Eating Disorders: Provision of Care

Baroness Janke Excerpts

Tuesday 4th February 2020 Lords Chamber

[Baroness Janke (LD)]

My Lords, I too am grateful to my noble friend Lady Parminter for the debate today. I will speak particularly about anorexia, a killer disease that frequently affects young girls and women between 14 and 25. That is the area I have had most experience of, although, as other noble Lords have said, anorexia also affects adults.

As other noble Lords have said, anorexia has the highest mortality rate of any psychiatric disorder. The death rate associated with anorexia nervosa is 12 times higher than the rate for all other causes of death for females aged 15 to 24. Yet, as other noble Lords have said, there is much to be grateful for in that there can be a recovery, with enough support and treatment. Research suggests that 46% of anorexia patients fully recover, 33% improve and 20% suffer chronically. I am grateful that my daughter was one of the 46% who recovered.

According to Beat, the eating disorders charity, the average duration of the illness is eight years, but it can become severe and enduring, lasting for many years and having a hugely debilitating effect on the sufferer and their family. Thinking about people at the younger end of that age group, we know that the teenage period is a time of such emotional development as well as physical growth. It is a time of intellectual development and moving into the adult world. For sufferers of anorexia, isolated not only in their body but socially, the illness brings this growth and development to a halt. Cognitive development at this age is of huge importance, as it is often much more difficult to catch up afterwards, even if there is a full recovery. Eight years is the average time it takes to recover. Eight years in the life of a 14 year-old is a lifetime, and a huge loss of a key period in anyone's life.

The disease is sometimes considered not so much a disease as a life choice. There is perhaps a lack of awareness that the obsession with weight and body is so compulsive; that there is an overwhelming fear of gaining weight, and a distorted body image. Sufferers will do anything to get thinner, and the thinner they get, the more they think they need to become even thinner.

Sufferers also change personality. If somebody in your house is suffering from anorexia, you will find that your cheerful, open teenager can become aggressive, abusive, deceitful and manipulative, and an expert in inflicting pain on their loved ones. It is very hard for anyone who has not had first-hand experience of this debilitating and vicious disease to imagine what it is like to have to keep up surveillance and constant care just to keep your precious child alive. It is a deadly disease but, as the noble Lord, Lord Lexden, said, it is often seen as an extension of vanity—the obsession with image and appearance. It is far more complex than that, as other noble Lords have said in the debate.

It is alarming that the January NHS figures show that hospital admissions for eating disorders have risen by 37% across all age groups in the last two years. Hospital admissions are only for those who have to be prevented from starving themselves to death, so this is just the tip of the iceberg. It is a huge issue, and sufferers need intensive support and early intervention. As other noble Lords have said, the sooner they get the treatment they need, the more likely they are to make a full recovery. Prompt access to high-quality treatment and support can prevent people getting to the point where hospital admission is the only course of action that will keep them alive.

I agree with what has already been said: research has been starved of funding. My experience was quite some time ago, but there was very much a feeling that this was not really an illness but the teenage behaviour of adolescent girls, and a failure to recognise the results that could occur when people did not get the care that they needed.

I was interested to hear that research has proposed the idea that there may be a hereditary aspect, for example, and also that people are now looking into a metabolic dimension. As has been said, the relation to obesity is something that appears to be being looked into more. Certain individuals may be much more likely to suffer from anorexia when they experience stress, bullying or very severe pressure. I feel that we need to raise awareness of this as a disease that kills people, not a lifestyle choice, affectation or folly of teenage girls.

I hope that treatment and support will be made available consistently across the country. Whether you survive this disease should not be a matter for a postcode lottery. In my opinion, eating disorders have for many years been a Cinderella service within mental health, which is itself a Cinderella service. I hope, from the information we have had, that the Minister will reassure us that this will not continue to be the case. If not, there will be more and more tragic and unnecessary deaths, as sufferers’ lives continue to be at risk. Again, families and carers live with that risk of death every day. I hope that we are to get assurances from the Minister, as more and more families will be torn apart if there is not very prompt and urgent action to provide support and treatment for people suffering from all eating disorders. However, I make a special plea for anorexia.