Sarah’s Story

A teen finds support, strength and recovery through the family-based therapy at the MUSC Health Center for Eating Disorders 

At age 18, Sarah B. has overcome a lot. The high school senior has recovered from anorexia nervosa, major depressive disorder (MDD) and generalized anxiety disorder (GAD). Three years ago, she says, “I was suicidal, I wanted to die constantly. I got to the point I was so anorexic, my brain wouldn’t work.”

Today, after years of hard work and treatment, including therapy and medicine, Sarah says, “It’s crazy how far I’ve come. I never thought I’d get here. I don’t feel any depression or suicidal thoughts, and I have minimal anxiety. I love myself now.”

Encouragement & Recovery

As she looks forward to college next fall, Sarah has encouraging words for other young people and their families going through similar challenges.

“Don’t listen to haters or people that tell you you’re ugly – you’re beautiful no matter what. What matters is what’s on the inside.”

“Sarah has made really remarkable progress in recovering from an eating disorder and going from struggling a lot with suicidality, with self-harm and difficulty in managing her emotions – to now being a well-adjusted, future-oriented and motivated 18-year-old,” says Elizabeth Wallis, M.D., director of the Division of Adolescent Medicine and of the MUSC Health Center for Eating Disorders. Sarah and her parents turned to the center when they realized Sarah was suffering from anorexia. As well as treating the child, the center’s team of multidisciplinary professionals provides parents with the skills and tools needed to help their child regain health and maintain recovery.

It's common for an eating disorder to be misunderstood as a lifestyle choice. Yet eating disorders are serious, often fatal illnesses associated with severe changes in eating behaviors along with related thoughts and emotions. Recovery is possible with effective treatments, says Dr. Wallis.

“For families who can’t see the light at the end of the tunnel when it comes to an eating disorder, Sarah is such a wonderful example of what evidence-based treatment, family support and hard work can do in terms of recovery,” says Dr. Wallis. “Sarah is off to college next year and is in such a different headspace than when I met her three years ago.”

How Sarah Did It

“Sarah was not herself, her mood was off, so she was seeing a therapist,” says her mom, Allison. “We suspected she might have an eating disorder, but when we questioned her, she always had a good answer.”

But when Sarah was transferred to MUSC Health after a suicide attempt, Dr. Wallis met with the family and confirmed Sarah had anorexia nervosa. “It was a hard thing to hear,” says Allison. “You don’t know what to do or how to respond. The first initial months are chaos. There are different phases. It’s like riding a scary rollercoaster blindfolded – you know the drop, the going down part is coming, but you have no idea when or which way you’re going. Right when we felt like we were headed in the right direction, she would tank. We had three different hospitalizations, and each time Sarah lost her progress.”

Along with Dr. Wallis, the family credits Sarah’s therapist, Marcella Berman, LISW-CP, with supporting and guiding her through recovery. “Having somebody to talk to and get my emotions out really helped with my anxiety. Marcella made me eat with her. I told her, ‘I don’t like you.’ She said, ‘It doesn’t matter, I’m going to help you.’ That impressed me because she challenged me. I knew she wasn’t going to back down. She saw me at my worst. And now she’s seen me at my best.”

Marcella helped Sarah build a strong relationship with her parents, too – particularly her mom. “Trusting my mom and talking to her has been part of the process,” she says. “My parents would push me to eat and get harsh. I would tell them I was full. They would get stressed and mad if I threw up. They didn’t want me to lose my progress. The way Marcella advises you through it – you have to be aggressive. She and my parents would be aggressive and tell me, ‘You have to eat all your dinner.’ They would sit with me after dinner – this would make me mad. We might watch a show or play a board game together. This was so I wouldn’t throw up.”

Sarah and her family participated in family-based-treatment (FBT), says Dr. Wallis. “This is the most evidence-based treatment for adolescents with eating disorders. The family is a powerful tool in recovery.” The MUSC Health Center for Eating Disorders is the only comprehensive program in the state that offers FBT.

“My parents read books about anorexia and got therapy. I saw that as, ‘Wow, they’re working for me, they’re doing all this for me.’ That helped build the trust. Once I realized they were trying to help me, I was more honest with them.”

During FBT, Sarah says her parents would talk about the things they hoped would change. “Hearing their concerns from them made it mean more. My parents learned tips that would help them help me. They learned to be in control of all the food, so I wouldn’t have to make decisions. My choices were the snacks – I could have any snack I wanted, but I had to eat dinner. I got more control over my food as I got better, so I saw the progress. That really helped me understand. You feel a lot better when you’re eating well. That’s a feeling of happiness.

“To other people going through this – realize your parents want the best for you,” Sarah says.

“It’s been a long journey — I wasn’t prepared for it to be this long,” says mom Allison. “I thought once Sarah started eating, things would get better fast, but it doesn’t work that way.” Sarah started improving last summer, after nearly three years of treatment.

“There’s been huge progress this year,” Allison adds. “To see her plan for college, get her driver’s license, look forward to the future – is everything! I’m so proud and excited to see what her future holds. She overcame this – she can handle anything!”

Looking for the Good

Relying on her faith during her struggles was important to Sarah’s recovery, and she chose a faith-based university to attend in the fall. “It’s important to look for safe spaces where there are people who have the same values as you.”

Journaling also helps. “I journal and look for the good instead of just the bad…for what I’m doing right. It’s hard to think that way, but I try to train my mind. I used to not feel good enough. I used to scroll through my phone and look at women who were anorexic and convince myself that I wasn’t skinny enough. “Now, I write positive messages to myself on my mirror. Those remind me I’ve come so far; I don’t want to go back.”

Sarah is now in remission. “It was hard to get to this spot. There are always setbacks. But now I’m open with my mom. If I’m studying too much, not eating enough, I’ll talk to her. I enjoy my good snacks! I want a piece of cake. It makes me happy to eat junk food.

“You can do it!” she encourages others. “Trust your care team, know your family wants the best for you. It’s a long process. It’s the hardest thing I’ve ever done, but now – I’m alive! I’m happy! You will get there.”

There are several types of eating disorders, including anorexia nervosa, bulimia nervosa, binge-eating disorder and other specified feeding or eating disorders, or OSFED. Symptoms and behaviors that may signal an eating disorder include:

• Lack of appetite or interest in food
• Notable weight loss
• Upset stomach, abdominal pain, or other gastrointestinal issues with no known cause
• “Picky” or limited range of preferred foods that becomes even more limited

To learn more about FBT and other treatments for eating disorders, visit the Center for Eating Disorders or call 843-876-8431.