This World Mental Health Day comes a week or so on from the good news that the Time to Change initiative has been given an extra £20m in funding from the Department of Health, Comic Relief, and the Big Lottery Fund. Time to Change, a campaign by UK mental health charities Mind and Rethink Mental Illness, aims to tackle stigma around mental health issues, working with schools, employers and local communities to raise awareness around a subject that is still so misunderstood.
At Beat, the UK's eating disorders charity, we welcome this move to challenge the ignorance around mental health issues. After all, we have to work constantly to combat widespread failure to understand that eating disorders are mental illnesses at all. Eating disorders are dismissed as simply vanity, attention-seeking, or lack of self-control, and treated as phases that will pass if they're just left alone. These are dangerous myths that cause shame, isolation, and unnecessarily prolonged suffering for people with eating disorders, and leave those around them, including friends, family, and healthcare providers, ill-equipped to give them the support and treatment they need. These ideas are among the many things that create barriers to early intervention, a life-saving approach to treatment that we at Beat urge and that we're committed to raising awareness about this World Mental Health Day.
Sufferers also face a barrier to treatment in the form of misconceptions about what an eating disorder looks like, an expectation that there will be specific physical signs of a mental health condition. When most people think of eating disorders, they're likely to picture a woman with anorexia, probably young and white, and almost certainly very thin. Anorexia is a serious mental illness, but accounts for only around 10 to 15 percent of diagnosed eating disorders. Eating disorders also include bulimia (eating very large quantities of food in one sitting and then compensating by purging, using laxatives, or excessively exercising), binge eating disorder (eating very large quantities of food in one sitting without the purging associated with bulimia), and other specified feeding or eating disorder (OSFED), the latter of which is often given as a diagnosis when a person's symptoms don't fit the diagnostic criteria for other eating disorders. They can affect anyone, regardless of gender, age, or background. They don't always lead to significant weight loss - people with bulimia often fluctuate within a "normal" weight range, while people with binge eating disorder frequently see their weight increase. And people with anorexia may be suffering for a long time before their weight loss becomes alarming to the people around them.
This is the problem: by the time noticeable physical symptoms manifest, if they do at all, it's likely that the mental illness is already deeply ingrained. Eating disorders cause enormous damage to a sufferer's psyche long before they cause lasting harm to their body, and the more time they go without getting the support they need, the worse the problem becomes. This is why Beat champions early intervention. Treatment should be given as swiftly as possible, offering a greater chance of full recovery; no one should be left untreated until they match an understanding of what an eating disorder looks like that is at best narrow and at worst fundamentally flawed. Yet that's exactly what's happening to people seeking specialist treatment across the UK.
At Beat, we hear from countless people who have sought help, only to be denied treatment because they're not deemed sufficiently underweight. Over the summer, a BBC Freedom of Information request found that a third of the 44 UK health trusts that responded use BMI criteria for treatment, despite the fact that such criteria isn't outlined in any policy or guidelines outline BMI. To someone with an eating disorder, who might have been reluctant to speak to their GP at all and may deny there is a problem, the reason for this delay in treatment is typically heard as "You're not ill enough", which can not only draw out the problem but exacerbate it. Lack of funding for treatment for eating disorders and lack of training for the professionals who are the first port of call for sufferers plays a huge role, but the reliance on solely physical signs to diagnose and gauge the seriousness of a mental health problem cannot continue.
Beat's early intervention initiative aims to tackle the barriers to early treatment from the root causes upwards. The current state of treatment means that many people go through a cycle of partial recovery and relapse, lasting an average of six years. We want to see eating disorders tackled at the onset, or as early as possible, when disordered eating behaviour and the way of thinking that causes it is less entrenched, and when less invasive, less time-consuming treatment is more effective. We need to raise awareness about the early signs of eating disorders, focusing on not on physical symptoms but on thoughts and behaviour, which may include obsessive preoccupation with or secrecy around food, a distorted perception of weight, mood swings and anxiety. We need to stress to GPs the importance of referring to an eating disorders specialist as soon as patients raise a concern, rather than delaying referral until they lose more weight. And we need to equip sufferers with the tools they need to get a positive outcome when they ask for help. By focusing on getting people into treatment as quickly as possible, we hope that we can take an important step towards ending the pain and suffering caused by eating disorders.
For more information about eating disorders, visit www.b-eat.co.uk.