Knuckles white on the steering wheel, heart pounding in her chest, Sarah* drove from one Wagga McDonalds to the next with an insatiable clawing at her insides.
It was a hole nothing could seem to fill: No amount of chips, nuggets or ice cream could satiate the bitter hollowness that welled inside her. And yet she tried, with every painful, greasy mouthful, to quell her feelings of deepest self-loathing.
Sarah’s eating disorder developed when she was just seven years old, when, she admitted, she was overweight for a girl of her age.
From that point on it was a downward spiral, first beginning with rapid weight loss until she was diagnosed with anorexia at 14.
Unfortunately, Sarah’s seemingly never ending battle with her eating disorder is not a rare occurrence, with recent figures suggesting almost 10 per cent of Australians now suffer from some form of the mental illness.
Despite its insidious creep however, Sarah says it is an issue society all too often sweeps under the carpet, deeming it too uncomfortable and awkward to deal with.
"You never hear about it and it's never spoken about,” she says. “It's almost as though it's a non-issue and there’s so much that people don’t know about it."
After years of punishing calorie restriction and over-exercising, Sarah’s eating disorder transformed into bulimia, which saw her turn to bingeing until she would make herself physically sick.
But, whether starving herself or stuffing herself, the eating disorder’s intent was always the same: to offer brief and fleeting respite from an unbearable feeling, before leaving its victim with the deepest sense of emptiness and self-hatred.
“It's like your either starving yourself of a need, or you’re stuffing something down to kill off a feeling you can’t handle,” she says, her voice catching in her throat.
“When your bingeing, it's not that you're hungry, you’re trying to get rid of something you don't want to feel and you’ll just keep stuffing and stuffing something down because you don't want to deal with it.
After multiple involuntary hospital admissions, Sarah finally decided to reach out for help when her eating disorder became too unbearable to manage.
Despite her willingness to recover, Sarah says finding adequate services in Wagga was extremely difficult.
Her treatment, which includes psychology appointments, doctors appointments and medication, has become a financial burden costing her up to 12 thousand dollars a year.
"There's not many services available for people with eating disorders in regional cities and towns,” she says. “I’m very fortunate that I'm able to afford recovery, because I know a lot of people in Wagga can’t.”
While Sarah is still recovering and admits to occasionally engaging in eating disorder
behaviours, she said she is "through the worst of it” and committed to full recovery.
American-born Megan Crossfield, who overcame her eating disorder after a 20 year battle, said it could be particularly difficult for those in regional areas to seek help given the stereotypes surrounding the disorder, as well as the lack of services available.
“The stigma is so much stronger in regional cities, because there’s a smaller population and people are afraid to speak out and ask for help,” Mrs Crossfield says.
“It’s so important for sufferers to say something, because once someone does and starts to share their experience, all these other people come out of the woodwork.
“We're all human and have our own struggles and when we’re open about them and share them, we can shine a light on these issues and help people start the healing process."
Mrs Crossfeild, who has lived in Wagga for three years, battled with anorexia, obsessive exercise, bulimia and binge eating until her early 20s, when her crippling depression caused by the illness forced her to reach out.
"It got to the point where I knew I was either going to be killed by the physical side effects of my eating disorder, or actually commit suicide,” she says.
"The depression is very debilitating. There are times when you feel so completely powerless in your whole being.
"There were moments when I would look in the mirror and wouldn't even recognise myself, because the eating disorder had taken over my whole sense of self. It had consumed my body and my entire mind."
Eating disorders are frequently associated with depression and anxiety, making sufferers of the illness particularly vulnerable to self-harm, with one in five of those diagnosed with anorexia nervosa dying prematurely by suicide.
A Griffith mother, who did not want to be named, agreed with the challenges of finding appropriate eating disorder services, after being forced to send her daughter to a private clinic in Sydney for six months to receive treatment.
“There's not a lot of help for those in regional areas and there's very little professional knowledge about the mental illness itself,” she said.
“This is a serious problem out here, because there's a huge lack of understanding, empathy and no support, apart from putting the patient in hospital for a few weeks, which just isn’t good enough.”
The mother, who said her daughter’s illness completely alienated and isolated her from the family, said the only treatment that helped her daughter to recovery was a coordinated approach from a range of health professionals, including doctors, psychologists and dietitians.
Despite the challenges of finding appropriate treatment services, Mrs Crossfield, managed to overcome her illness with an eating disorder-focused 12-step program, combined with a holistic lifestyle and yoga, which she now teaches in Wagga.
She is now married and pregnant with her first child, something she thought would never be possible.
Mrs Crossfield said anyone ready for recovery should take the first steps, because the uphill battle of treatment was “worth every second” of life without an eating disorder.
“When I was in those deep, dark moments I never thought I would recover,” she says.
“You forget what it’s like to really live, but once your mind tastes the freedom of life without an eating disorder, you realise what a gift living really is.”
Sufferers and those effected by an eating disorder can seek help from The Butterfly Foundation support line on 1800 33 4673.
Lifeline 13 11 14.
*Not her real name.