How to stop the tragic rise of eating disorders
AN EPIDEMIC of mental health problems affecting the young is becoming a fullscale public health emergency, with new data showing that more than a million children needed treatment for serious mental health problems in the past year. the data also showed a startling increase in the number of under-18s admitted to hospital with serious eating disorders — a jump of 82 per cent in two years.
As an eating disorders specialist, i have seen first hand the increase in the number of patients being referred to my clinic, as well as those increasingly unwell patients for whom hospital admission is now the only option.
so why has this terribly sad situation developed? i think there are two reasons.
the first is the rise of smartphones and social media. According to a survey conducted in 2021, 58 per cent of children aged from eight to 11 have smartphones — and 89 per cent of uK children aged eight to 17 had their own social media profiles.
We all know that images of models and celebrities in adverts are airbrushed in order to sell products, but increasingly this is also now the case for images posted by individuals, some of whom tweak and alter pictures using filtering and editing apps.
THIS means young children and teens are being bombarded with images that appear to have been taken spontaneously but, in reality, have been manipulated to create impossibly perfect faces and bodies.
No wonder young people feel under increasing pressure to copy these unrealistic images — with the result they are more likely to diet or work out to change their own body shape. in those who are susceptible, often due to underlying psychological and emotional difficulties, this can develop into an eating disorder.
i worked in eating disorders for ten years and many of my young patients told me they’d become obsessed with images they saw online, particularly things such as ‘thigh gaps’ (a space at the top of the thighs) on people’s instagram accounts.
Yet they entirely failed to realise that only a tiny fraction of the population naturally look like this, and that many of the images had been digitally manipulated.
But i think there is a second reason for the rise in eating disorder admissions — and it revolves around who is prioritised for treatment within mental health services.
When i began training, it wasn’t unusual to hear of patients waiting several years to get talking therapies on the Nhs for things such as mild depression.
The response to this was the establishment of the iAPt scheme (improving Access to Psychological therapies).
It was argued that, as well as humanitarian grounds, there was a sound economic argument for providing therapy quickly and effectively for people with depression and anxiety, as it would reduce the cost of incapacity benefit. On the basis of this, cognitive behavioural therapy (CBt) services were rolled out across the country. At the end of the first three years of operation, in 2012, more than one million people had used the service and 45,000 people had come off benefits.
With its success over the years, the scope of iAPt has increased and it now treats a broad range of mental health conditions in adults and even some children and adolescents (as of 2019, it saw one million people a year). unfortunately, it has been a victim of its own success. those with only mild symptoms are seen quickly by specially trained professionals — though they are not doctors or psychologists, which limits the complexity of conditions they can deal with.
And this is where the problems began. While money poured into iAPt services, waiting times for more complex cases, such as eating disorders, lengthened. in the specialist service where i worked, there was, at one point, a twoyear wait for psychotherapy. Yet eating disorders have the highest mortality of any mental illness, and one in five of those with a disorder will die from it. that is a horrendous statistic — yet people are having to wait years in order to get the treatment they need.
this is not to denigrate iAPt services — they do a great job. the real problem is that with the success of iAPt, the Government feels it has nailed the difficulties of accessing psychological therapies, when, in fact, there are still shamefully long waiting lists for those who need help the most.
it is a scandal that clinicians working in services for the most unwell patients are powerless to do anything except watch as they deteriorate to the extent they need hospital admission.
so what can parents do? Find out who your children are following on social media and why; and encourage them to unfollow those people who aren’t portraying real bodies positively.
For parents who are worried their child might already be showing signs of an eating disorder, please feel emboldened to push for referrals to specialist services. if the waiting list is long, try phoning regularly to see if there are cancellations.
it can be difficult to know what to say and how best to proceed, so you can also get support from the eating disorder charity BEAt. Finally, there is an excellent book, Getting Better Bite By Bite by Professor Janet treasure, which can also help.
DO YOU recall how we all became obsessive about Covid mortality rates during the daily TV briefings? So why aren’t we all up in arms about the 300-500 avoidable deaths being caused, according to figures from the Royal College of Emergency Medicine, by the A&E crisis? Why aren’t there daily briefings about this?