Eating disorders – a growing concern

The news this week that there has been a dramatic rise in the number of people admitted to hospital who have a diagnosis of an eating disorder, combined with a leading ED charity reporting similarly rocketing numbers of calls to their helpline, goes to illustrate a distressing state of affairs in terms of treatment of eating disorders in the UK.

As reported in the Guardian and elsewhere, the number of admissions in the year to April 2017 was 13,885 – a figure which has been steadily increasing for many years. Figures for the under 19s were seen to double, from 1050 to 2025.

Listening to a spokesperson from BEAT Eating Disorders on the radio – we hear that the rising figures are part of a more complex picture. Not entirely about increased prevalence, as increased awareness inevitably leads to more people seeking help. But the fact we are talking about admissions is alarming – because there are also reports that a great many people are being refused referrals for treatment (hence would not be included here). Some people are sadly being turned away by doctors who suggest they are not “ill enough” if their BMI is not below a given figure.

While the physical effects of an eating disorder such as anorexia are of grave concern, and are the reason that it is suggested to have the highest mortality rate of all mental diagnoses, to suggest that someone is only ill when they reach the stage of being dangerously thin, is to misunderstand the nature of the condition. That it is a mental health issue, caused by many factors but often rooted in emotional distress, anxiety and harmful coping behaviours which mutate into something very dangerous and disruptive. The earlier someone’s troubled relationship with eating can be recognised and acknowledged, the easier it is reported to help a person to overcome these harmful behaviours through talking therapies and other support. In an ideal world this could be done before a person’s distress and condition deteriorates to the point now being considered as a threshold for treatment.

If this chart of the South London and Maudsley’s Eating Disorder Clinic Guidelines is anything to go by – Hospital Admission comes only with a BMI of 13.5 and below – where a person’s organs are in danger of failure. Is this the stage being reached by the 13,885 people logged above? Comments on the failure of some GPs to help people seemed to suggest that this also meant that they were not being referred for counselling at the earlier stages as recommended by this chart. And if people are not able to access such help at the earlier stage, it is no surprise that they end up needing hospitalisation further down the line.

Of course behind all of this, and potentially the reason for GPs’ reticence to refer, is the lack of available services, waiting lists for mental health services generally, but also quite specifically the postcode lottery relating to specialist inpatient or outpatient services for eating disorders. There are many deeply distressing stories of people having to travel hundreds of miles to visit their family member – who is often a child or young person. This difficulty can cause significant problems in itself – where to be involved in supporting a child through recovery a parent is unable to work, or where travel costs become simply unaffordable.

As ever, spotting the signs and symptoms of emotional distress at an early stage increases the chance of a good recovery – anxiety or depression may be evident before the eating disorder takes hold. Eating distress can take many forms – and does not always involve someone becoming very thin. Wherever a person’s behaviour becomes obsessive and their relationship with food causes them distress, or interferes with their ability to carry out normal daily activities, or social interactions (such as going for a meal with friends) – it could be problematic in the long run.

More about specific eating disorders can be found on the BEAT website – if you are concerned about a family member or friend, do take a look or call their helpline on 0808 8010677

The Mental Health First Aid two day course helps people to recognise and offer support to people experiencing a variety of mental health issues, including a short section looking at eating disorders.

 

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