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Watching her two beautiful daughters starve themselves to the brink of death four years apart – victims of the slimming disease anorexia nervosa – a terrified mother feared her own issues with food were to blame.
Teaching assistant Pam McKenna, 47, of Coventry, West Midlands, England, was just 19 when she embarked on a damaging cycle of binge eating and yo-yo dieting, which, despite her slim appearance, has dogged her adult life.
Referring to her own issues as “a non-specific eating disorder," Pam was heartbroken when her eldest girl Jade McKenna was diagnosed with anorexia in 2014, followed by her sister, Amba McKenna, 15, in 2018 – leaving them both just “weeks away from death."
“I can't describe how horrendous it is as a mother to watch not one, but two of your daughters go through anorexia," Pam said. “They both starved themselves to the point where they looked like walking corpses. If they hadn't started eating when they did, they would've died. As a mother, there is nothing worse than wanting to help your children so badly, wanting to make them see sense, but not being able to."
“And you'd think I'd have noticed the warning signs the second time around, but I didn't," Pam continued. “I just thought Amba was going through puberty and losing puppy fat. I suppose I was in denial. I was thinking to myself. 'This can't be anorexia – this can't be happening to our family again.'"
In 2014, Jade's weight plummeted to just 70 lbs and she saw it as “an achievement" when she slid into pair of jeans from when she was 11.
Four years later, in 2018, Amba weighed down to 74 lbs and was so fearful of gaining weight that she was “too scared to drink water."
“I've always been on one fad diet or another since I was about 19. I was stuck in a vicious cycle of binge eating and overindulging and then punishing myself and just eating fruit," Pam said. “I never made myself sick or starved myself, but I'd say I had a non-specific eating disorder."
“My weight's always gone up and down between seven (98 lbs) and nine stone (126 lbs)," she added. “When I look in the mirror, I don't always like what I see – but I've tried to hide the way I feel from my daughters. Only maybe I didn't hide it as well as I thought. I can't help blaming myself or wondering if things had been different and my relationship with food had been better, whether this still would've happened to them."
Luckily Jade has made a full recovery. And although Amba is now maintaining a healthy weight, it is still early days and the risk of her relapsing remains high.
Despite their mother's guilt, her daughters say their closeness to their mom and the unconditional love of their family pet Gizmo are keeping them well.
“I honestly believe Gizmo was the reason Amba got better and got well enough to come back home. She wanted to see him as much as she wanted to see us," Pam says.
Jade, the first daughter to develop the eating disorder, said her problems with food started in 2013 when she began exercising and became obsessed.
“I'd always been a sporty teenager and I cared more about football than what I looked like," Jade said.
“But I felt out of control at university. As a perfectionist I wanted to be in control – and that's where my obsession with exercise and food kicked in," she continued. “In October 2013 when I was 19, I started exercising obsessively – I'd exercise before I went to lectures and when I came home. Alongside this, I began eating less and less. I felt a sense of self-achievement if I didn't eat and still exercised."
“I was under a false illusion that I was fat – but other people started noticing and commenting on how slim I was," she said.
As the pounds started falling away Jade's mental health began to deteriorate. Rather than socializing with other students, she kept herself shut away in her room.
“I was in a bad mood all the time – and I didn't want to hang out with any of my housemates anymore," she said. “I wasn't living, I was just existing."
When Jade returned home for the Christmas holidays, Pam was shocked by her appearance and made her see her family doctor.
“In January I went to see the doctor," Jade explained. “At that point, I was in denial about being ill. I don't think the doctor took me seriously, though, and told me to eat more."
But Pam persisted, taking her back for a second appointment.
At 5.3 ft, weighing around 84 lbs, Jade was referred to the head eating disorder services for Coventry and Warwickshire.
“I was added to the waiting list," she said. “It was about six months before I was seen."
“I went back to university, but I was a shell of myself," she said. “I lost myself – I was still obsessed with exercise and went down to about five stone (70 lbs). I'd clean because I knew it would burn calories, or I'd walk around the town center for no reason."
“I'd try to go for as long as I could without eating, or I'd do things to avoid eating food like burning bread on purpose," she continued.
But when Jade came home on weekends, she would still insist on cooking hearty meals for both her mom and Amba, while making do with a tin of soup herself.
“It must've destroyed my mom having to watch me sip soup, while they ate a wholesome meal which I'd cooked," she said.
In July 2014, Jade finally saw the eating disorder specialist who issued her with a stark ultimatum.
“The doctor told me that unless I started eating properly, I'd be dead within a week."
