It’s blighting the lives of more girls than ever. So why is the NHS failing to help anorexia sufferers?
WHEN they visited their 19-year-old daughter Fiona last weekend, Stephen and Julia Hollings were careful to fill the conversation with the kind of updates familiar to any family, from their labrador’s limp to her sister’s revision.
‘Our time together is precious but we try to make it as normal as possible,’ says Stephen, 55.
Sadly, however, it is anything but — because Fiona is at an eating disorders clinic. After suffering from anorexia for four years, she was so thin by last July that she was being kept alive through a drip in her nose.
Yet even though she was hovering on the brink of death, there was no bed at a specialist clinic available for her.
It took six weeks for a vacancy finally to be found — and it was in Scotland, 400 miles away from the Hollingses’ Buckinghamshire home.
Stephen and Julia have so far travelled 10,000 miles visiting Fiona. ‘We miss her desperately and the distance makes it harder,’ says Stephen.
Our eating disorders treatment system is in crisis — a fact brought into sharp focus by this week’s story of anorexia sufferer Pippa McManus, who committed suicide at the age of 15, five days after being discharged from a psychiatric unit.
An inquest jury agreed her discharge had been poorly planned by Trafford Child and Adolescent Mental Health Services.
The strain on the NHS caused by increased demand (the number of eating disorder sufferers admitted to hospital has risen by more than 40 per cent in the past decade) is compounded by a lack of resources.
Research released recently by the eating disorder charity Beat found that 30 per cent of sufferers are not being referred to mental health services by their GP, despite guidelines stating that patients should ‘receive treatment at the earliest opportunity’.
THOSE who are referred face nationwide searches for space in specialist units. ‘Many eating disorder services are at near-breaking point and some centres have to turn patients away until they are dangerously underweight,’ says the Mail’s Dr Max Pemberton, who works at an eating disorders clinic in London. ‘About 20 per cent of sufferers will die from their illness, yet all too often the NHS fails to take it seriously.’
Julia and Stephen, from High Wycombe, describe Fiona as a bubbly girl who loved pasta and playing netball before she started skipping meals when she was 15.
Although Fiona was referred to her local Child and Adolescent Mental Health Services and given therapy, she learnt, like all sufferers, to be ‘deceitful’, says Stephen, who runs a property business with Julia, with whom he has two other daughters, Emma, 21, and Philippa, 18.
‘She stuffed food into her pockets and got up at 3am to do 1,000 star jumps because she thought we wouldn’t hear her.’
Fiona’s condition deteriorated after she turned 18 in May 2015, as she was no longer eligible for treatment under Child and Adolescent Mental Health Services. Stephen says: ‘We fought for months but were told last April that general therapy was no longer offered. There was a year’s waiting list for eating disorder therapy, by which time Fiona would have been dead. Fiona despaired at not receiving the help she needed and started starving herself in response.’
The Hollingses won’t give their daughter’s weight — experts say that disclosing the weight of anorexia sufferers can encourage other girls to starve themselves. But Stephen says Fiona was, by this stage, ‘skeletal’.
That June, Fiona was sectioned and fed through a nasal drip. Shunted between the general psychiatric ward and the shortstay ward of two Oxford hospitals, she urgently needed specialist eating disorders care.
‘For six weeks there was a real possibility that Fiona would die,’ says Stephen. ‘It was horrific.’
That July, a place finally became available at The Priory Hospital in Glasgow, a private facility for eating disorder sufferers which also treats NHS patients. ‘It was a relief. Fiona was dying in Oxford,’ says Stephen. ‘She was going somewhere she would be understood.’
Fed through a drip for the first two months, Fiona now follows a strict healthy diet and has four hours of therapy a week. Last October a bed in an eating disorders unit became available in Oxford but Stephen believes it was too late to move her: ‘Trust in her carers took a long time to build and is not something we want to put at risk.’
At the age of 15, Laura Munday spent three months in a mental health unit 63 miles from her home because there was no specialist clinic any nearer.
