long. And until they can, you can't really do any proper work with them. You're just giving them the courage and the support to start nourishing themselves. And that's really important. it's so important to be there for them. [DR. CRISTINA] It's scary. [CAROLINE] Oh, it's terrifying. It's absolutely terrifying. [DR. CRISTINA] So you went through this long process and it sounds like you obviously took longer than, maybe it could have if you had had some support and help along the way. So now you're a different place in your life. I mean it sounds like having gone through that you learned a lot and now you're, now like if you want to talk a little bit more about what you're actually doing now and how this has all brought you to your life now. [CAROLINE] Yeah, so I'm now an eating disorder coach and I just love what I do because I'm the person who I wish I'd had, I mean, not necessarily exactly me, but somebody who I could talk to. I work with people who, a lot of the people who come to me, they've tried a lot of different, they've been to hospital, they've had general counselors who can be very good, they say, "Oh, they were lovely but they never addressed the food." Well, that suits them to the ground because they go, go to their sessions, they talk about everything else apart from the food, and then they go home and do exactly the same behaviors. So I work with people who, most of the people I come to, who come to me have tried other things and I think my strength maybe is that I've been through it myself. Now, the disadvantage of that, and I always say this to my clients, I say the advantages, I've been through it, the disadvantage for them is that I've been through it and I know when they're bullshitting me, excuse the language, I know when they're trying to get around things or through things or over things, under things, whatever. Because I've done it myself. I've had, I had 35 years of practice, I got pretty good at it. So I know most of the tricks in the book, but they do seem to get so much comfort from the fact that I get it. It doesn't mean I'm easy on them. I challenge them, I really challenge them, but I, well my job is to empower them to do it for themselves. Anybody can be force-fed. That's easy. Lots of people go into hospital and say, well, I'll just do what they tell me to do so I can get out and do my own thing. Now the way I work is a lot slower, which is hard for the carers because they think, well this is taking a long time. But I often talk to parents if it's appropriate and say this will take a long time, but every step they take is because they've decided to do it. I'm not sitting there forcing them to do it. I've challenged them, I've encouraged them, I've suggested to them, we've come up with challenges together and sometimes they'll say, I can't do that. You get to be a good judge of when you get to know the person are they just saying that, is that the eating disorder saying it or are you genuinely pushing them too far? And sometimes, yeah, I think, okay, that was a bit too much to suggest that and you pull back a bit. For me, I'm learning all the time and everybody is different. So you have to, you work with each individual. There's no cookie-cutter program. I have people say, well how do you work? It's very much, it depends on each person. My big thing is I challenge and I empower them and I never ever give up hope. I say, if you don't believe it, let me believe it for you until you believe it yourself. [DR. CRISTINA] That is so true that there's no one path for everybody and no one, okay, at week four you're going to be doing this and people, I don't know if you get this question, well how long is this going to take? [CAROLINE] Exactly. [DR. CRISTINA] I don't know. [CAROLINE] I can't tell you. I cannot tell you. And also am I doing it right? There is no right or wrong way to recovery. Everybody's recovery looks different. Some people lapse, some people relapse, some people don't at all. There's no one right way to do it. Some people go all in, some people do it really slowly. It's got to be right for that person and feel safe enough, but challenging enough. That's the balance, isn't it? You've got to challenge the eating disorder but make the healthy person feel safe that they can do it and you are holding them while they're doing it. [DR. CRISTINA] So do you continually instill that hope, that belief like recovery, full recoveries, like possible, they can achieve it? What do you say to somebody who says, oh no, like we're going to fully recover. I'm always going to have this somewhere in the back of my mind or always engage in something. [CAROLINE] I say, well, one, it's up to you. You can decide to stop at any point, but if you want to fully recover, you can. You absolutely can. You've got to want it. Nobody else can do that for you but if you want to, yeah, of course you can. So yeah, I never let them give up hope. I've got a client at the moment who's on her way to relapsing but we're going to be fine. I said, it's okay, this is part of recovery we can learn so much from this and you can come back even stronger. [DR. CRISTINA] I love that. I love that you're out there spreading more of the hope and helping people. Because I often say on here that myth that you can't fully recover, it's powerful and if you believe in it, that has a lot of power over your path. [CAROLINE] Of course, it does, especially where eating disorders are concerned because they want to hold on. They don't like being let go of and being dropped. They're going to do everything they can to just keep in there a little bit, just to keep their foot in the door. [DR. CRISTINA] So I know I'm in the states and you're not so, but I have listeners from all over. So if somebody does want to work with you how can they find you? How can they get in touch with you? Even if they don't want to work directly with you, how can they find you? [CAROLINE] I mean I work, I'm working with a guy in Australia at the moment. I work with people in the states. I work, obviously, time difference, we have to work it out. But I'm on Instagram at Zest Health Coaching, my website is I'm always happy. People don't have to want to work with me if they want to get in touch with me. If they just, I get emails saying I heard your podcast, it really resonated. They can just, we can have a conversation like that. I just want to help people. They don't have to become a client. If they want to work with me, amazing. We can do the proper work. People all can always book a discovery call on my website just to have an initial, obviously, free of charge chat, just to find out more about me, how I work, if that's the route they want to take. [DR. CRISTINA] That's fantastic. Thank you so much. That will all be in the show notes so people can find you and I'm sure people will want you, you're doing amazing work and thank you so much for sharing your story. [CAROLINE] Oh, well thank you so much for having me on. It's been so great talking to you. Thank you. [DR. CRISTINA] So before we finally end, is there any last final words for the audience or anyone listening? [CAROLINE] I think it is, like we've said right the way through this chat, never give up hope. I had it for over 30 years and it was, I had it badly and I am now fully recovered and I am living the best life I could imagine. I just couldn't imagine doing what I do and living the life I'm living with food freedom and full freedom. So just do not let anyone tell you you can't recover. [DR. CRISTINA] Great. Fabulous final words. Thank you so much, Caroline. [CAROLINE] Thank you, Cristina. Thank you. [DR. CRISTINA] This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher, or the guests are rendering legal, accounting, clinical, or any other professional information. If you want a professional, you should find one.