In her book Stand Tall Little Girl, she gives the figures to back this up: 40% of people who have had an eating disorder never think about it again; 15% are unable to fight it off and are stuck in it; and 45% of people find a way to live with it, using coping mechanisms. Virgo’s pioneering work has an overarching purpose: to say, in her words and through her actions, that recovery is possible. It’s a rescue mission launched from regular life into a world of crisis – in which no one is seen as irrecoverable.

She began her activism with the campaign Dump the Scales – a challenge to the idea that treatment for eating-disorder patients can be tied to their BMI. “I was trying to make sure that people with eating disorders could get treatment on the NHS regardless of what their BMI is. And now I’m trying to take it further, to get people to understand that not all eating disorders are visible. Regardless of someone’s size or their shape, the question is what their eating patterns are, what their food behaviours are like.”

Clinical preconceptions are in a feedback loop with a culture that both valorises thinness and sees it as the sine qua non of disordered eating. Anyone with an eating disorder who isn’t underweight is discredited by this fundamental misunderstanding of what the illness is, which makes it very hard to seek help – particularly if, when you try, you are not taken seriously. It is incredibly rare for anyone who isn’t underweight to talk openly about anorexia, understandably. When the plus-size model Tess Holliday revealed earlier this year that she was anorexic and in recovery, she faced an explosion of opinions that she summarised at the time: “I’ve had a lot of messages from folks that are anorexic that are livid and angry because they feel like I’m lying.” If clinicians also struggle to believe in a mental illness that they can’t see on the scales, it creates a wall of silence. “I was just so fed up with the way eating disorders were treated, the real lack of understanding around them,” Virgo says. “I felt I really had to do something.”

It was in November 2007, at the age of 17, that Virgo herself was admitted to hospital because her BMI had dropped far enough that the doctors considered her life was in danger. Six months before that, she had started treatment with child and adolescent mental health services for her eating disorder, which, to her mind, was when the problems started. Since the age of 13, she had been rigidly controlling her calorie intake and exercising obsessively. She once ran a half-marathon having eaten nothing for four days. She avoided her meals at school by giving away her food, and those at home in the melee of being one of five children.

But it was only when professionals got involved, she feels, that she started having to hide her behaviour, which unleashed a dark inventiveness. Before every weigh-in, she would down water. She would vomit after every meal, counting the food out. She would exercise excessively. The sheer pain screams from her description, and she finds it cathartic now to write and talk about it. “I think I romanticised being unwell because it served a purpose at the time. But, describing it, I can see that I was never happy. So that helps, because otherwise when you have a bad day, you always think: ‘Maybe if I went back to that behaviour, that might work.’”

Yet she is keen to emphasise that it was no one thing – and certainly no one feature of modern life or the internet – that caused the anorexia. “It’s 50% down to your genetics, and I did often wonder if there was a genetic predisposition even before I saw that research.” Virgo’s grandmother suffered with disordered eating all her life, and Virgo tells an absolutely tragic story of going to visit her in hospital, just as she herself was at the end of an almost year-long stay on the eating-disorder unit. “When my grandad died, my grandmother just decided to not eat any more. She wasn’t in a psychiatric ward, she was on an old people’s ward. I think at that point, they’d probably just given up on her. I remember being really frustrated, looking at her on the bed, thinking: ‘Why can’t you just eat? I’ve done it, you should be able to do it.’”

Recovery may start with the intellect, but even the mightiest mind can’t just flick a switch. The days were structured around meals, snacks and talking therapies, with all the normal aspects of teenage life excised. Patients were “constantly competing, over how much food we were eating, around people’s weights. We’d all be queueing up outside the nurse’s room where they weighed you. As soon as that person walked out of the treatment room, you could see in their face what had happened with their weight, and that was really hard. They looked distressed whatever, but they’d look more distressed if it had gone up too much – too much for them.”

She kept her cereal bowl from the unit with her, so she could be certain of the amount she was eating. Close friends got used to making sure they ate at 6pm. It was already a world away from her school life, pre-hospital, when she used elaborate avoidance strategies for any group meals, but it was still a slog. “You get to a healthy weight, then you’re discharged back out into the community, on an NHS hospital food plan. You still don’t really know how to eat and how to listen to your body. It’s weird; I used to watch people eat at university and think: ‘Why can’t I eat that?’”

The university years had their own extraneous shocks – her parents divorced in her first year, her grandmother died in her third year. But she weathered these events without relapse, emerging with a degree, a solid set of friends with whom she is still very close, a few half-marathons accomplished and a running habit that was intense but under control. It wasn’t until 2016, when she was 26 and living in London, that her eating disorder returned, triggered, she believes, by the death of her other grandmother. It was a few days after this grandparent had moved into a care home, and Virgo had been to see her. “I didn’t really want to be there. I think I stayed for an hour, max, and I remember feeling really guilty for leaving, but convinced myself that I could come back the week after and it’d be fine,” she says.

Source: The Guardian

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