Health: Anorexia

Lord Alderdice Excerpts

Monday 25th February 2013 Lords Chamber

[Lord Alderdice]

My Lords, I express my appreciation for the noble Lord, Lord Giddens, obtaining this debate. I note that there have been a number of debates on this issue; there was a debate recently in Westminster Hall at the other end of the Building. It is something in which I have been interested for some time. It is almost 30 years since I first published a paper on anorexia nervosa. At that stage I was of course interested in the psychological aspects of things: in individual and family therapy, and cognitive behavioural therapy. The papers I was publishing were on zinc, trace elements and gastro-intestinal hormones in anorexia nervosa, trying to see if we could understand a little better this devastating disturbance and the other associated eating disorders to which the noble Lord has referred.

Of course, as the noble Lord rightly says, these disorders did not appear in the past century. In fact, the first description of the disorder was in this city by Doctor Morton in 1689. He described a patient he had treated five years earlier: a young lady who had a disorder if this kind and died after a few months. The name itself was described by William Gull in London in the late 1800s. It is not a recent phenomenon, but it has become much more pervasive.

What is really striking looking back over the past 30 and more years is how little has changed except for the prevalence of the disorder. Most of the ways we have of understanding and treating these disorders have not changed terribly much. We have not really come much closer to understanding in an evidence-based way what we are dealing with. We can see some of the resultant phenomena. I came to the conclusion with gastro-intestinal hormones, for example, that most of what we were seeing, which was not very clear anyway, was probably consequential. It is clear that when a young person’s—or even an older person’s—body weight gets down to a certain level, their capacity to judge their body image changes. They become impervious to any kind of psychological intervention. It is necessary to get their body weight up to a certain level. In the case of young women, their periods start to return and their thinking begins to change. This is not simply a psychological phenomenon. It is not simply a biological phenomenon.

As the noble Lord, Lord Giddens, has also indicated, there are also sociological aspects to this, which we can think and postulate about. I guess we do that a lot in your Lordships’ House. One of the difficulties is trying to ensure that we have research that takes us forward in understanding these things in a scientific way. That is one of the reasons why I was a little disappointed when my honourable friend Tessa Munt asked of another honourable friend, Paul Burstow, who was the Minister in February 2012, what the Government’s guidelines were for the prevention of eating disorders. What targets exist? What is the departmental budget for the prevention of eating disorders? The answer was that there are no specific targets in respect of the prevention of eating disorders. Nor has the department set aside a specific budget.

I find that disappointing because it seems clear to me that after decades, during which a good deal of research has been done, mostly in specific areas—people will take a biological approach or a psychological approach and a few perhaps even will take a sociological approach, although not very many—it is very difficult to get a multidisciplinary research project put together without substantial backing from the Government, a major foundation or whatever. That is why I am a little disappointed that resourcing does not seem to be coming forward from the department. I hope that my noble friend the Minister will be able to say that that is not true and that resourcing is available.

I am disappointed that it has not been possible to put together the kind of multidisciplinary approach to research, a bio-psycho-sociological approach, which might take us a little further forward. As the noble Lord has said, this is a difficult problem to get people out of and to understand. It has proved to be a very difficult problem on which we can make any progress at all. The figures tell us that it is getting worse.