“It was hard-hitting to hear, but I still had this compulsive sense of achievement."
Jade was admitted to the Aspen Center, an eating disorder facility in Warwick Hospital, the same month and told she would have to spend at least six months there.
“I didn't want to go, but mom practically dragged me there and begged me to stay until I got better," she said. “I remember looking at all the other girls in the clinic and thinking how unwell they all looked."
“It wasn't until someone said to me, 'The way you're looking at the other girls is the same way people are looking at you,' that something clicked," she said.
Determined she was not staying, after one night, Jade met with staff and promised to eat the required amount to reach a healthy weight if she was allowed to do it at home.
“I hadn't been sectioned, so they couldn't keep me in the facility," Jade said. “But they did warn me they'd keep my bed open in case I didn't stick to my promise."
Jade kept her word supported by the clinic and a university counselor.
“Something just changed, and I became determined to reach a healthy weight," she said. “I followed the diet plan they set out for me, and within that year I was back to being a healthy weight."
Despite being shy, Amba had a passion for performing arts, but was being picked on by some of the other children at school and became adamant that losing weight would make her more popular.
“I found it hard to fit in when I first went to secondary school," she said.
“I was called names like 'fat' or 'snake' and it just made to feel really low," she continued. “I wanted to lose weight, because I wanted to try and be pretty like the other girls. At first it wasn't so much about what I looked like but more about fitting in, but losing weight became addictive."
What started in April as simply cutting out chocolate and crisps, by August saw Amba avoiding eating dinner altogether and trying to survive off fruit and the occasional Pot Noodle at school.
“I became obsessed with my looks, I was constantly checking myself in the mirror," she said. “I started looking to see if I could see bones in my face, my arms or the back of my legs."
And by September, Pam knew something was seriously wrong with her youngest daughter.
“Mom tried to make me eat, but I wouldn't," said Amba. “All I'd eat was a chicken salad. By November I'd made myself so ill – I barely had enough energy to get off the sofa."
Desperate for help, Pam took Amba to CAMHS – Child and Adolescent Mental Health Service – who then referred her to University Hospital Coventry & Warwickshire.
“I went to the hospital and was told if I didn't eat, I'd die and would have to be admitted to an eating disorder clinic," Amba said.
“I tried to eat. Part of me wanted to eat, but the other part of me didn't want to put on weight, so I didn't let myself."
In January 2018 Amba was admitted to a specialist eating disorders unit, Newbridge House, in Sutton Coldfield, where she spent four months trying to recover.
“It was hell. I hated being away from mom, Jade and Gizmo," she said. “I forced myself to eat enough so I could put on my target weight of about seven stone (98 lbs) and get out of there."
In May 2018 Amba was allowed home. At a size 6 to 8 (US size 2 to 4), she has maintained a healthy weight and is on the road to recovery, but still struggles around food.
“I'm not completely fine, but I am better," said Amba. “I've come close to relapsing a few times and I don't completely like what I see in the mirror."
“I still think I'm fat – even though everyone says I'm still really slim. I motivate myself to eat what I need to, because I don't want to leave my mom, sister or Gizmo again – I want to get better for them."
“Watching Amba going through anorexia just like I did was heart breaking," Jade said. “It made me realize just how much my mom must've struggled to cope seeing me go through it. I can't even imagine what it would be like to watch not just one person you love so much, but two, almost die. Now we're doing all we can to support Amba, who is doing brilliantly. She's a very brave and special girl."
And Pam is doing all she can to create a safe and comfortable environment for her daughters, where they can share their problems and find support.
“I'm so proud of both Amba and Jade. They're both such strong girls," she said. “Jade is like a mini mom to Amba and I know she'll do whatever she can to help her little sister get through this."
“I know that by supporting each other and with Gizmo's love, we can get through anything."
A spokesperson for BEAT – the UK's leading eating disorder charity – confirmed that there can be a genetic predisposition to these kinds of illnesses.
“People can be at risk when they are exposed to a number of factors, including a genetic predisposition to developing the illness, and environmental factors that act as triggers, such as peer pressure, stress or trauma," she said.
“Anyone, regardless of their age, sex or cultural background, can develop an eating disorder such as anorexia, bulimia, and binge eating disorder," she concluded.
You can find out more at www.beateatingdisorders.org.uk
Jade and Amba have shared their story as part of the Coventry and Warwickshire Year of Wellbeing. To find out more about Jade and Amba's story visit www.bettercarecovwarks.org.uk/year-of-wellbeing-2019