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27 February 2023

James' story: therapy helped me see my eating disorder differently

James case study

James, 29, has struggled with an eating disorder (anorexia) throughout his twenties. Now in recovery after receiving treatment through Cognitive Behavioural Therapy (CBT), James is keen to raise awareness of eating disorders - particularly in men - to let others know that it’s okay to ask for help and to seek the support they deserve.

It’s estimated that around 1.25 million people in the UK have an eating disorder and around 25% of them are male. At Shout, around 3.5% of our text conversations mention eating disorders/body image as an issue.

Stigma can prevent men seeking help, and from his own experiences James feels that a lack of understanding about the prevalence and presentation of eating disorders in men can mean that eating disorders are not identified or treated early enough.

In James' words:


I now show myself compassion and I can recognise and check in with myself when I have thoughts that might not be healthy.

What led to your diagnosis of an eating disorder?

I’ve lived with my anorexia diagnosis for two years now. Initially I had convinced myself I was fine, but when my weight dropped I finally agreed to get the help I deserved. It’s as a result of being in recovery that I now raise awareness of the illness to help others.

For me, it was a slow build up of things throughout my twenties that led to my diagnosis. I’d found a routine I enjoyed after I finished school; going to work, making my own lunches, then going to the gym in the evenings. I lost weight, felt good and my life as an 18-year-old seemed very normal.

But then I was offered a secondment in London, and being away from home and the familiarity of my routine, things began to change. As I began eating all of my meals alone and doing nothing but work and going to the gym, I started to isolate myself from other people.

I didn’t feel comfortable being around anyone else, having people watch what I was (or wasn’t) eating, so I withdrew myself. My work colleagues didn’t really know me, so they didn’t notice much difference, but when I went home after my secondment ended, my family saw that my behaviour had changed.

I kept telling them I was fine; I thought I was. I just wanted to be left alone and the more they told me to eat, the less I wanted to. But I guess that deep down I knew things weren’t okay. I remember at the same time thinking that I just wanted to fade away, to not exist.

However, I pushed those thoughts and feelings down and carried on. There were moments during those months - before my diagnosis - where there was a lot of tension. My family wanted to help but didn’t know what was happening to me; how could they when I didn’t know myself? When you’re malnourished, it plays havoc with your emotions.

Fast-forward to getting an appointment with the GP, and I was told I was severely underweight.

What has helped you in your recovery?

As part of my diagnosis I was told I was entitled to 30 weeks of Cognitive Behavioural Therapy.

It can be hard to explain, but with anorexia you can only start to accept help and get better when you hold your hands up and say: “I need help”. But at the time I was in complete denial.

I’m not sure at what point the therapy started to help, but gradually it just did.


When you start to feed yourself physically with food, and mentally with therapy, you get a better perspective and understanding.

I learned to recognise the voice in my head - the one telling me that my weight needed to be as low as possible for me to be happy - and change it.

When the therapy ended, the hard work on myself really began, but the treatment had given me the tools to do that and what’s more, I wanted to. I now show myself compassion and I can recognise and check in with myself when I have thoughts that might not be healthy.

Therapy helped me see things differently, admit that I did need help and recognise that I never want to be back in that painful place again.


I’m very aware that there are so many people convincing their friends, family - and themselves - that they’re fine. I hope that by talking about my experience, it might help them.

It’s why I’m now extremely passionate about raising awareness of male eating disorders and talking about how to recognise it in friends and colleagues - and in yourself.

What do you want others to know about eating disorders?

Recovery from eating disorders is possible. As a lived experience sufferer, I believe accessing the right treatment early is key.

Taking steps to contact your GP can feel overwhelming at first, but it’s important to seek help. If you’re feeling anxious about reaching out or that you won’t be understood, this leaflet from BEAT can help prepare you.

If you could take anything away from my story, I’d want you to remember the following: “All the advice in the world won’t help, until you are willing to help yourself.”

You can and will get better.

If you are struggling to cope with your mental health, our trained Shout Volunteers are available 24/7. It’s free, confidential and anonymous to text us. If your life is in imminent danger, please call the emergency services on 999.