A student doctor whose studies were waylaid by a severe eating disorder is making her recovery story public. She has also returned to medical school to qualify as a doctor in the hopes of helping others.
Sarah Rav, 22, migrated from Malaysia to Melbourne, Australia, at the age of 7. Detailing her story in a series of videos on IGTV, Sarah said that her eating disorder took root in her late teens and by 2018, it almost took her life.
Sarah believes that certain features of her childhood predisposed her to an eating disorder. As an immigrant, she always felt like an outcast, describing the experience of trying to assimilate with Australian culture as if “wearing a mask” and “pretending” to be something she wasn’t just to fit in.
At 13, Sarah built a collection of high-end fashion photos on her Tumblr account, deciding that she wanted to become a model herself. To achieve her dream, she found her inspiration in skinny high-end models and made her mind to lose some pounds.
The best way to lose weight, she reasoned, was to stop eating.
“I started by skipping lunch,” Sarah said. “My desire to be a model was stronger than my desire for food, so I stuck it out.”
Sarah convinced her parents to sign her up to a modeling agency. She wasn’t booked straight away, and the rejection propelled her weight loss efforts. Eventually, Sarah found herself obsessed with the idea of achieving “perfection” in every other aspect of her life, including her fitness lifestyle.
She thought that “being fit, healthy and an overachiever” defined who she was and that she would be “less worthy of a person and less liked by others” if she didn’t keep these things up.
“I would spend hours researching and reading up on health [and] nutrition tips,” Sarah said. “[T]his knowledge made me extremely regimented in what I ‘could’ and ‘couldn’t’ do [and] eat.”
The teen also forced herself to run “insane distances,” even when her body was breaking down, and even until her feet bled.
“I couldn’t let myself take a day off,” she said.
Sarah reduced her calorie intake to “a ridiculously low number” just because it filled her with a “sense of “accomplishment,” she said. Her typical breakfast during this time was a fat-free, sugar-free yogurt; lunch was a protein bar and a Diet Coke; and dinner comprised lettuce, zucchini, or broccoli and a low-calorie dressing.
Worried parents sent her to a psychologist, but appointments were expensive so she stopped attending. “I didn’t realize the importance of psychotherapy at the time,” she said.
Wishing to eat more but still “look good,” Sarah became interested in weightlifting, but now knows that her punishing regime was a coping mechanism for her anxiety due to the “overwhelming feelings of guilt and shame” if she didn’t hit her so-called fitness goal for the day.
It is a “huge misconception,” she said, that eating disorders are solely motivated by vanity and looks.
By 2018, Sarah’s exercise regime and self-imposed limit of 400 calories per day were taking a dangerous toll. Then 20, she was experiencing fatigue, trouble sleeping, pressure pain when sitting or lying down, and a diminished social life.
“I remember honestly thinking, during that time, ‘I don’t want to do this for the rest of my life,'” she said.
Describing herself as looking “like a zombie,” Sarah faced an intervention. The Dean of her university called her for a discussion; Sarah’s peers and tutors had noticed her radical weight loss and impaired performance and recommended a leave of absence.
Sarah weighed just 30 kilograms (approx. 66 pounds) with a BMI of 10—a healthy BMI for a young woman is between 18 and 25. Her doctor sent her directly to the emergency room. After seeing both medics and psychiatrists, it dawned on Sarah that her eating disorder—anorexia nervosa “restrictive” subtype—was real.
“That week was probably, like, the week where my whole life changed,” she said. “From that point on, I knew I needed to get better.”
Sarah was closely monitored, even being accompanied to the bathroom, but credits the nurses for making her hospital stay bearable.
“They knew that I was coming from a place of hurt and a place of fear,” she said. “That is something that I hope to take with me into the future as a doctor: to treat the patient, not the disease.”
Sarah was discharged with an eating plan and joined a community rehab program, allowing her to manage her recovery with the support of her parents and a psychotherapist. She admitted that regaining weight was difficult, but credits her medical knowledge for being able to accept her body’s healing process.
After reaching a healthy weight, Sarah employed a personal trainer to manage a brand-new strength training regime. “I was relinquishing control in a way that was actually good for me,” she said.
The suicide rate among eating disorder patients, who can suffer severe depression, is 32 times greater than that of the general population. “I’m very, very thankful that I never once considered taking my own life,” Sarah reflected, “but there are many people out there who may be thinking about that.
“When I was diagnosed with my eating disorder, I felt nothing but shame, guilt, and fear of what others would think of me,” she said. “But ever since I opened up about my journey, I have received nothing but positive messages and support.”
Sarah credits her mentor in particular, Dr. Richard J. Brown, for reminding her exactly why she wanted to become a doctor. Now 22, Sarah is back at university and has returned to what she describes as a “normal weight.”
In an emotional letter to her past self and others, Sarah advocated recovery for the following reasons, among others: “You won’t look sick,” “Your hair will grow back,” “You will be full of vigor,” and, perhaps most poignantly, “You will become the person you want to be.”
Today, Sarah has over 1.4 million followers on Instagram and 900,000 followers on TikTok. She also runs a Lifestyle and Productivity Masterclass for other students who may be struggling.
“I had to go through absolute hell before I saw the light,” Sarah said. “And yet, I still consider my battle with anorexia nervosa as a blessing … through sharing my experience, I can save others from going through the hell that I had to endure.”