When asked to conjure up an idea of what anorexia is, most people would immediately say restricted eating and a fear of weight gain.

Others with a bit more knowledge might throw purging, exercise and laxatives into the mix, all of which can also be correct. But there are a lot of behaviours that come along with anorexia that most people aren’t aware of. Many of these are physiological responses to starvation, but some are symptoms of the mental side of it – it can often be hard to differentiate between them. Anorexia can make people behave in ways that are completely out of character for them which is a huge challenge to the sufferer, as it becomes difficult to separate your identity from your illness and can make you feel like a bad person. Some of the things we do when unwell are things we might not even realise are due to anorexia, which is why I wanted to highlight some of them here.

Body Checking/Avoidance
People can go one of two ways with this, and in fact it can morph over time – for example as I have been in recovery I have moved from compulsive checking more into avoidance. Body checking is a safety behaviour used by people to check the size of their body. The majority of people (although not everybody) with anorexia has body dysmorphia – we just don’t see our bodies the way other people do. That’s why no matter how thin people get, they don’t believe what other people are telling them. Body checking can take many forms including obsessively seeking out and looking in reflective surfaces, using measuring tapes, weighing, using clothes and jewellery, using hands to measure and touch different parts of the body (usually bony parts and/or ‘softer’ parts), taking and comparing photographs. I’m sure there would have been many a time people would have seen me grabbing my collarbones and wrapping my hands around my wrists – it’s compulsive and it’s constant. Body avoidance is, as the name suggests, not wanting to look at your body at all. People might cover up mirrors, wear baggy clothes or refuse to have photos taken of them.

Food Dreams
Having dreams about food, particularly nightmares about bingeing, is very common and is a direct side effect of starvation. They can be absolutely terrifying and this is one of the reasons anorexia is so very evil – you can’t even get any respite from it when you are asleep.

Hoarding
This is something that might surprise some of you, as most people thing of anorexia as being a complete avoidance of food. Whilst it is an avoidance of eating food, some people can actually end up collecting food and hoarding it, but never eating it. Personally I struggled with this at times buit not at others; often my fear of eating anything not on my ‘safe’ list was so high that I wouldn’t even keep anything else in the house, but I know a lot of people who have had cupboards full of cakes and crisps and chocolate that has sat there untouched for months on end. And interestingly, it can be hoarding of anything, not just food.

Lying
This is something I really hate about anorexia. I don’t like dishonesty and it makes me lie and manipulate everyone around me, which then just brings up more feelings of guilt, an emotion that weighs heavily on us anyway. The most important thing to be aware of is that it’s not personal, and that is isn’t who that person really is deep down.

Obsession with Other People’s Food
Again, another outlet for food obsession. When I was at my worst I was utterly fixated on other people’s food. If anybody went to the shop I’d have my head in their carrier bag when they got back. I was always grilling people on what they’d had for breakfast or dinner the night before, and what they were eating for lunch. I’d stare at people while they were eating and always encourage them to have more. I cannot imagine how annoying this was for everyone around me.

Rituals
A lot of people develop rituals around food that do not have any direct impact on the calories consumed but help reduce the anxiety around eating. This can include things like only eating with certain cutlery or crockery, separating food, eating in a particular order, chewing food a certain amount of times, cutting food up into small pieces and only eating at strict times or in particular places.

Recipe Collecting
This is something I did obsessively and I know is true of many people with anorexia. In just three months I amassed over 60,000 recipes on Pinterest, a lot of which included meat and eggs which I don’t even eat. It became a compulsion and I would sit for hours and hours in silence every evening pinning every food photo I could find. A lot of people might also collect physical recipes from cookbooks and magazines.

Pretend Shopping
Again, another element of food obsession. Probably once a week I would visit my local supermarket, go around the shop filling up a basket of things like chocolate and cakes and cheese – all things I wouldn’t dream of eating – then leave it somewhere in the shop without buying it (sorry Sainbury’s workers!). It was fun to pretend, even for a small window, that I would be allowed to have these things. I also used to make enormous takeaway orders online without ever checking out, and do online shops at different supermarkets but closing them down once the basket was full.

Chewing and Spitting
Sometimes, in order to get to taste the food without the calories, people will chew whatever it is they want to eat then spit it out and throw it away. Yes it’s pretty gross, but anorexia leads people into desperate behaviours.

Watching Food Videos
Every morning when I woke up and every night before I went to bed I would watch videos either of people cooking or people eating – it’s almost like I could eat vicariously through them. People with anorexia often become very fixated on cooking shows or looking at videos and photos of food. When you are starving, your brain will do anything it can do draw you to food with the aim of getting you to eat.

Lower Level Movements
Compulsive exercise is common in anorexia, but a lot of people might not be aware of the sister of hard exercise – lower level movements. These are the micro movements people do with the aim to burn more calories – shaking legs, fidgeting, standing instead of sitting, cleaning etc. In reality these things have very little impact on burning calories, but that doesn’t stop many of us from feeling the need to be constantly moving.

I hope this helps to provide a bit of insight into how complex and all consuming an illness anorexia is. There is so much more to it then food restriction, it takes over your entire life. One of the key things to recognise here, is that almost all of these behaviours reduce or disappear entirely with adequate nutrition. Within only two weeks of being at day patient I had stopped watching food videos, doing hypothetical shopping, trawling recipes. My obsession with other people’s food has significantly reduced although it hasn’t gone away entirely. I never have dreams about food anymore, I can sit down comfortably without feeling the need to be constantly moving and I am much less ritualistic about my eating than I was, although this is definitely still something I am working on. This is miserable way to live, but I promise that these things do go away with recovery.

You just need to trust in the process and see for yourself.