‘It was horrible being so far from my family when I needed them most,’ says Laura, now 19. She developed anorexia at 13 after her mother Sara, 49, went on a diet. ‘I started to think about what I ate for the first time. Turning down food gave me a high.’ Sara, a school nurse married to Paul, 51, a glazier, with whom she also has a son, 25-year-old Dean, says: ‘Laura smashed every plate in the house. I had to tell myself that this wasn’t my daughter and that she needed my unconditional love.’ By 15, Laura was surviving on just half a bowl of cereal a day. ‘Size 6 trousers hung off me. My hair fell out in clumps,’ she says. While the causes of eating disorders are much more complex than a diet taken too far, with genetics and brain structure believed to play a part, some experts believe our social mediafuelled culture of obsession with image has helped to exacerbate the recent rise.
Laura became ‘hooked’ on pictures thin girls posted of themselves on the social networking website Tumblr.
In July 2014 Sara took Laura to her GP. ‘The first doctor we saw simply said she was dehydrated. A second told me to “take her home and feed her — it’s not rocket science”,’ recalls Sara. ‘I came out feeling powerless.’
A third GP referred Laura to Child and Adolescent Mental Health Services, but there was no bed available in an eating disorders unit near Laura’s home in Hazlemere, Bucks.
‘Laura was so poorly I slept on the floor of her bedroom because I thought her heart might stop,’ says Sara. ‘I was so desperate I tried to feed her milkshake through a straw as she slept.’
SO LAuRA was sent to Marlborough House, a child and adolescent mental health unit in Swindon, where she was fed three meals a day. Yet although she gained weight, she says staff showed little understanding of eating disorders.
‘While we were struggling to eat pasta we’d hear them say they had brought their own food in because of the high fat content of our meals,’ says Laura. ‘It made eating ten times worse.’
Sara made the 80-minute journey to see her daughter three times a week after work. ‘Leaving was heartbreaking,’ she says. ‘I’d stop at the motorway services on the way home and cry.’
It wasn’t until Laura — now at university and a healthy size 8 — was 18 and pushed for therapy that she fully recovered.
‘Therapy made me understand my anorexia wasn’t my fault,’ she says. ‘Every sufferer should be offered it.’
A spokesman for Oxford NHS Foundation Trust, responsible for both Fiona and Laura’s care, told the Mail: ‘Sadly, it is sometimes unavoidable for patients and families to have to travel long distances for treatment.
‘Whenever patients have to be placed outside our Trust, we work closely with the other provider to ensure we can offer a local bed at the earliest time.’
Hope Virgo, 26, knew she was
susceptible to anorexia when she sought help last April — only to be told she wasn’t thin enough to receive it.
‘Withholding food started as my way of gaining control,’ says Hope, who developed anorexia at 13 after difficulties with a boyfriend.
By 17 Hope was so frail that a hospital scan revealed her heart could stop beating at any time. She was transferred to an eating disorders unit in Bristol, where she was put on a 2,500calorie-a-day diet and given regular sessions with a psychologist.
‘I learnt how to talk about my feelings there,’ says Hope, whose book about her illness — Stand Tall Little Girl — has just been published.
But Hope relapsed last April, after the death of her grandmother. ‘I arrived at the hospital ten minutes after she had passed away. Skipping meals and exercising for hours helped me deal with my feelings.’
Within a month she had lost a stone and visited her GP. ‘I needed help before my weight dropped further,’ says Hope, who was by then a size 6.
Her GP referred her to the eating disorders unit at Springfield University Hospital in South London. ‘I told them my anorexia history and requested a specialist counsellor,’ says Hope. ‘They said I wasn’t underweight enough.’
South West London and St George’s Mental Health NHS Trust defended their decision, telling the Mail they offer treatment to those with ‘moderate to severe eating disorders’.
Instead, the unit referred Hope for cognitive behavioural therapy, more commonly prescribed for people suffering from anxiety.
‘I didn’t have anxiety,’ she says. ‘I felt suicidal.’ All that stopped her was the thought of leaving family, friends and her boyfriend, who were ultimately left to oversee her recovery.
‘Mum would text to check I’d eaten and friends sat with me at mealtimes,’ says Hope. ‘Their support prevented my relapse, but more treatment should be available.’