When Norwich-based eating disorder charity Beat was founded 30 years ago, anorexia patients were force fed five meals a day to try and make them put on weight.
Now, the conditions are far better understood and treatment options more humane - but as the organisation marked its 30th anniversary its boss admitted that although they had come a long way, the future was "daunting".
Beat started life in 1989 as the first national charity for people with eating disorders with the merger of two local charities, Anorexic Aid and Anorexic Family Aid.
Since then, the charity has grown to become the leading charity for anyone affected by not just anorexia, but also the more common conditions of binge eating disorder, bulimia and other types of eating disorders.
Sarah Middleton, 63, has suffered with anorexia for more than 30 years. Diagnosed in her 20s Ms Middleton, of Barnards Yard, Norwich, said treatment back then was "brutal".
She said: "No one really knew what anorexia was, they all put it down to little rich girls, to be honest, trying to look like models. They hated us, we were put on a ward and there were eight of us in there. We had eight beds and a table in the middle, we'd have to eat five meals and they were big."
Ms Middleton said nothing was known about refeeding syndrome, which can develop when someone who is malnourished begins to eat again after starvation and can be fatal.
"A lot of people died because they ate too much," she said.
"It was horrible."
It is a picture Nancy Pearce OBE, who founded Beat predecessor Anorexic Family Aid in response to a friend's experiences in 1976, recognised.
Speaking as she visited Beat on Tuesday, she said: "Very few people really understood what it was all about, and in many ways I didn't understand it. I think it was something people did not talk about, that they were ashamed of."
Andrew Radford, Beat chief executive, said: "I suspect if you had anorexia then, you were told just to eat. Fortunately those days are largely passed."
But he said that did not mean there were not issues in eating diagnosis treatment. He said although the mental illness side was more fully recognised he said: "We're still in a situation where medical students only get two hours of training on eating disorders."
He said: "Looking back, it looks brilliant how far we've come. Looking forward, it looks daunting."
But both Mr Radford and Mrs Pearce were proud of the steps Beat had taken.
Mr Radford said: "Long before Beat's founding, Nancy was working tirelessly to support people with eating disorders and their families, despite starting with no funding and facing an even greater lack of understanding than exists today. Her compassion and drive continues to inspire and, as the charity she co-founded turns 30, we're delighted to recognise her enormous contribution."
While Mrs Pearce, who was made an OBE in 2007 for her services to mental health, added: "It's like seeing your child excel in ways that you'd never dream of. It's wonderful to see how the charity has grown and developed and spread its reach across the whole of the UK. The information and training it provides is particularly important, empowering and educating not just those suffering but their loved ones and healthcare professionals too. May Beat continue to grow and support the many thousands of people affected across the country."
Ms Middleton said looking forward she wanted to see more personalised treatment and the eradication of using BMI in medicine.
She said: "Everyone is different, and their reasons for being there are completely different."
Today Beat operates a free national helpline that is open 365 days a year, answering thousands of calls, emails and webchat contacts annually from people seeking help.
The charity also trains school staff and parents on how to spot the signs of an eating disorder and where to get help, including training parents in Norfolk.
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