Dear Baroness Bakewell,
Ever since reading your comments on anorexia being narcissistic (by the way it's anorexia nervosa, not anorexia... anorexia refers to appetite loss, anorexia nervosa refers to the anxiety surrounding appetite. Many people experience appetite loss, even in old age, this is why anorexia nervosa is different) I have felt obligated to respond.
I am a person you are describing in your comments. My eating disorder developed in the onset of adolescence, and at age 26, I am still struggling and fighting hard in recovery. I have spent a lengthy period in an inpatient unit, and since then my family has spent thousands of pounds on my outpatient treatment (because NHS support was unavailable). I have lost out on social opportunities, professional opportunities, academically and financially and as someone who is highly driven and motivated all these things HURT. They are also key motivators in my battle for recovery.
I was highly shocked to read a piece on the front page of a national newspaper from someone who not only holds political power, but previously worked as a journalist basing her entire article on conjecture and no reference to facts. The article was entire opinion, and had there been any research she would know that the earliest documented cases of eating disorders date back to Roman times and in the 13th century. Furthermore she highlights that the illness doesn't exist in the developing world/Global South...actually it does. Mental illness is extremely prevalent and depression is predicated to be the biggest world health programme by 2030. As for eating disorders, it's very hard to diagnose something that you cannot see, it's even harder to diagnose something you cannot see and don't understand. Instead you label it with what you do understand. Until recently, being diagnosed with cancer was attached with stigma and having HIV still attracts comment and negativity. One of the issues in the Global South is the lack of trained psychologists (let alone other mental health professionals). A few years back there were just 3 psychologists in the whole of Ethiopia, so yes eating disorders do exist, we just aren't diagnosing them or treating them in the same way as when she was growing up there wasn't the research to explain what the disorder was.
Stigma is extraordinarily dangerous, and when you are in a position of power and place an opinion, which is factually incorrect this ends up misleading and puts the public at enormous risk. It is notoriously difficult for sufferers to admit they need help (often this happens at the point when things have got really bad physically). It is even harder for people to get help when they fear the reaction such as "you're only doing it for attention", "why are you worrying about your weight anyway", "there are bigger issues in the world"...actually people might develop eating disorders for a whole manner of reasons. Abuse and rape are commonly associated as triggers with bulimia and there are not only psychological and sociological reasons for a person to develop an eating disorder; biology plays a role too. In my case, I used my eating disorder to speak up for myself when people or circumstances hurt me, because I didn't have the self confidence to defend myself. There are many others whose disorder has nothing to do with the media, model industry, fashion, make-up and so on, it is merely a coping mechanism for another issue.
One of the things I'm currently experiencing is related to body image as I gain weight to achieve a healthy weight. At a low weight your anxiety levels are heightened, you become more obsessed with food and your next meal (see Minnesota experiment) and a biological drive for survival feeds the eating disorder more. When you have undernourished your body for so long, it can take time to adjust to a greater intake (and needs to be done slowly). Learning to tolerate this is part of recovery. As a gain weight I am learning to adjust to a body, which I haven't had for a number of years. It's a bit like re-learning to walk after breaking a bone in the leg. The above becomes easier if the sufferer receives prompt and early treatment into their illness as the symptoms and behaviours have had less time to embed.
Recovery takes enormous courage, effort and is comprised of many bumps along the way. If eating disorders really were a choice, I would have chosen to give up my eating disorder long ago.
In summary, eating disorders can be caused by all manner of issues. They affect people of all ages and genders, have existed historically and globally and manifest themselves in different forms (anorexia nervosa is the least common of all eating disorders). Whilst sociological factors like the media do contribute, this is not representative of every sufferer and for many the combination of psychological and biological issues are the main root.
I hope anyone reading this will note the references evidencing the argument. Furthermore, as someone in recovery, I really encourage anyone suffering to get help. It isn't a choice, it isn't your fault but you can choose to fight it.
If you think you might be struggling with an eating disorder or know someone who is, then I recommend speaking to your GP or someone you trust.
You can also contact beat's helplines.
Adult Helpline: 0345 634 1414 or email email@example.com
The Beat Adult Helpline is open to anyone over 18.
Youthline: 0345 634 7650 or email firstname.lastname@example.org
The Beat Youthline is open to anyone under 25. Parents, teachers or any concerned adults should call the adult helpline.