Health: Anorexia

Lord Giddens Excerpts

Monday 25th February 2013 Lords Chamber

Asked By

[Lord Giddens]

To ask Her Majesty’s Government what steps they are taking to reduce the prevalence of anorexia and other eating disorders.

[Lord Giddens]

My Lords, what a pleasure it is to be able to introduce this debate. I shall start by saying how I got interested in anorexia and other eating disorders some while ago. It happened one Sunday when I got two newspapers—I was feeling flush at the time—and each had a colour supplement. On the front of one colour supplement there was a starving black teenager in Africa, emaciated and on the point of death, suffering from malnutrition. On the front of the other colour supplement there was a starving white teenager in the United States who looked identical in terms of her emaciated frame. It seemed to me that the dynamics of those two things must be completely different. In the first, there was a person dying from traditional starvation: not enough food to go around; in the second, there was someone dying in the middle of probably the first society in world history where there is far too much food to go around.

After that, I started looking fairly intensively at the history of anorexia and other eating disorders, especially bulimia. It is very interesting that there is a history. It goes back some way. We do not know the details, but anorexia seems to have been very uncommon historically and was mainly associated with fasting to death, especially female saints who fasted to death in pursuit of the greater glory of God. Bulimia has some analogues in history, but it was not even named until the 20th century. You can say that anorexia, bulimia and other eating disorders are essentially, in their mass form anyway, illnesses of our time. They started to spread rapidly in the 1960s and from beginnings in the industrial countries they then spread around the world.

As everyone knows, anorexia and bulimia are most frequent among teenage girls, but interestingly there is now a kind of extension through the lifecycle. There are children as young as seven who are already suffering from anorexia symptoms and there are cases of women in their 70s suffering from anorexia and bulimia combined. Male eating disorders have been called the hidden epidemic or silent epidemic. They are not out in the open to the same degree, although there is stigma associated with all forms of eating disorder. The latest stats we have on the UK suggest that one in five children in this country with a serious eating disorder is male, which is a substantial and seemingly growing proportion.

Anorexia may have a physical basis, but this cannot explain the spread of these phenomena. You find an interesting thing in some parts of the world where, in the same society, some people are starving to death from classical starvation in remote regions, and in the affluent cities people are starving from anorexia. It is a global phenomenon. This cannot be explained by physical reasons. Why did it happen?

I think that it is primarily because of the rise of supermarket culture; I do not simply mean the rise supermarkets themselves. Once you have the rise of supermarket culture, you have all forms of food available. You have to choose what to eat, and there is a sense in which everyone has to be on a diet, with a barrage of information about their bodies, their health and so forth. In the case of young women, as we know, they are also bombarded by images of what a desirable body is like. These are powerful images. We now see through the advent of the internet very young children picking up the image of the slim body as the embodiment of attractiveness. These two things come together and, like many other aspects of our culture, they develop an addictive, compulsive character. Anorexia is a compulsive cycle from which there is often no escape without specific medical and other help.

In our society we have a variety of food problems and problems with the relationship between food and the body. Therefore, anorexia and bulimia are the tip of the iceberg in terms of what has become normality. In our society, over 90% of women have been on a diet at some point in their lives. The figure for men is now over 50%. Interestingly, over 60% of women who have no history of weight problems are on a diet, which shows how extensive these characteristics are. We are dealing with a pervasive phenomenon in our society, rooted in a compulsive relationship to food. There is a sense in which, at the other end of the continuum, all of us have to wrestle with what to eat and drink in relation to our health.

Anorexia, as we know, can be treated. Bulimia can be treated but normally demands intensive treatment. About 20% of female anorexics who are diagnosed before the age of 20 die before the age of 40. It is a lethal affliction.

I ask the Minister four sets of questions. First, do the Government have a coherent policy on anorexia and eating disorders? If so, what is it? I found it difficult to locate, having been through the government websites. Do the Government recognise the connections between eating disorders and obesity? One linked factor is binge eating, which is characteristic of bulimia and some forms of obesity; all problems of the body, plainly.

Secondly, what are the Government doing about male eating disorders specifically? These still do not receive the same degree of attention as female eating disorders. One of the main agencies involved in analysing male eating disorders says:

“Nationwide, there is simply a massive deficit in programmes that specialise in men with eating disorders”.

Are the Government taking some steps to address this?

Thirdly, what is the Government’s attitude towards pro-anorexia and pro-bulimia websites? As the Minister doubtless knows, they have proliferated in recent times. They are connected with the social media whereby these ideas become propagated. Essentially, these websites argue that to be extraordinarily slim is a desirable thing, and they do so in a forceful way. The websites themselves can become addictive. There are many precepts and so forth on these websites, but I will mention just one. Supposedly, Kate Moss once said:

“Nothing tastes as good as skinny feels”.

You can see the lethal impact that that might have on a young person who is absorbed into these websites. Is there some way in which the Government can intervene to help control them and the impact they have, especially on young women and, as I have said, increasingly, young men?

Fourthly, what is the Government’s reaction to the case of Laura Willmott which has been extensively debated in newspapers this weekend? She suffered from anorexia and died recently aged 18. She was apparently making good progress under care. When she turned 18 she was treated as an adult and essentially fell through the system. A headline from one of the Sunday papers read:

“At 17 years and 364 days, she is a sick child. At 18 the NHS can watch her die”.

What is the Minister’s reaction to that?