A record number of young people are on waiting lists to receive eating disorder treatment in England. This increase has been driven by the mental and emotional strain brought by the pandemic and the amount of time young people are spending isolated and removed from their support networks. Back in February, doctors warned of a tsunami of eating disorders and this prediction has sadly come to pass.

Reports suggest that between 1.25 and 3.4 million people in the UK are affected by an eating disorder. That range is so massive because of the large number of people who will never seek support for their eating disorders. People may not seek support because they believe their symptoms are not significant enough, or because they are not at a stage where they feel ready to seek help. With so many people in the UK suffering from eating disorders it is likely that you know someone who has struggled with their relationship with food. If you think you don’t, remember that eating disorders are by their very nature incredibly secretive.

Eating disorder services in the UK

Making the decision to seek eating disorder support is a major challenge and, unfortunately, so is actually accessing this support once you have made the decision to seek it. Delaying eating disorder treatment is massively detrimental to the physical and mental health of sufferers at can put their lives at risk; anorexia alone has the highest mortality rate of any psychiatric disorder in adolescence.

‘Services are struggling with soaring demand, fewer beds because of social distancing, and an ongoing shortage of specialist doctors,’ stated Agnes Ayton, chair of the faculty of eating disorders psychiatry at the Royal College of Psychiatrists. ‘The government made an ambitious commitment on waiting times, but the pandemic has set us back years. Urgent action is needed to ensure children and young people with eating disorders get the help they need when they need it.’

Some people with eating disorders have been denied certain treatments due to their BMI not being perceived as low enough. There have been calls to scrap the use of BMI in decision making around eating disorders as it is a potentially harmful metric. Being told you are not light enough to be considered in need of treatment is incredibly harmful to those experiencing disordered thoughts. Weight loss is a symptom of the mental processes of an eating disorder and a person’s weight does not necessarily reflect the extent of the mental distress they are experiencing.

Horror stories have emerged over the years about patients who have been admitted to hospital due to malnourishment not receiving any nutritional or psychiatric support when there. This and the denial of treatment based on ‘not low enough’ BMIs suggest that medical staff need enhanced training on spotting the signs and supporting those with eating disorders within the NHS.

Challenges of meeting demand amidst the pandemic

Demand has been increasing throughout the pandemic and is showing so sign of decreasing. Reports emerged as early as February of this year stating that the proportion of urgent referrals has shot up to 80% from the usual 20%.

According to Beat, ‘there were three times more children and young people waiting for treatment at the end of 2020 than the end of 2019. On our Helpline, demand for our services is also three times higher. We know NHS staff are working tirelessly, but they are being forced to make difficult decisions about who can receive treatment now and who must wait.’

The NHS was struggling to meet the demand for eating disorder car even prior to the pandemic but in some cases the NHS is now ‘referring people to Beat because they simply can’t treat everyone.’

A lot of early-stage eating disorder support involves peer support groups facilitated by a single member of NHS staff or someone from an eating disorder charity such as Beat. Peer support is effective as it means people can hear from others who share and understand their experiences, these groups also mean one member of staff can support a group of people at once. Unfortunately, the pandemic disrupted these group meetings.

Beat has offered chatroom alternatives during the pandemic that feature live moderation on every message – any messages that are potentially triggering to other users (such as specific food mentions) simply don’t send. This is a way for people to talk about their experiences in a safe environment without the risk of anyone encouraging disordered habits.

While the number of young people on waiting lists to be seen for eating disorder support is at a record high, so is the number of people that have been treated. Claire Murdoch, NHS England’s national director for mental health, stated that ‘thanks to additional funding of £79m this year on top of dedicated services already rolled out in every part of the country, the NHS has treated more people with an eating disorder than ever before.’

Social media’s social responsibility

It is impossible to discuss the body image of young people without mentioning social media. It may seem like an cliche but the connection cannot be overstated. Research has shown that high social media use is linked with greater odds of developing an eating disorder. In light of this, social media platforms arguably have a duty of care to their users to protect them from potentially harmful content.

In July, Pinterest banned weight-loss ads and anything referencing BMI in a bid to prioritise users’ ‘emotional and mental health and wellbeing, especially those directly impacted by eating disorders or diet culture or body shaming.’ They are the first social media company to do so and have been working for some time to remove pro-eating disorder content from their platform.

Unfortunately, advertising trends are not all following the patterns of Pinterest:

‘Weight loss brands’ spending on advertising across TV, digital and print formats reached $372 million between January and June 2021, up 89% compared to the same period last year, according to advertising intelligence firm MediaRadar. It reported a 120% increase in year-on-year spending for weight loss ads on Facebook.’

Social media platforms have been working to crack down on content that promotes disordered eating behaviours but it is an ongoing battle. Many young people seek understanding online communities and it is all too easy to fall into this kind of content instead. It is vital that social media sites continue to promote support services and share the numbers of helplines when users search for eating disorder content.

Summary

The number of young people seeking support for eating disorders has skyrocketed during the pandemic, but it is worth noting that the number of people receiving treatment through the NHS has increased too despite the challenges the health service currently faces. Current government treatment targets are noble goals but the demand is far outstripping the capacity for treatment and waiting times are slowly but surely growing longer.

Protecting young people from content that can exacerbate disordered thoughts and encourage disordered behaviours is an important part of the puzzle when it comes to supporting young people suffering from eating disorders.

If you or anyone you know is struggling with an eating disorder, Beat’s confidential support is available 365 days a year.