Katie Metcalfe once thought being thin was everything... but as an anorexic she alienated her closest relatives. LISA JEWELL reports

Life would be better if only she could be thinner. Katie Metcalfe lived by that belief for most of her adolescence and it is only now that she can look back and see the reality of the situation.

"It seemed like all my friends and so many celebrities were thinner than me," the 20-year-old explains. "Their lives were good so I thought that if I was thinner, everything would turn out okay. Any problems in my life would go away."

Instead, Katie's life took a turn for the worse when she became anorexic to the point of being dangerously ill. She weighed just under six stone when, at the age of 15, she was hospitalised.

She writes about her personal battle against the disease and the effects it has had on her and her family in a searingly honest book, Anorexia: A Stranger in the Family. In a sense, Katie became the stranger in her family. By her own admission, she was not an easy person to live with during this period.

"My family knew there was something wrong with me but I think they were scared about forcing me to do something because of the way I reacted to confrontation. I was completely oblivious to what was going on."

Her mother Rosemary says it was heartbreaking to see such a change in her daughter. "When we visited Katie in hospital, I'd see this little girl but she wasn't my little girl. I didn't recognise her at all. As a parent, you feel you're there to protect your children but with anorexia, you feel powerless."

Katie, who lives in Teesside, always had a normal body weight. But for her New Year's resolution in 2001, she vowed to become "fitter, healthier and slimmer". However, it would be simplistic to say the resolution was the cause of her anorexia.

Then aged 14, Katie was experiencing a lot of changes in her life. Her family was planning to move house, her parents were going through a rough period in their relationship and Katie also experienced taunts, some based on her appearance, from the boys in her class.

"I suppose I was an easy target for them because I'd always been sensitive," she says. "Little things would devastate me."

Within a matter of weeks, Katie's healthy regime soon turned into an unhealthy obsession with both exercise and food. As she writes in the book: "By March, I had become totally obsessed with food. Food, exercise and my weight were my life and all I could think about . . . It was March when I was adopted by my new best friend: a trusted voice in my head, which told me what I could and couldn't eat and what to do."

This voice led Katie to cut out of her diet anything seen as potentially fattening. Rice cakes and dry cereal soon became the cornerstones of her meal times. Her exercise regime was so extreme she would go on long bicycle rides in all weathers.

As she lost weight, her body began to lose its ability to retain heat. One alarming example of this was when she got scorching red marks on her back from resting up against a radiator for warmth. But Katie found ways to hide her illness from her family, who were growing concerned about her. Her mother took her to the family GP but the anorexia wasn't detected. It wasn't until she began to experience heart problems, as a result of her weight loss, that reality hit home - to everyone except her.

Her perception of her body and the situation she was in were completely altered and removed from reality. "Looking in the mirror, what I saw was hardly human," she says. "I saw blubber and fat. I wasn't the slim person I wanted to be."

She was admitted to hospital and placed on bed rest so that she wouldn't exercise and lose more weight.

"The first few months in hospital were horrible," she says. "Everything I did was watched and I felt my life was being ripped away from me. But then I became friends with some of the nurses there and began to open up to them."

Katie's decision to eat more came after five months of bed rest. "I was so frustrated with having the same routine, day in, day out. I saw that other people were enjoying life and I wasn't. I wanted to be a writer and I couldn't do that, staring into space everyday."

During the time she was ill, Katie says she never understood what her family went through. "It was only when I decided to get well, that I began to see what it was like for them. . . . When I was on bed rest, anorexia was my best friend and all that mattered to me."

Katie's younger sister Penny (18) and one of her two younger brothers, Sam (15), both contribute sections to the book, describing their experiences of Katie's anorexia and how it impacted on them.

Mum Rosemary, who is involved in setting up a support group for relatives of those suffering from anorexia, says her concern now is that Katie's identity isn't forever linked with the illness, as she wants her to move on with her life.

"It was hard to read the book because we don't always want to relive the bad times," she says. "There are certain things that you've forgotten and some things you wish you could forget."

Katie describes herself now as a "recovered anorexic. I no longer hear the voice in my head. I've still got another half a stone of weight to put on. It will take a while because my metabolism is so messed up but I'll get there. I've got a great relationship with food now."

Currently in her second year of studying for A-levels, Katie plans to do a creative writing course at university. She has a renewed sense of optimism about the future.

"I've lost a number of years to this illness and I now try to enjoy every day to its fullness."

'Anorexia: A Stranger in the Family', by Katie Metcalfe, is published by Accent Press.

For information and support regarding eating disorders, contact Bodywhys on Lo-Call 1890 200444 or visit www.bodywhys.ie