Earlier this month Healthplus featured eating disorders and how parents can cope with them. Here, PIPPA NEWCOMBoutlines her own battles with the problem
I AM A 20-year-old sufferer of anorexia, and have already twice been within days of death, according to my doctors. I could yet die.
For me, among the foremost issues around anorexia and bulimia is the lamentable ignorance about anorexia which I have encountered everywhere. There is so little research of the condition here in Ireland. I believe knowledge is power, especially in this illness.
However, so little awareness, indeed so much secrecy, seems to surround eating disorders. I know this from personal experience. Yet those who must deal with it need to be as well informed as possible about it – including the signs, symptoms, secondary effects, and especially treatment of those going through it.
The Healthplusarticle highlighted the lack of hospital beds in Ireland for the treatment of eating disorders. There are three beds available. With an estimated 200,000 sufferers, this strikes me as an appalling failure of the system.
And again, I have personal experience of the consequences. On many occasions since being diagnosed with anorexia nervosa, I have been in need of a hospital bed, having become dangerously ill from lack of nutrition and fluids.
I was just days from death due to dehydration and starvation, with doctors having huge concern for my body’s ability to keep going at such a low weight – at my most critical, my Body Mass Index was less than 13. I desperately needed one of these beds, immediately, and couldn’t get it.
Instead, I was admitted to a general hospital without even the help of a nutritionist: I was simply put on intravenous fluids and given the same meals as ordinary patients. As anyone with any experience in dealing with eating disorders will know, this actually made me worse, as my own mother fed me a nutritional supplement spoonful by spoonful.
Nurses showed a complete lack of empathy and patience.
Another time, in my worst ever condition, I spent several weeks on a general ward in a different hospital, simply under the guidance of a dietitian. It was up to me to stick to the meal plan we devised together and put the weight on.
If I had not done this, I would have been sectioned under the Mental Health Act and fed via a tube: naso-gastric feeding. It was entirely due to my own responsibility and autonomy that I avoided this: I had no professional help.
Between these two hospital stays was a much more lengthy one, of 10 months, in an eating disorders unit, in England. I was admitted there without choice, with a referral from my GP, who felt he had no choice but to send me, given the lack of facilities in this country. I am lucky that we had family members willing to help with the funding: the stay at this private hospital cost £60,000 (€66,800). What are those who do not have this luxury supposed to do? Die?
A huge problem in treating eating disorders is that patients are only considered for treatment when impossibly and dangerously thin, and not before.
This is completely the wrong way to deal with things: the best way to help somebody struggling with food and weight issues is before it gets really bad. The longer someone continues the behaviours, the harder these behaviours are to break and change.
Yet many people I know have been turned away from treatment because they are “not thin enough”. Not anorexic enough. So there’s a level? Yes: your BMI has to be below 17.5 to be diagnosed as anorexic.
But why wait until it gets this low? It is surely better to treat the eating disorder now. Telling someone they are not thin enough inevitably results in the person striving to lose more weight. I have seen it countless times, and have done it myself.
I have learned, through my treatment, that the brain contains a layer of fat, essential for cognition and rational thought. When a person drops below a certain weight, they don’t just lose body fat, essential muscles such as that around the heart and other organs; they also lose this layer of fat.
So they then lose the ability to make decisions. Rational thinking is actually not an option: the person can’t think straight, literally. Therefore, it becomes immensely difficult to help people eat themselves healthy again.
This is the anorexic mindset: perfection. They want to be the perfect anorexic, so telling them they do not need treatment as they are not ill enough gives them licence to go away and get a lot more perfect at being anorexic.
The way healthcare professionals deal with sufferers of eating disorders can have disastrous consequences and cause relapse. Those famous words “You’re not that thin” were said to me to encourage me, and caused an untold worsening in my condition. These exact words were uttered by a psychiatric nurse.
There is immense and immediate need for change. Change especially in two areas.
Firstly, we need beds dedicated to eating disorders. Our present three beds for 200,000 means endless waiting lists and months if not years of waiting.
There is little a doctor can do: the facilities simply do not exist. This causes utter desperation among both patients and families, as the situation becomes critical. Help needs to be immediate: the despair is devastating.
Secondly, there needs to be much more communication and openness surrounding eating disorders: so much of it is shrouded in secrecy. These secrets need to be exposed and dealt with. There are too many people in Ireland suffering for this level of silence to continue.
I believe communication, honesty and sheer awareness are the key to solving the problem, or at least alleviating the suffering of somebody out there.