Struggling with an eating disorder is hard enough at the best of times – but if you live in Northern Ireland and need intensive hospital treatment, you face being separated from friends and family in order to travel hundreds of miles for the care you need.
At a gym in Omagh, Aileen Ui Dhonnghaile is using her hard-won knowledge of anorexia to break down some myths.
“You can control what you eat, but you can’t control what you’re feeling at times,” she tells her audience of personal trainers.
Many of the trainers report working with clients they think might have an eating disorder but not knowing what to do.
Aileen can answer their questions with authority because she has endured her own struggle with anorexia.
But when she became so ill she had to be admitted to hospital, no facility in Northern Ireland could offer the specialist mental and physical care she needed.
She ended up leaving her home and family and travelling to London, hundreds of miles away.
“It was really, really lonely and it was a time in my life when I just went, ‘How did I come to this?'” she says.
“You’re being put in a country you just didn’t know.
“You are trying to recover from an eating disorder and that in itself is a struggle, never mind having the added factor of being away from your family.
“There’s people out there that are really, really struggling with life and can’t access the help that they really, really need.”
Aileen spent more than two years being treated in London and is not an isolated case.
The lack of specialist hospital care is now part of a wider review of eating disorder services provided by the NHS in Northern Ireland.
But Dr Stephen Bergin, of Northern Ireland’s Health and Social Care Board, says the size of the population may work against establishing a specialised service.
“We may lack the critical size to ever develop that, given Northern Ireland’s [population of] 1.8 million,” he says.
“The advice we’ve sought is that you need a population base of, say, five million.
“So would we ever justify an inpatient service? I’m not sure.”
Community-based teams in Northern Ireland do offer psychological therapies, but the number of people seeking help is putting those services under intense pressure.
There is also an issue around getting the condition recognised in the first place.
Student nurse Olivia Ervine realised she had anorexia while at university, but when she sought help she was shocked by a simple lack of understanding.
“I cried a lot after that, because no-one was taking me seriously,” she says.
“For any health professional that is supposed to be trained in this, they should know it’s not to do with food, it’s to do with maybe some emotional trauma you went through, or the unhappiness in your life.
“It’s a very destructive disease, physically, mentally, it’s just absolute torture.”
Olivia ended up getting help through a private clinic, and like Aileen is now making a good recovery.
But if doctors fail to spot there’s a problem, the consequences can be serious.
Pam Nugent lost her son Laurence when he was just 24.
Laurence had lived with bulimia for years, but Pam believes he missed out on the best care and so too are hundreds of others.
“We lived in hell every day, because every day we worried whether our son was going to be alive by night time.
“It can be fatal, it has been fatal, not just my son but lots of people, in different age ranges, not just at 24 years of age, at 30, 40 and 50.
“People need to get the right support, they’re entitled to it, they deserve it. “
Northern Ireland is not the only place in the UK where people find it hard to get speedy access to mental health services.
But having to journey across the Irish Sea for treatment presents those who need intensive care with a dilemma: say goodbye to family and friends to get the help you desperately need, or put your health at risk.