Could an early intervention have saved Winehouse?
Last night I saw Amy, the much-hyped Amy Winehouse documentary. I cannot recommend the film highly enough. It is beautifully crafted, poignant, haunting and, perhaps most importantly, fair. But I must confess to not being able to muster my usual “opinionated with a dash of sarcasm” public persona for the post-film panel discussion. In fact, all I could feel was an overwhelming mixture of sadness and anger.
Like millions of people, I relate personally to Amy — in fact, her ability to make everyone feel as though they should have been her best friend was undoubtedly a key component in her charm. Like Amy, I am culturally Jewish and I cling on to a sort of Yiddish sense of humour in the face of misery and adversity, using it both to connect and shield me from the world. Like Amy, I have a penchant for big hair, lashing of eyeliner and tattoos. But perhaps most importantly, like Amy I have endured a long battle with bulimia nervosa.
We discover during the course of the film that Amy told both her parents she was throwing up her food at the age of 15. This was pre-Frank, her debut album, and whilst she was still sporting a curvaceous, bordering-on-chubby physique — the sort of body Katie Hopkins would be quick to criticise. In a voice-over, her mother and father tell us that they did not take her confession seriously. Early footage shows Amy peering into camera lenses and complaining that she looks “ugly”, or shovelling food into her mouth and laughingly describing herself as a “pig”.
In the interim between Frank and Back to Black, Amy begins to lose weight, but still bears the hallmarks of someone battling bulimia; the raw knuckles and bloated face are all too familiar. Her therapist later tells us that it was the ravages of bulimia, combined with excessive alcohol consumption, which put Amy’s heart under strain and caused her sudden death, aged 27.
For a minimum of 12 years, Amy suffered an illness which dominated eight years of mine. What struck me most as I watched the film was that urgency in getting her help was only shown when Amy began to “look” ill - when she was visibly at a very low weight — which, unfortunately, is another thing I relate very personally to.
When I first went to my GP, three years into my illness, and explained that I was making myself sick several times every day, the first thing he did was weigh me. It was declared that I was, according to the BMI chart “not underweight” and therefore “did not qualify” for eating disorder treatment. I left thinking about the women I had seen in magazines, emaciated, child- like figures in white cotton underwear. They were the ones with the real eating disorders, I told myself, who deserved to benefit from the help available.
Contrary to received wisdom, bulimia does not tend to cause weight loss in the same way as anorexia. Initial rapid weight loss is water, after which weight will plateau. B-eats official guidelines state that most people diagnosed with bulimia nervosa are within either a “normal” or slightly overweight BMI. Yet cycles of bingeing, purging, compulsive exercising and starving places strain on the internals, which can lead to heart attack or organ failure.
Bulimia can be every bit as deadly as its more “glamorous” sister, anorexia, yet there is still a stigma surrounding it — after all, it involves an awful lot of vomit, bile and excrement. It’s far more palatable to muse sadly on the prospect of a starving waif that to contemplate a slightly overweight person bent over a toilet bowl.
Early intervention might have saved Amy. We will never know. But with “EDNOS” (“Eating Disorder Not Otherwise Specified” — a combination of symptoms which means a straightforward diagnosis of anorexia or bulimia nervosa cannot be made) now the most common diagnosis of eating disorder in the UK, it’s time GPs treated distress and behaviours as the first criteria for qualifying expedient help. Let’s learn from Amy and disregard the scales when measuring the impact eating disorders can have on those still lucky enough to be alive. THE INDEPENDENT
For a minimum of 12 years, Amy suffered an illness which dominated eight years of mine. What struck me most as I watched the film was that urgency in getting her help was only shown when Amy began to “look” ill - when she was visibly at a very low weight — which, unfortunately, is another thing I relate very personally to.