Is it the cost of living or an eating disorder?

Rosie Wilkinson (she/her) was diagnosed with anorexia nervosa at 15. Things had been stable for years. But when she moved to Auckland in 2021, everything changed. “It all kicked back up again,” she says.

“After a public therapist told me I was being waitlisted because my ‘BMI wasn’t low enough,’ I had no choice but to go private,” Wilkinson says. “It had been a year – I knew if I didn’t get help soon, something terrible would happen.” That meant forking out $350 a week for private sessions.

Despite having a secure career in data science and earning more than the average 26-year-old, Wilkinson still couldn’t afford the ongoing cost of private treatment. “I had to get out a credit card to pay for my sessions,” she says. “Which I am still trying to pay off.”

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Wilkinson felt backed into a corner. “If I had not gone private, I would have died,” she says.

In addition to private therapy, she was also following a strict meal plan to support weight restoration – an expensive undertaking in itself. All of this while paying rent in a shared Auckland flat and maintaining a professional wardrobe for her corporate job.

“The cost of living 100 per cent triggers me, especially in the grocery store,” Wilkinson says. “I choose lower-calorie, cheaper options to justify my eating behaviours. It’s easily excused because of the cost.”

Despite being weight-restored for 10 months, she still finds recovery difficult. “In recovery, particularly as a woman, you need healthy fats – olive oil, avocados, nuts, seeds, fresh produce, and proteins. That diet is so expensive,” she says. “It’s what everyone should be eating, but no one is.”

Her reality includes sharing a flat with seven others, all of whom are grappling with similar financial limitations. “I hear people say, ‘I guess it’s sleep for dinner’. When you're recovering, that kind of talk is triggering.”

While eating disorders have long affected Aotearoa, the dual pressures of financial hardship and food inflation are intensifying the crisis. In 2020, an estimated 103,000 New Zealanders were living with an eating disorder. By 2022, hospital admissions for children had increased by 168 percent, with many missing out on critical care. A 2024 Ministry of Health briefing reported that eating disorder services remain under intense pressure.

Now, as food prices soar, demand for food parcel services has reached historic highs. The New Zealand Food Network reported a 45 percent increase in demand for food support last year alone – an 83 percent rise since 2021.

New data shows New Zealand has one of the highest rates of food poverty in the developed world. Around 6.5 percent of students report missing meals more than four times a week, with Māori and Pasifika communities disproportionately affected.

Dr Eve Hermansson-Webb, a senior clinical psychologist at Eating Disorder Therapy Aotearoa, says the link between food insecurity and disordered eating is undeniable.

“The foundation of recovery from eating disorders is access to regular, adequate, reliable nutrition. It’s a major barrier to full recovery if you can't afford that.”

Hermansson-Webb says food insecurity can worsen behaviours in those already struggling and even trigger new eating disorders in vulnerable people.

“One of the biggest risks people aren’t aware of is the feast-or-famine cycle. People skip meals when money is tight, and when payday comes, they binge. That’s a common path to binge eating disorders.”

Recent research from the University of Auckland found a rise in eating disorders among Māori, who also face higher rates of food insecurity. The study highlights the urgent need for culturally appropriate care models in Aotearoa.

Eating disorders don’t discriminate, but recovery is a privilege. Those who can afford private care, a diverse range of nutrient-rich foods, and time off work for treatment have a much better shot at healing. For others, recovery is practically inaccessible.

The current state of the world – marked by economic uncertainty, the long tail of COVID-19, and the pervasive influence of social media – is fertile ground for disordered eating, says Hermansson.

“Even before the pandemic, we saw rates of eating disorders rise from 3.5 percent in the early 2000s to 7.8 percent in the late 2010s. That’s a dramatic increase. It’s likely even higher now.”

At the core, eating disorders are maladaptive coping mechanisms, she says. “It’s a way to deal with trauma, low self-worth, stress, or instability.”

She also points to society’s obsession with “clean eating” and restrictive diets.

“In my view, any diet is disordered. The healthiest relationship you can have with food is intuitive eating – responding to hunger cues, eating with balance, without guilt or shame.”

Billy Blamires (they/them), 21, also finds the cost-of-living crisis dangerously compatible with their eating disorder. “The problem is, it gives the perfect excuse not to eat–and no one questions it,” they explain. “When I was recovering, I didn’t even know what a normal amount of food looked like. Now, I do, but I can’t afford to eat that way,” they say.

“No one can afford the food they need to be healthy, functioning, human beings – let alone someone who needs more because they are underweight.”

Like Wilkinson, Blamires was told by the public system that they weren’t “sick enough” for treatment, forcing them into costly private care.

“To recover, your brain and body need consistent nourishment. This crisis doesn’t allow that.”

Where to get help:

If it is an emergency and you feel like you or someone else is at risk, call 111.

EDANZ: Find support, information and treatment options online, call the helpline 0800 2 EDANZ / 0800 2 33269, fill in the contact form, or email info@ed.org.nz

1737: Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

OUTline: 0800 OUTLINE (0800 688 5463) every evening, 6pm to 9pm.

Rainbow Youth: (09) 376 4155

Depression Helpline: 0800 111 757 (24/7)

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz