Awareness weeks and days are common events taking place throughout the year, Globally and here in the U.K. The intention of such events is to promote awareness, whatever the cause.
This week, in the U.K., is Eating Disorders Awareness Week. The field of disordered eating is one that I have a particular interest in. And this interest has considerably increased post-pandemic following a surge in diagnoses of ED and a realisation that services are failing our young people.
The prevalence of eating disorders in the UK is currently estimated at around 1.25 million people. Note that this is an estimate, as sadly there is not enough research to provide a definitive number, according to Beat (2024). Statistics are based upon research from other Western countries and much of the UK research that is available is out of date.
Anorexia, Bulimia and Binge eating disorder are often highlighted in the media. Other types of disordered eating conditions are OSFED (other specified feeding or eating disorder) and ARFID (avoidant/restrictive food intake disorder). The eating disorder charity, BEAT, are placing the spotlight on ARFID this Awareness Week.
Eating disorders can be devastating and have the highest mortality rate of any psychiatric disorder. Why the lack of research? An inquiry into this was published by the All-Party Parliamentary Group on Eating Disorders (APPG) in 2021 with a report compiled by BEAT. In summary, there is a severe lack of investment for researchers and underfunding in this field of mental disorders creates a vicious cycle that appears difficult to break. A lack of investment also inhibits training and career opportunities and there is very little specialist support. Waiting times are at a crucial high and early intervention is needed to accelerate recovery and save lives. Please click on the following link for the full report.
Three years have now passed since this report and cases have alarmingly increased. Findings suggest that since March 2020, incidence of disorders are 32-42% higher in teenage girls with Beat seeing a 300% increase in calls to its helpline (skynews.com, 2023).
Considering this, young people are being denied treatment and support and to be honest, this is simply not fair. There is also a discrepancy in intervention and treatment between counties in the U.K. Support is not universal and can be seen as a ‘postcode lottery’. Living and working in Worcestershire, I have found that there is no immediacy unless a person is literally at death’s door. And this, sadly, is often too late. A real-life case example follows.
Case example:
Patient: a 17-year-old female that acknowledged they needed help/intervention for Anorexia Nervosa in April 2021, during the Pandemic. This developed after an excessive exercise regime followed by restrictive eating.
After an initial visit to a G.P. it took 3-months for a mental health assessment, which was seen as poor. As the patient was almost 18, they were referred to Adult Mental Health services.
Reviews by the G.P. following this were non-existent and it is now nearing the end of 2021. A parent had to insist on an appointment due to their child being distressed. They were now 18 and having to deal/speak with professionals themselves. After breaking down during a call, which was handled poorly, the parent was allowed to be involved and attended an appointment. This visit indicated that the patient had not been classed as a priority.
In January 2022, details were received relating to online group therapy. This was to begin in February, however, was a non-starter due to ‘staff illnesses’. These sessions were to be coordinated by Mental Health Nurses, who were neither eating disorder specialists nor therapists. No follow-up to this was ever received.
Anorexia and loss of body mass results in menstruation ceasing, which is another symptom that can have long-lasting effects. And in the same month, January, a gynaecological appointment was received. This visit was described as an awful experience, that took place with a senior [male] consultant that had no idea of the cause of Amenorrhea. The patient was prescribed the contraception pill, to ‘kick-start’ monthly periods. This was questioned and has since been proved to be wrong for this patient. Subsequently, this was only taken for a short time. Again, reviews were non-existent.
It is now nearing 12-months since the hunt for treatment began and there was never any indication of a ‘team’ of specialists being assigned, no nutritionist or dietician, no psychotherapist or counsellor and no specialist medical support.
Access to private support was then sought and access to therapy, a nutritionist and women’s health were denied. Primarily due to a lack of specialist support. Unless a person is in crisis, and needing life support, they are not provided support.
In March 2022, it seemed that 1:1 support was to be given and initial information inferred that this was to be of a therapeutic nature. Between March and December, the patient received a total of 7 (50-minute) sessions, and these were with a mental health nurse/practitioner, who appeared to be only concerned with a weigh-in. Despite asking for nutritional support each time, nothing was offered. Sessions were often cancelled and did not run consecutively and did not occur during the summer months. The patient was told in their first session that there were, at that time, only 3, available so-called specialised practitioners in Worcestershire. There were allegedly 6 in total but 3 were on long-term sick leave.
After these 7 individual sessions, this patient was discharged in December 2022 by the Mental Health practitioner. There have been no follow-up appointments to date.
This story is still ongoing, but I can report that this individual is now approaching 21 years of age and is in recovery. Although, recovery has been of her own making with support from family. Resilience, determination and a desire to become well again were important factors in her recovery. However, it has not been without personal impact. Friendships were lost, studying at university and living away from home were difficult. Mum became the nutritionist and devised meal plans and was the go-to for emotional support. Other close family members also played a huge role and are still actively involved.
She is now using her experience to promote awareness and educate others. Social media played a negative role in this story with society’s obsession with thinness, body shape and fitness together with cyber-bullying, which are unhelpful and unwelcome. Now working in the realm of social media, this has become a form of therapy in a way with it enabling a means of advocating and campaigning for others with a similar story. This journey is by no means over, recovery is ongoing. Their hope is that funding and research will eventually reach the levels required to help support young people. They are acutely aware that some do not have informal support and may struggle with self-recovery, therefore early intervention is crucial for all battling with ED.
This case example is given to highlight the poor system that those with eating disorders are facing. I am aware that mental health services for all conditions are in crisis, however, the disservice to our younger generation is simply unfair and lives are at risk. It must be noted that ED’s are not limited to younger people, but onset typically occurs in the teenage years.
Recovery is possible but it cannot be accomplished alone. The Pandemic short-changed the younger population with regards to education, sociability, medical access (current measles rate increase due to MMR vaccinations on hold), increasing health-anxiety to name a few areas. And now, the impact on their lives, whatever the mental health issue, is being ignored. If you look-up health research funding in the U.K., more is being pumped into treatment into Long-Covid than mental health which has considerably less sufferers. It really does beggars belief.
This post is not intended to berate the NHS or mental health services, or to call out individuals for being unsupportive. At the end of the day, analysis will conclude that the lack of funding is at the very heart of this problem. But this problem has become an emergency. As a counsellor, I am finding that young people are crying out for help and desperate for support. Yet, private counselling is not affordable for many, and the NHS does not currently provide external counselling as a means of support for eating disorders. Statistics prove that funding for specialised training is fundamental and with specialist support, early intervention can happen and above all else, recovery is possible.
We all have a connection with young people and so, if you happen to see a social media post that asks for support by means of campaign petitions, try not to scroll past. And if you are wanting services to improve within Worcestershire, why not message your local MP, Mr. Nigel Huddleston. Aptly, he currently holds the Government post of Financial Secretary. If you are not in the Mid-Worcestershire region, you can find your local MP by visiting the Government website.
Change only happens with collective action, and the more of us that get onboard with raising awareness into, and campaigning for, eating disorders, the more likely that young people will get the support that they need and deserve.
References:
Beat Eating Disorders (2024) Prevalence in the U.K., Available at:
https://www.beateatingdisorders.org.uk/about-beat/policy-work/policy-and-best-practice-reports/prevalence-in-the-uk/ (Accessed: 28 February 2024).
Sky News (2024) Eating disorder cases soar since COVID with wealthier teenage girls more likely to be diagnosed, Available at:
https://news.sky.com/story/eating-disorder-cases-soar-since-covid-with-wealthier-teenage-girls-more-likely-to-be-diagnosed-12906649 (Accessed: 28 February 2024).
TOCS 
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