Backbench business

Jackie Doyle-Price Excerpts

Thursday 14th February 2013 Westminster Hall

[Caroline Nokes]

My hon. Friend makes an important point about the mortality rates, compared with those for other mental illnesses. In this place, we have made great strides in being far more open and willing to discuss mental illness. This illness is hidden, and has not received priority or generated the attention that it so desperately deserves. It is incumbent on all of us to ensure that the Minister, who I am sure is listening, gets that message loud and clear.

[Jackie Doyle-Price (Thurrock) (Con)]

Whenever we approach a public health concern such as this, one of the biggest things we have to do is educate the public. The media are an important partner in that. Does my hon. Friend agree that the media’s obsession with the cult of celebrity, and the focus on that, is holding us back on a significant public health issue?

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[Caroline Nokes]

The hon. Lady makes exactly the point that I am coming on to: it is critical that when sufferers feel that they can reach out for help and acknowledge that they have a problem, the help is there for them. A delay of six to nine months can be dangerous—or, indeed, fatal.

[Jackie Doyle-Price]

Is my hon. Friend satisfied with the level of knowledge among medical professionals? Is there a job to be done in raising awareness of what they should be doing and of the signs that they should be looking for among sufferers of these disorders?

[Caroline Nokes]

I have been struck by the number of times that relatives of sufferers have contacted me to make the point that their family member was slow to get a diagnosis, or to say that the GP dismissed the eating disorder as nothing more than a teenager being a bit fussy about their food. It is critical to raise awareness, not only among the wider community and the media, but among our general practitioners, because we need these disorders to be identified earlier so that damage to growing bodies, in the instance of young people, does not become permanent.

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[Mr Howarth]

The hon. Lady is correct. I intend to address that issue when I bring my comments to a close, and I will make suggestions for what we need to do.

The consequence of people being treated either by a diabetologist who does not understand eating disorders, or by an eating disorder specialist who does not understand diabetes, is that they can be signposted to an unsuitable service altogether, or unforgivably, they will not be taken seriously when they have a serious problem.

An example I have been told about involved a young woman sufferer who was told that she was too heavy. That is not to say that she was heavy; she was very light, but she did not meet the criteria for being light enough to have an eating disorder, and was consequently told that she did not qualify for any support. The advice that she was given was that she needed to relax about food. Anybody who knows anything about diabetes knows that the relationship diabetics have with their carbohydrate intake is crucial to their well-being, so to say to a diabetic, “Go away and get more relaxed about eating”, could put them in a position where their life is threatened. Subsequently, the young woman concerned had to be admitted as an emergency case to hospital with ketoacidosis, which, had it not been treated quickly enough, would have been fatal. That was somebody who had presented themselves in the health system, looking for help, but was told to go away and get a better relationship with food.

DWED has some aims that I hope Ministers can address, and I shall go through those now. First, it wants to establish the principle, which I strongly support, that no diabetic with an eating disorder should be misdiagnosed or told, “There is nowhere to put you”, which is what is commonly said to them at the moment. That comes back to the point made by the hon. Member for Romsey and Southampton North.

Secondly, for type 1 diabetics with eating disorders—what I have termed as diabulimia—the condition needs to be properly recognised as a serious and complex mental health problem. I do not think that it is controversial for the hon. Lady to refer to it being a mental health problem, because although, in all the cases that she gave, there are serious physical consequences, the springboard often relates to mental health, relationship with body image, and so on.

Thirdly, those who seek treatment should receive the correct treatment with respect and compassion, on the basis of a multidisciplinary approach. In the example that I gave, there was not enough expertise in one specialism to be able to satisfactorily deal with the problem. Such an approach requires the Department actively to promote an understanding of the problem, so that health professionals catch on to what is happening. Protocols probably need to be in place, so that when somebody presents themselves with such a condition, health professionals know what to do.

