I didn't think I was skinny enough for eating disorder help
It took Rhi Rennie-Morgan three years to seek help for an eating disorder, because she did not think she was "skinny enough".
Seven years on, she is a peer mentor helping others in the same service that supported her and sees it for the misconception it was.
"The eating disorder is about the thought process, not your weight, and our service doesn't have a BMI criteria or anything," said the 29-year-old.
The specialist eating disorders service (Seds) at Aneurin Bevan health board is expanding to accept self-referrals to increase early intervention.
Staff credit several years of consistent funding for the growth, where same day assessments are made for new referrals and waits for support are as low as four weeks, although not all health boards across Wales have been as fortunate.
Ms Rennie-Morgan developed an eating disorder at 19 and was referred to the service at 22.
She was discharged when she was 25 and, now married with two children, said she succumbed to some eating disorder myths.
"I thought this would be something I would fight with the rest of my life – but that's not true," she said.
Patients often ask her if she finds being around others with an eating disorder triggering.
"I know how hard having an eating disorder is, and I know what my life is like now, and I would take my life today over an eating disorder any day.
"So actually, it doesn't trigger me, because I don't want that – I know how painful and heavy it can be."
Emma-Jayne Hagerty, the clinical lead for the service in south-east Wales, said she saw men and women of all "ages, sizes, shapes and weights" and the "true scale" of the issue was unknown.
"Recent stats say about one in 50 people will have an eating disorder, but I think it's difficult to tell because so many people live with it in secrecy and don't seek help," she said.
She said the service started in 2011, only for people with "high risk" presentation, with lower risk patients supported by community mental health or primary care teams.
But increasing Welsh government funding has allowed them to expand.
"We started off as a team of four in 2011 with about 30 patients and we're now a team of 25 with close to 200 patients – and it's a very small percentage of those that are high risk.
"You don't have to reach that low point to get help. The earlier we can help people, the better."
The staff includes a wide range of specialists but also the more recently recruited support workers with lived experience, either as patient or carer, including Ms Rennie-Morgan.
As the first carer peer support worker for eating disorders anywhere in Wales, Ann Knapman, a former wedding dress designer and seamstress, said she "soaked up any support" she received when her own daughter developed anorexia at university six years ago.
Now 24, her daughter Shauna has been discharged from the Seds team.
"She's doing really well and eating freely. I'm not going to say those thoughts never come up, but she has the skills to cope with them and not act on them any more," she said.
"That's amazing to hear from a mother's perspective, because there were times when you're walking on eggshells in case someone had said something that you knew was going to be acted on."
Ms Knapman, 56, explained even well-intentioned words of support could be misconstrued.
"Someone might say 'you look really well' but unfortunately someone with an eating disorder can hear that in a completely different way."
Ms Rennie-Morgan said the service worked to "build up tools in that person" to better manage triggers, whether those were from loved ones, strangers, or "society's diet culture".
She explained talk of "getting our steps in", T-shirt slogans declaring "calories don't count at Christmas" and even calories on menus could trigger a negative response for someone dealing with an eating disorder.
"It's just about building the tools up in the person to manage it, or upskill themselves to look at a menu, see the calories, but still order what they want, not what the eating disorder wants."
Ms Hagerty acknowledged the service in Aneurin Bevan had been lucky to have consistent funding, and not all services across Wales had been as fortunate.
Referrals in this part of Wales get an immediate response and telephone assessment, with a maximum wait of four weeks to start on early intervention programmes, which are moved around the five boroughs to improve access.
She is also working with the NHS Executive on plans to widen the skills of healthcare staff across Wales, as well as develop an all-Wales model for early intervention.
If you or anyone you know have been affected by any of the themes raised in this article, help and support is available on BBC Action Line.
