ONE of the first things Elysa Roberts remembers ever reading as a child was the quote: "You can never be too rich or too thin".
Now Newcastle-based, Dr Roberts grew up in Miami, Florida - where every season is bikini season, and the family business was in the diet industry. It was at a time when most people didn't know what airbrushing was, and every magazine spruiked another way to lose weight quickly for summer.
"There was a belief that the thinner you were, the healthier you were," she said. "That was the societal message at the time. We now know that is not true."
Dr Roberts was an occupational therapy student, poised to do her final clinical placement in a unit with people with addictions and dysfunctional relationships with substances, when she realised she needed to help herself first. She was struggling with bulimia nervosa, and had been since she her early days at college.
"It dawned on me that perhaps I shouldn't be out there attempting to help individuals who are struggling with a mental health condition when I thought I might be too," she said.
Dr Roberts said she received the best available help and support that existed at the time - although she did not know then that relapses would be part of her recovery.
Her eating disorder spanned 20 years, crossing the international date line with her when she moved to Australia in 2013. Since her diagnosis she has become passionate about busting some of the myths about eating disorders that can serve as obstacles blocking people seeking support - the way people look, their cultural background, socio-economic status, age and gender.
"We need everyone to start understanding that eating disorders do not have a 'look'," she said. "When someone is telling you they are struggling with their relationship with food and their body, and that they have certain behaviours that are harming their body, listen.
"Be curious, and be compassionate. Do not be critical."
Dr Roberts shared her story after a Butterfly Foundation survey found that 75 per cent of Australians living with an eating disorder do not seek professional help due to stigma, stereotyping and a belief that they do not "fit the mould" of how an eating disorder "should" look.
Dr Roberts is one of the voices in a national campaign for the Butterfly Foundation that serves to challenge some of these prevailing myths and misconceptions.
"It is critically important to reduce the stereotypical perceptions that eating disorders only happen to a certain demographic, that they only happen at a certain age, and that the way to stop an eating disorder is just to eat," she said. "Because of these stereotypes, we are seeing an increase in inability to access treatment."
Dr Roberts said the number of people reaching out to The Butterfly Foundation's help line was rising, and conversations that used to take 20 minutes had pushed out to 60 minutes.
"We still have a society that is very weight-centric and fat phobic, and weight stigmatising," she said.
"It is great that people are reaching out, but if they can't get past their GP then they can't get specialist help. We have people looking at each other and saying, 'But you don't look like you have an eating disorder, you look well, you look fit, I'd love to look like you' and it is really unhelpful.
"People would look at me, and because I am in a privileged-size body, they would say - even in my worst and my best stages - 'Oh you've never had to worry about your weight'. This campaign aims to help the general public stop being so weight-centric, stop being so fat-phobic. Stop commenting on people's size, weight and shape. At all.
"Instead, let's compliment one another on our qualities and characteristics and the vibe and the energy we are giving off instead. Like, 'Wow, you look vibrant today'."
Dr Roberts, who has three degrees including a PhD, said we knew far more about eating disorders now than we did 10 years ago.
"We know more about eating disorders and we have better ways of naming what we are seeing now, but the trouble is, we don't always have the help to give people," she said. "While we have these diagnostic boxes to put them in, some people don't fit those boxes, and they are seriously struggling. They sometimes get turned away because they don't fit the profile of an eating disorder, and that is just devastating to hear."
Dr Roberts said The Butterfly Foundation was a community that offered "frontline support", and it was seeking donations to continue to provide critical services that help in the prevention and treatment of eating disorders.
Hamilton's Tim Conway has also lent his voice to the awareness campaign after a long battle with anorexia that began when he was 21.
"I had my 21st birthday at The Del' - and when I got the photos back, I just really wasn't happy with how I looked," he said. "I also have a diagnosis of OCD, so I just became really obsessed about what I ate, trying to get to this good looking weight and be attractive and have everyone like me. It was a slippery slope."
Mr Conway moved to England where he worked 15-hour days at a bar in Brixton.
"I'm nearly six foot four," he said. "And I lost a lot of weight. My parents came and visited me and took one look at me and started crying.
"I ended up fronting up to an eating disorder clinic in South London. But they told me they didn't take males. My parents got me a flight back to Australia, and I actually ending up sitting next to an eating disorder specialist on the plane. He put me in contact with some people and I ended up doing four or five hospital admissions."
In all of those visits to hospital, Mr Conway said he never came across another male seeking treatment.
But he knows that of more than a million Australians living with an eating disorder, more than one-in-three are male.
Between 15-to-20 per cent of people living with anorexia and bulimia are male, and there are about as many males and females suffering from binge eating disorder.
At his worst, he said all he could do was sleep.
"I look at some of the photos now and realise I was on my way to being brown bread," he said.
"I didn't have the energy to do anything because my body was so starved of nutrients. The brain fog... At times I couldn't make a decision. I'd just stand there.
"A whole lot of people, and even medical professionals, think you have to look really gaunt, or really sick, to have an eating disorder.
"I've had doctors that won't proceed with the appointment until I jumped on the scales, even though I told them how anxious it made me. But I still don't think many people understand."
Mr Conway said one of the most traumatic moments he can recall during his illness was when staff at John Hunter Hospital thought he had HIV because his white blood cell count was so low.
"I ended up having a panic attack and I had to be sedated while I got the results," he said. "I was a 28 year old male having to get my dad to hold me while I cried. It was horrendous. That will haunt me.
"My GP, who probably saved my life, was really angry about it. He said 'You don't have HIV, you're anorexic'."
Mr Conway became "sick of being sick".
He was sick of seeing "ripped" social media influencers telling people what to eat and what to avoid while trying to sell weight loss supplements.
But it was an ultimatum from his family that pushed him back onto the road to recovery.
"I had an altercation with some of my family members who were worried about me, and they said if I didn't give this a red hot go, I had to go back to hospital," he said. "So I did. And while I'm a healthy weight now and I am on the road to recovery, realistically, there is still work to do."
Mr Conway said while many men struggled with different mental health battles, he was happy to be a voice that starts the conversation to get them talking.
"Males have typically always been told to 'stop being a pussy' or to 'harden up', and I think that has really affected us, making us feel like we can't or won't be taken seriously," he said. "I want to help change that."
Mr Conway urged people to take the time to understand that people don't necessarily have to look "gaunt" or sick with an eating disorder. Keeping an open mind would help friends and family members - as well as doctors - identify them better.
"I want people to understand males suffer from this as well," he said. "And I want them not to judge people who are struggling. It can be really hard to open up."
People who are concerned about themselves or their loved ones can speak to their GP to access professional psychological treatment, or contact the Butterfly Foundation Helpline on 1800 ED HOPE (1800 33 4673).
Anita Beaumont is a health and general news reporter at the Newcastle Herald.
Anita Beaumont is a health and general news reporter at the Newcastle Herald.
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