The only people raising this problem, apart from me in today’s debate, are DWED, who work together with other bodies, such as Diabetes UK. DWED currently exists on an income, in the last financial year, of £9,000, which is not even enough to employ one full-time member of staff. DWED operates on the basis of having previous sufferers who are volunteers, under the co-ordination of Jacqueline Allan, who I mentioned earlier. I do not know whether it is more appropriate for support to come from foundations or the Government, or somebody else. I am not talking about needing hundreds of thousands of pounds, although I am sure that DWED would welcome that, but some way needs to be found to support the one organisation that is campaigning on, and raising and dealing with the problem. Given the importance of its unique role, I hope that the Government can find some support—not only for DWED, but for the issue as it exists across the health service.

Finally, just as it is vital that health professionals take a more multidisciplinary approach to this and other eating disorders, it is equally important that the Government take a more joined-up approach. I could have made the same criticism of the previous Government, and I realise how difficult it is to get a joined-up approach to eating disorders and many other things. However, on medical cases, there needs to be co-operation between different Departments, because a stronger push is required on the issue of body image and how that is dealt with. Perhaps it is not best dealt with by the Department of Health, but at the same time, some of the health issues involved need to be addressed.

[Jackie Doyle-Price]

Perhaps I can put an alternative view to the right hon. Gentleman. In my experience, people do not like being told what to do by the Government. If we acknowledge that the media are among the biggest perpetrators in pushing forward images that we should all aspire to, do we not need a good, populist campaign to educate the public that actually, curves are great?

[Mr Howarth]

The hon. Lady makes a good point. There is this idea of politicians wagging our fingers and saying, “This is what you should do”. For a couple of years in the previous Government, I had the responsibility in the Home Office for drugs policy, and one thing I know is that middle-aged men like me—perhaps I am flattering myself there—are probably the worst people to go into the media and say, “Actually, you should not be taking drugs.” A subtle, sophisticated approach is needed. A lesson from that, which applies equally here, is to provide information to young people so that they know the consequences of what they do. One problem we are dealing with is that people think there is an easy way to lose weight and to get to be the shape that they, or others, think they should be. Action has to be taken smartly, on the basis of real information about consequences, but it still has to be done.

The hon. Lady anticipated my next point, which is the responsibility of people in different industries. There is relentless media hype about what the perfect body shape should be, and the irresponsible attitudes often displayed by the fashion and entertainment industries need to be highlighted. Looking round the room, there might be one or two people who can remember what it was like to be a teenager—[Interruption.] I take that back. Several people around the room well remember what it is like to be a teenager, and one experience that we probably all share, and that every teenager in history has shared, is insecurity. They have not developed into who they are going to be, and they are insecure about everything, including their appearance—as is obvious, I have long since given up worrying about my appearance—the way they present themselves to the world, what it is to be cool, and all those things. A lot of that is dictated by what they read in magazines and see on cable channels—even on mainstream reality television shows.

It is wholly unrealistic for the industries that show those images to say, “Well, that’s a matter for the Government.” They have a responsibility to provide for young people role models that are realistic, that are just like the rest of the world, that show young people that they do not have to look like those images to be an acceptable, successful and attractive member of society. That responsibility is not just for Government or politicians, but for everyone who is in a position to influence how these things are presented to young people in particular, and to society in general. I hope that, as a result of this debate, we can at least move that agenda along a little further.

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[Heather Wheeler (South Derbyshire) (Con)]

I appreciate being called to speak, Mrs Osborne, particularly because I am going to nip off later to the second debate in the main Chamber. I hope that my hon. Friend the Minister will forgive me. It is a pleasure to serve under your chairmanship, Mrs Osborne.

I begin by paying tribute to my hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for securing this very important debate during eating disorders awareness week 2013. She is respected by hon. Members on both sides of the House for her knowledge of this issue. I thank her for the tireless way she is championing an issue that is one of the most pressing and, if the medical profession’s statistics are to be believed, one of the most rapidly growing health issues that the nation faces. Indeed, male admissions to hospital are up by 68% in 10 years.

I also pay tribute to the all-party group on body image, of which my hon. Friend is the chair and which exists to inform the media, the fashion industry and wider society of the complex issues arising from poor body image. Body image is, as reported by the First Steps charity, which works in my constituency of South Derbyshire, one of the most significant causes of disordered eating behaviour. It is heartening that such groups exist and it is evidence that, in some small measure, awareness of the issue is starting to grow. Only a few years ago, the very idea of a group committed to improving body image would have been met with a roll of the eyes and a dismissive comment, yet the reality has always been that women, and now increasingly men, spend fruitless hours examining themselves critically in front of the mirror and obsessing over every lump and bump. They are often driven to self-loathing by what stares back at them.

