I'll wake up at 4 or 5am,
and go for a two hour jog.
I'll go until that voice is satisfied.
Is that voice isn't satisfied, there's no stopping.
It's daybreak in suburban Melbourne,
and Sarah is slipping out early before
her mother knows she's gone.
She's nearly 24 years old,
I can't tell her to do or not to do anything really.
She parks her car a few blocks away
to hide her routine
that sees her push her body to extremes
for up to 4 hours every day.
A routine she's been warned is dangerous.
I'd go to drive to the shops and I'd see her car
and I'd think, why is her car there?
She's not in it.
She's jogging. Somewhere.
SDo despite all of the specialists
telling you you shouldn't exercise,
you still come here and hide your car
and lie to your mum...
Yep.
... so that you can exercise.
Well either way, I'm going to feel guilty.
If I lie to Mum I feel guilty.
If I don't exercise I'll feel guilty.
I try and use things to distract me.
I'lI think of the body that I want.
Skinnier arms, skinnier legs,
a bigger bum, flat stomach, bigger boobs.
Just a pretty face, you know.
To anyone else up early, she looks like
another healthy fitness enthusiast.
But hidden is what's going on inside her head
which is far from healthy.
The guilt starts kicking in.
Those calories are going to turn to fat
if you don't move, you're lazy.
You're disgusting, you're fat.
Look at yourself.
The more you sweat and the harder it is,
you get sort of a kick.
It's like you're high from this exercise.
Several gyms have been so concerned
about her extreme exercise,
she's been told not to come back.
Ironically, she's even had to drop out of her studies
to be a personal trainer
because of ill health.
It sounds sick but allI really care about
is having the body that I want
and being thin
and being accepted by others.
Because, yeah, you look a certain way...
I was always a bigger girl in my eyes.
I've never liked my physical appearance.
The worst time was when I was hospitalised.
I got down to 44 kilos.
There were nurses, there were doctors,
my family was there,
people were in tears, you know,
and the anorexia was so strong
that it was laughing at me, going, 'don't listen to people'.
They told me she was going to die.
So now people say, oh, she's better.
And that's fantastic,
but she's still really sick.
Okay, I'm just going to have what I always have.
In recovery, obviously, you have to eat.
That's when excessive addiction to exercise came in,
because the illness gets you in another way.
It picked something else, and it picked exericse.
Compulsive exercise or exercise addiction
and anorexia - they co-occur quite frequently.
We had a young man who we treated for
muscle dysmorphia.
it's a condition like reverse anorexia.
He had broken his right wrist
and he found it impossible to stop bench pressing
despite excruciating pain.
Because the anixety of not being in the gym
and working out was greater for him
that that physical pain of enduring his broken wrist.
It's been fuelled by internet enabled body image ideals
like fitspo or fitness inspiration -
designed to motivate, but can also add
intense peer pressure.
We call it schematic society -
a society obsessed with the body,
and body image, and shaping the body,
and changing it to make it look like
some impossible ideal that research has shown us
is only getting harder and harder
to obtain.
They're photoshopped,
they're on steroids often if they're men,
and when men and women compare themselves
against these body ideals,
they end up coming on the negative end of that.
So how important is it to you to look
like the women in these magazines?
Very important.
At the risk of your health?
Yeah, even with the risk.
My physical appearance is much
more important than even my own happiness.
So you prefer to look like one of these women,
and be unhappy?
I don't want to admit that, but yeah.
Mum, I'm just going out for a little bit.
Yeah, okay. I'll see you.
Still, Sarah can't stop.
Even with her heightened risk
of osteoporosis and stroke as a result of anorexia,
even the fact that today she's carrying
a painful groin injury.
The complexity of human nature is just staggering.
There's always going to be some people out there
for whom they get into a sitation
where body image or eating or exercise
becomes the sole source of their self-esteem.
That small minority of people
they're walking around with a tendency to
latch on to these kind of things.
Everyone has that in them
where they don't like something.
They'll look in the mirror and go,
I wish my eyes were a bit bigger,
or my lips are small - whatever.
The anorexia or the eating disorder or the illness
has the ability to grab hold of anyone
but some people are just strong enough to flick it away.
I sort of let it grab a very tight hold
and it still hasn't let go.