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Why Eating Disorder Treatment Is Failing Patients in the UK

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Editor's Note

If you live with an eating disorder, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “NEDA” to 741741.

As National Eating Disorders Awareness (NEDA) Week approaches, it’s important to look at the way they are currently treated, which in my opinion has to change.

Hospital admissions for eating disorders in the U.K. have doubled in the last six years – peaking at 13,885 in April 2017.

The result: a terrible shortage of beds for people struggling with eating disorders, and people not getting the help they need until they reach a critically low weight and BMI.

Eating disorder treatment typically has three stages: outpatient care, day patient care, followed by inpatient care (hospital admission). Day patient care is Monday to Friday, morning to evening. Inpatient care is 24 hours a day, seven days a week.

Doctors, campaigners and MPs have warned that the surge in inpatient admissions tells us that outpatient treatment and daycare is not working effectively.

I can relate to this personally. When I look back at my time as an outpatient, I heard things like “you have not lost enough weight to be considered anorexic, but if you carry on then you will be.” I was also told one time that I was not thin enough to be experiencing the chest pain and dizziness I had been, even though the purging behaviors I was constantly involved with would have been potentially causing this regardless of my weight in number form.

These kinds of things should never be said to someone struggling with an eating disorder — it’s like holding up a red flag to a bull. I felt inadequate for not being a “good enough anorexic” and was given a new goal to hit: Admission weight.

Already, there is far too much importance put on the numbers. People living with anorexia nervosa are obsessed with numbers — it’s a big part of the illness — but so too are the doctors. Numbers dictate everything relating to where someone fits within treatment and the level of help they receive.

It’s easy to look at an eating disorder and believe food itself is the issue. It’s not. Eating disorders are a mental illness, the same as any other. The physical food aspect is a response to thoughts and feelings. There needs to be more help and more resources to tackle this side of things early on, with meal support alongside.

As someone goes further down the path of an eating disorder, the harder it is to treat. Their brain literally becomes starved. By that time, the food behaviors have become too ingrained and they are unlikely to respond to outpatient treatment or even daycare.

It’s a vicious cycle. Outpatient treatment isn’t effective and so more people need admission. The rise in admissions leads to a shortage of beds and increasing waiting times. Increased waiting times lead to outpatient treatment happening too late and more hospital admissions.

The only way for this rise in admissions to fall, therefore, is to make changes to outpatient treatment. By that, I mean forgetting about these strict number guidelines against which we base someone’s illness. It’s ironic, really. This only reinforces the anorexic thoughts and behaviors — people with anorexia frequently base their self-worth on numbers.

I also believe doctors need to be more aware of the words they use when treating patients. These words can be more harmful to patients with eating disorders than we perhaps realize.

In short: we need to treat individuals, not numbers on a scale.

There are so many stories of people having to relocate to get effective treatment and to avoid long waiting lists. Sometimes they have to go hundreds of miles away, making it difficult for patients to see their families while receiving treatment which is not going to help aid recovery.

It all comes back to the same point: people living with eating disorders are not receiving the correct treatment until their weight is dangerously low or they are severely unwell. At this point, outpatient treatment is not enough and they will inevitably need inpatient treatment. Or, in some cases, by the time they receive treatment, they are already critically ill and go straight to inpatient care.

Early intervention and care for people — not numbers — is essential for treating this highly complex and sensitive illness.

Something needs to change.

Photo by Zohre Nemati on Unsplash

Originally published: February 19, 2019
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