This week is Eating Disorders Awareness Week. For Beat, the UK’s eating disorder charity, that means a focus on shining a light on these serious mental illnesses, raising funds for support services, and asking policymakers to take important steps towards better and faster treatment. With everything we do, we aim to help people into treatment as early as possible after the onset of their illness, as it’s this that gives them the best chance of fully recovering.
But we’re a long way from achieving that aim. Last November, we published research that found an average delay of three-and-a-half years between symptoms emerging and treatment starting. The last six months of this takes place after the person suffering has sought treatment. Lack of funding means that people can be left waiting for beds, sent to treatment facilities hundreds of miles from home, and granted or denied access to treatment based on physical criteria like their Body Mass Index – this is despite clear guidance from NICE that BMI should never be the only factor considered.
With access and waiting times targets in place for young people in England, there is at least some effort to address this part of the wait for some of those suffering, though far more needs to be done. But Beat’s research makes it clear that far more must be done, too, to address the three years before someone seeks treatment. During Eating Disorders Awareness Week, Beat is focusing on this three-year gap, and on how we might close it.
Why the wait? Those suffering from eating disorders aren’t just deciding not to seek help; they’re faced with barriers that make doing so extraordinarily difficult. Almost half of those three years pass before someone suffering from an eating disorder realises that’s what their symptoms point to. Particularly where eating disorders involve restricting food or frequent exercise, the behaviour those suffering feel compelled to carry out may at first be seen as positive, and the nature of these illnesses is secretive. In anorexia, denial that there’s anything wrong is even an expected symptom. Often, eating behaviour in eating disorders feels like a form of control or relief, however temporary; acknowledging that that control mechanism is a serious mental illness is far from easy.
Recognising the illness is only the first step. With eating disorders come feelings of guilt, shame, fear, and low self-esteem, all of which can make people reluctant to tell anyone what they’re going through. Often people talk of feeling that they don’t “deserve” treatment, or that they’re “not ill enough” to be given support for their illness.
Stereotypes and lack of understanding about eating disorders don’t help the situation. Anorexia is often the only eating disorder people have much familiarity with, despite bulimia, binge eating disorder, and the umbrella of “other specified feeding or eating disorder” all being more common. Those suffering are often expected to be young white girls and women, and these perceived typical sufferers dismissed as vain, attention-seeking, and simply striving to imitate what they see in magazines, rather than being treated with compassion. This narrowly defined and widely held notion of what an eating disorder “looks” like and who is likely to get one makes these already secretive illnesses even harder to spot when those suffering don’t fit the expected mould.
It’s clear that many people just don’t know what they should be looking for. In a survey by YouGov of over 2000 people, 34% of respondents couldn’t name a single sign or symptom. Respondents who could list one or more correct symptoms were twice as likely to list “being thin” as any other symptom. 79% of respondents who gave a correct answer couldn’t name a psychological symptom.
This is worrying, because psychological symptoms are among the earliest warning signs, and the earlier someone can get treatment, the better their chance of a full recovery. Physical signs are unlikely to appear until later, by which point the illness has had time to become ingrained and the mindset harder to break free of. “Being thin” is a development that may not happen at all – people of any weight can have an eating disorder, just as people of any age, gender, or background can have an eating disorder. We simply must do more to raise awareness of these highly complex mental illnesses.
So we’re encouraging people to familiarise themselves with the early signs and symptoms of all eating disorders, and asking that, if you recognise these symptoms in yourself or someone you know, you don’t wait to talk about it. Talking about mental health can be hard; talking about eating disorders specifically has its own set of pitfalls and difficulties, but eating disorders don’t go away on their own. If you’re worried about starting the conversation, Beat has produced guidance for both those concerned about themselves and those concerned about someone else.
There is no such thing as “ill enough” – everyone living with an eating disorder, no matter how long they’ve had it, deserves help as soon as possible. If you need help, or you know someone who does, why wait?