I read with dismay this morning another article decrying the current state of treatment for people with eating disorders who are being referred on from GP’s. I have pasted a link to the article below:
https://www.theguardian.com/society/2023/mar/22/i-worry-my-young-patients-will-die-uk-eating-disorder-services-not-fit-say-gps
The article states that 60% of GP’s are worried that the patients they refer for treatment for an eating disorder will die before they get the help. As a psychotherapist and I equally scared and raging about this. I have written a long blog on my professional thoughts around current treatments for eating disorders – which are woefully inadequate at best and just plain wrong to the point of making people more unwell – at worst.
Treatment for eating disorders and mental health in general is already massively underfunded, but they way what money there is, is spent is a big part of the problem when it comes to treatment.
Someone with an eating disorder has a complex mental health issue that is likely linked to historical trauma, attachment issues or other serious life experiences that impact on a persons view of self and the world. I have never worked with anyone with an eating issue who didn’t have to work through some very complex issues to understand why they think and feel so negatively about themselves. These issues can take many years to work through fully and when someone comes into my private practice with any kind of eating issue I say to them we could be looking at five years or more in terms of time and money for their treatment.
Within the NHS there is no long term financial planning or thinking. The people in charge go from quarter to quarter demanding everything be done as cheaply as possible and as quickly as possible. This is at the heart of the problem with eating disorder units and the way they ‘treat’ the people in them.
Anxiety and a need to control internal and external environments are at the core of a person with eating issues. The treatments on offer largely focus on how and what the person eats which largely misses the point. People are then told they have to eat more, which triggers the control issues, which triggers the anxiety which then means the psychological defence gets higher and stronger. In other words, the person eats less and tries to take back control more. It is a downward spiral for them from there.
A person with an eating disorder needs time and space to explore their patterns of thought and feeling around themself. They also need time and space to bring forward the core issues that underlie the psychological defence that an eating disorder is. Without this they will struggle to address the core issues and even those who do well initially through the treatment, will likely relapse at some point in the future.
When a person is diagnosed with an =eating disorder they should be enough financial resource for a minimum of five years treatment. They should then be given the time and space to do the work they need to around their disordered thinking around self and others. This takes the focus off the food and onto the self, as a result the relationship with food will change and over time return to something healthy.
If this was offered to people newly diagnosed with an eating disorder I guarantee that 80-90% of people getting this support will be functional and contributing to society again positively within five years. As things are so many people are spending their entire lives incapacitated by the eating disorder because they are not getting the right treatment and support by the mental health professionals around them. Some people are also needlessly losing their lives because they are not getting adequate, care, understanding and support from the mental health professionals around them.
The solution is so simple, so easy, it just needs the people in charge to understand the disorder properly and the people above them to give them the money they need to help people heal. As is it we waste millions of pounds on ineffective treatments that cause more damage than they heal.
Something needs to change soon. I have been saying these things and having the same conversations around eating disorders for nearly twenty years and at some point something has to shift other wise people will continue to lose their lives unnecessarily.