Poor body image and a media full of unrealistic and unobtainable examples of body shapes that we are told to emulate are undoubted drivers in individuals who go on to develop eating disorders. Many who suffer low self-esteem and poor body image, especially men, go on to suffer serious mental health problems, often manifested in eating disorders and chaotic, dysfunctional and disordered lives, and suffer lifelong unhappiness. Therefore, the focus of the all-party body image group is more than welcome; it is essential and, indeed, it is a weather vane for how attitudes towards such real human issues are changing for the better as awareness of these issues improves.

Eating disorders are a complex issue to discuss in just a few minutes. It is a shame that this debate is not getting the priority that it deserves, perhaps by taking place in the main Chamber, but I am very grateful to the Backbench Business Committee for allowing the debate to be held in Westminster Hall. The number of MPs and, indeed, members of the public here today is testimony to the issue’s importance. Having the debate in the main Chamber would have gone a considerable way towards assuring sufferers that Parliament is at least serious about raising awareness of these issues and the problems that people face.

Of course, not all people with eating disorders come forward to get the help that they need. The most accurate figures of which we are aware are those from the National Institute for Health and Clinical Excellence. They suggest that 1.6 million people in the UK are affected by an eating disorder, of whom about 11% are male. Worryingly, the most vulnerable group are our young people, particularly those between the ages of 14 and 20.

[Jackie Doyle-Price]

Bearing in mind that we have heard from previous speakers in the debate that there is a critical window for intervention to support these people, and given that the incidence of these disorders tends to occur in the mid to late teens, does my hon. Friend think that there is a case for more education of our schools and teaching staff so that they know what signs to look for?

[Heather Wheeler]

Absolutely. I thank my hon. Friend for her intervention; she is absolutely right. We have been debating in the main Chamber what should go on the curriculum for personal, social, health and economic education. Perhaps the Minister can reflect on that in his speech. I apologise to him again for the fact that I will not be here at the end of the debate. I will read his speech in Hansard next week.

It is the case that 1% of the population between the ages of 15 and 30 suffers from anorexia. About 40% of those who suffer never fully recover and 30% suffer the illness in the long term. Official figures show that eating disorders rose by 16% in England from 2011 to 2012. The scale of the problem is therefore hard to ignore.

This subject raises issues pertaining to public health, mental health, nutrition, education and the way in which families are supported in dealing with disordered eating behaviour at an early age. That final point is, for me, the most important one and the one on which I shall focus in the few seconds that I have left. I am referring to how we raise awareness of disordered eating behaviour in such a way and at an early enough stage that recognition and treatment are possible and at a time that predates the long-term physical health problems that eating disorders can cause.

So many who suffer from eating disorders start to experience their troubles as children and adolescents. Many suffer in silence, and in so doing curse their lives, not just with a disordered relationship with food, but by destroying both their physical and their mental health in the process. That will probably affect every aspect of their lives: their career, their relationships and even, sadly, in some cases, their ability to become parents themselves.

The underlying cause of much disordered eating behaviour is a person struggling to cope with anxiety, stress and poor mental health. The cause of that anxiety and stress may be bullying. It may be an escape from abuse or traumatic events. The cause may be a lack of control, bereavement, poor parenting or simply uncertainty over one’s place in the world. However, the cause is undoubtedly psychological. The illness therefore deserves genuine sympathy and understanding, not dismissive attitudes, which compound the problem. Perhaps over time, the disordered eating behaviour may be modified through self-discipline or self-awareness. The sooner someone gets the treatment they need, the more likely they are to make a full recovery.

For the reasons that I have set out, this issue deserves at least equal priority with other physical and mental health problems. We cannot ignore or be indifferent to the obvious consequences of eating disorders. We have only to look at those who so bravely suffer them to see why we as a society must do more to tackle them, and we must start by raising awareness of their existence, their causes and their cures.