It’s high time we understood eating disorders as the devastating illness they really are.
Debbie Watson, founder of social enterprise Wednesday’s Child, discusses the crisis in our current management of this complicated mental health issue.
“Imagine walking into a GP surgery, presenting with a broken leg, and being told the severity of the break doesn’t look like it warrants immediate attention.
Imagine dragging yourself back home, questioning yourself as an attention-seeking fraud – despite your agonising pain, and wondering if your treatment priority might arrive when your leg finally starts to weep from a gangrenous wound.
Sure, this sounds completely unfathomable and extreme, but I paint the rather ludicrous picture for a reason.
Today, up and down the UK, in towns of wealth and of hardship, in communities of great healthcare access and those with lesser resource, there will be families and individuals finally plucking up the courage to walk through a GP’s door and discuss their fears about an eating disorder.
It’s a step which should by all accounts be the first in a pathway toward care, treatment and recovery – but the current state of play makes this a mere dream in many cases.
Despite the fact that there are estimated to be anywhere upwards of 1.25 million in the UK suffering from an eating disorder, our current care provision is so under resourced, overwhelmed and in some cases poorly educated, that more and more people are at risk of being turned away into a black hole of no support.
This is not to say our fabulous NHS clinicians are to blame or unwilling, but the extent of the issue around lack of beds, treatment options and swift mental health support, often means those urgently in need are still not deemed ‘sick enough’, or are asked to bide time on a waiting list for a course of cognitive behavioural therapy.
As if this wasn’t already a potential ‘disaster in waiting’ for a person struggling from the mental health illness which has the highest mortality rate of all psychiatric conditions, we then have to consider what impact the GP’s trust in the age-old BMI metric might be causing.
It’s known and well documented that junior doctors have very little specific training around eating disorders symptoms and causal links (mere hours), so many are still basing their initial patient assessment around a very unhelpful BMI measure, which merely aligns a person’s physical stature with a likelihood of being affected by the illness.
Those who know and understand eating disorders however, will shout and scream until we’re blue in the face that ‘eating disorders don’t have a look’, and that they’re not just about ‘thin bodies’ and that they’re certainly not seen and suffered by people only under a particularly unhealthy sounding BMI figure.
Indeed, that’s one of the planet-size societal misconceptions around an eating disorder.
The illness can affect someone in any size body, and a person of any gender, race or age. It cares not who it harms.
As a misconception, that’s just as harmful as being of the view that surely eating disorders are just something that teenage girls go through when they want to be picky about food and have a desire to look like a skinny celebrity.
Eating disorders, plain and simple, kill.
They’re a mental health illness which leads to numerous deaths through either suicide or organ failure and other complications.
So when we fail to understand the needs of a sufferer, to spot signs in a colleague, or to help parents navigate efforts of care, or to teach a GP that that their patient is still extremely sick and in danger, despite a more ‘reasonable BMI’, well, then we miss the opportunity to come charging in and providing lifeline care when it’s so needed.
Why then does all this matter so much to me?
Why is it something that gets my heart racing with a desire to ‘set things straight’ and create positive change in such an under-resourced and poorly perceived area – well, because I’ve been there.
When I say ‘I’ve been there’, I mean I’ve been through 20 years of eating disorder hell, with my brain and body ravaged by an illness which controlled every single thought, behaviour and life outcome.
No, I wasn’t a child that craved looking like a skinny celebrity, and I certainly never set out on a deliberate act of self-destruct.
Instead, as a high achieving, perfectionist, people-pleaser of a young university student, I found myself experiencing a ‘perfect storm’ of life and emotion events, which very rapidly culminated in anorexia nervosa.
My story is not at all unusual, and nor is the complicated and often frustrating experience I’ve had around attempting to access care, feeling limited in my options, and becoming more determined that ‘something needs to change’.
Adult care, in particular, is a huge battle for those with eating disorders, providing few options in between a series of CBT sessions, or a longer-term residential treatment stay (when a bed is available, and if you’re ready and willing to accept your career world must be curtailed).
In the midst of this, thousands upon thousands are trying to navigate their own recovery at home – sometimes with the help of loved ones, sometimes not. And what a great fertile ground this lonely place is for an eating disorder ‘voice’ to continue to have you at its mercy.
It’s for these very reasons that this year I shifted my career focus to create a social enterprise which has been a burning seed in my mind for so very long.
I’ve desperately wanted to be someone who could turn my lived experience – with all the frustrations and the positive encounters – into a recovery-focused not for profit business which could deliver something valuable for sufferers and families who are falling through the cracks (or crying out for more help).
Wednesday’s Child came into being this summer and is now evolving into a trusted community, as well as a provider of wellbeing boxes, recovery programmes, empathy events, and training.
What’s my vision?
Well, as a mere starting point, I’d love Wednesday’s Child to be playing a major part in how eating disorders are perceived, discussed, treated and experienced.
I have some ambitious visions for us as an organisation, and while today we’re slowly gaining traction with our mental health kindness boxes, our supportive suppers and our training for schools, I know that there’s so much more to be realised within Wednesday’s Child’s potential.
I can only urge – hell, implore you, if you do know someone who you suspect to be experiencing an eating disorder, or if you’re slipping on that dangerous path, please please PLEASE, raise your hand and ask for help.
Yes, as I’ve made abundantly clear, the general clinical set-up we have doesn’t make for a great picture right now, but you must get your voice heard, and you must do so fast. Early intervention is everything.
Mental health now rightfully has much more of a platform than it ever did. Let’s make eating disorders a part of this conversation and push time and again for the recognition that eating disorders come in all shapes and sizes, carrying devastating consequences.
Waiting is not an option.”
**If you’d like to talk more about the Wednesday’s Child’s programmes or the organisation’s ambitious goals, email firstname.lastname@example.org