Irish Daily Mail

Why I’m so glad The Crown’s dared to show Princess Diana’s bulimia

- Dr MAXTHE Let psychiatri­st Max Pemberton transform your life

EVERYONE has been talking about Netflix’s TV show The Crown in the past few weeks, which is now in its fourth series. I’m totally hooked. It’s like a gripping soap opera — EastEnders but with tiaras and corgis. However, it does also touch upon some very difficult and sad times for the Royal Family.

The latest series covers the 1980s, including Prince Charles’s relationsh­ip with the young Lady Diana Spencer. The misery of their marriage is laid bare for all to see.

It also shows, in graphic detail, Princess Diana’s battle with bulimia. The Royal Family is said to be ‘incredibly uncomforta­ble’ about this and it is said that it could cause the Princes William and Harry to clash after the Sussexes signed a €85 million deal with the broadcaste­r.

But I wonder why they are so angry about this being shown on TV? Would there be as much objection if it was portraying her battling a physical illness, such as cancer?

Would William and Harry really object to cancer being dramatised? I doubt it. To me, this show show there is still so much stigma around mental illness, particular­ly eating disorders. Especially, given how much the Princes have done to publicise mental health issues.

PEOPLEwith eating disorders still face tremendous prejudice. There’s a sense that they are self-indulgent, vain, narcissist­s.

I’ve heard even doctors say they don’t understand why someone can’ t just eat properly. Bulimia, in particular, is dismissed as a silly, frivolous condition.

I have worked with people with bulimia for more than a decade and the reality is truly grim. It ruins people’s lives, as well as their physical health.

One patient was sick so much she developed mouth cancer. Another blinded herself after an eye operation because she was unable to stop vomiting.

I have had several patients die from heart attacks caused by being sick so much.

But these are just the extremes. Most people with bulimia simply live impoverish­ed, tormented lives. Bulimia is typically a cycle of bingeing on food, purging (the medical term for being sick) and then restrictin­g. This pattern dominates everything they do and takes up considerab­le mental energy. What’s interestin­g about bulimia is that there are both physical and psychologi­cal aspects, which make it such a hard illness to beat.

After purging, sufferers are often repulsed by what they have done, and, racked with guilt and shame, then try not to eat the following day to compensate.

Inevitably though, the pattern of bingeing and then purging and restrictin­g causes their blood glucose levels to spike up then down which soon triggers another binge. And so the sorry cycle continues.

But bulimia also has a strong psychologi­cal component, too. People often think it is about food — actually, while it often starts with people trying to lose weight, making themselves sick after indulging, it typically soon changes into something very different. It becomes a strategy to manage feelings.

It is a compulsion similar to drugs or alcohol.

And the tragedy of bulimia, I think, i s that because it becomes the brain’s go-to, it is quickly entrenched as the default coping mechanism when things are difficult or stressful or when people feel overwhelme­d.

This means that they are less likely to develop other, more appropriat­e and effective LIKE coping strategies.

drugs or alcohol, it gives the illusion of helping, when in r eali t y i t makes things worse.

I have had countless patients sit in front of me and look back at their lives, and not know which past mistakes were just down to bad luck in life, or how things might have been different i f they had been able to use a better, effective coping strategy.

Would they have split up from their husband, or would they have got further in their career, for example, if they weren’t reliant on bulimia to cope with stress, but instead had better ways of dealing with it such as therapy?

I t’ s t his question t hat so often haunts people later in life. The good news is that bulimia is very treatable. It’s hard work, but people do get better.

The time though from onset of symptoms and seeking help is, on average, ten years.

This delay is in no small part due to t he s t i gma t hat people with eating disorders experience.

If even one person realises that they aren’t alone and gets help after watching The Crown, the show’s done a sterling job as far as I’m concerned.

I have worked with people with bulimia for more than a decade and the reality is truly grim

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 ?? X LI TF E N : e r u t c i P ?? Hard battle: Emma Corrin as Diana
X LI TF E N : e r u t c i P Hard battle: Emma Corrin as Diana

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