Eating Disorder Services: Men

Lord Evans of Rainow Excerpts

Wednesday 1st March 2023 Lords Chamber

[Baroness Parminter]

To ask His Majesty’s Government what steps they are taking to improve men’s access to eating disorder services.

[Lord Evans of Rainow (Con)]

My Lords, we are committed to ensuring that everyone with an eating disorder has access to timely treatment based on clinical need. Under the NHS long-term plan 2023-24, we will invest almost £1 billion extra in community mental health care for adults with severe mental illness, including eating disorders. Since 2016, investment in children’s and young people’s community eating disorder services has risen every year, with an extra £35 million per year from 2021-22.

[Baroness Parminter (LD)]

As the cricketer Freddie Flintoff showed, anyone can get an eating disorder, but there is very little information about the inequalities in access to community-based treatment and treatment outcomes. Can the Minister say when the national clinical audit which was promised this year by NHS England will take place, so that we can get the proper data that we need and give everyone the service and support they need?

[Lord Evans of Rainow (Con)]

The noble Baroness raises a very good point and gives a well-known example. Sadly, many men suffer from this disease, and there are community groups that help men with mental health issues, including Men’s Sheds. When I was serving in another place, I always made a point of seeing the Men’s Sheds in my constituency and they did an outstanding job in so many places. I cannot give a direct answer to her Question, but I have asked for a specific time when I can answer it in full and, once I have that, I will reply.

[Baroness Bull (CB)]

My Lords, the Minister will be aware that the NHS recommends that adult males require, on average, around 2,500 kilocalories a day. Can he therefore explain why the calorie labelling regulations that came into force last year require qualifying businesses to display prominently a statement that adults need around 2,000 kilocalories a day?

--- Later in debate ---

[Lord Evans of Rainow (Con)]

The noble Baroness raises a very good point. Sadly, not all manufacturers have gone along with that last legislation to make it crystal clear, notwithstanding the alcohol industry. Many other industries really need to step up to the plate to make sure it is crystal clear what the calorific intake should be per day.

[Baroness Chisholm of Owlpen (Non-Afl)]

My Lords, I thank the noble Baroness, Lady Parminter, for bringing forward this important Question. We know that boys and men are very unwilling to come forward when there is a problem. What is being done to make schools aware of this problem, and to make teachers aware of how to notice boys who may have a problem with an eating disorder?

[Lord Evans of Rainow (Con)]

I thank my noble friend for that very good point. Eating disorders are serious, life-threatening conditions which can affect people of any age, gender, ethnicity or background. People with eating disorders can face stigma, which can stop them reaching out for help and reaching their true potential. We have committed to offer all state schools and colleges a grant to train a senior mental health lead by 2025, enabling them to introduce effective, whole-school approaches to mental health and well-being. This is backed by £10 million in 2022-23. More than 8,000 schools and colleges, including half of state-funded secondary schools, have taken up the offer so far.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the noble Baroness, Lady Chisholm, suggested that men may be reluctant to see their doctor or seek advice on some health issues, which has been very well researched. One of the puzzles is why the Government seem to have set their face against establishing a men’s health strategy, given that health outcomes for men can be so poor in so many parts of the country. Will the Minister’s department give this further consideration and come forward with proposals to establish such a strategy?

[Lord Evans of Rainow (Con)]

The noble Lord raises a very good point, which I agree with. I will take his excellent question back to the department and come back to him on it. In terms of this Question, a significant number of young people affected are females and a relatively small part are young men, but the whole strategy will encompass all men and women.

[Baroness Manzoor (Con)]

My Lords, as the Minister has just said, around 70% of those affected by eating disorders are girls and women. However, there has also been an increase among young boys and men. Can my noble friend say what relationship boys and men have with their body image and what perception they have of it, in light of their physical and mental health? What specific resources will be dedicated to this issue?

[Lord Evans of Rainow (Con)]

That is another excellent question. Poor body image can affect anyone at any point in their lives. The pressure to achieve an idealised body image has wide-ranging consequences for mental and physical well-being. The growth of social and digital media has increased exposure to images of beauty which are unrealistic and, in some cases, untenable. Body image is recognised as a risk factor for mental health problems and is more commonly identified as a key risk factor for eating disorders and unhealthy eating behaviours. Members with teenage children in their families will know how much time they spend on their mobile devices.

[Lord McDonald of Salford (CB)]

My Lords, the Minister did not answer my noble friend Lady Bull’s question. Calorie labelling talks about a daily intake of 2,000 calories, which is the amount recommended for a woman. For a man, it is 2,500 calories per day. Why is this the case? Will the Minister undertake to change this and make it accurate?

[Lord Evans of Rainow (Con)]

The noble Lord raises a very good point. I apologise to the noble Baroness; I cannot give a specific answer as to why it is 2,000 calories rather than 2,500, but I will ask and come back to her.

[Lord Allan of Hallam (LD)]

My Lords, my noble friend’s Question brought back a memory from my teenage years of being told by a nurse that she would say that I had anorexia but that could not be the case because I was a boy. Fortunately, our understanding has moved on since then and we now recognise that eating disorders can affect everyone, irrespective of gender or age. Does the Minister agree that public health services have a vital role to play in broadening that understanding among the general population? What resources will the Government provide to them for that essential educational work?

[Lord Evans of Rainow (Con)]

The noble Lord raises a very good point. When he and I were young boys, there was not the internet. He shows that this issue did occur before the internet. Under the NHS long-term plan for 2023-24, we will invest almost £1 billion extra funding in community mental health care for adults with severe mental illness, including dietary issues.

[Lord Brooke of Alverthorpe (Lab)]

Is the Minister aware from his previous experience that there are 12-step recovery programmes available for both overeaters and undereaters? Is he aware that there is an all-party parliamentary group advocating and pressing for these to be extended over a wider area? This is particularly because they are free. If so, would he be prepared to meet the group and talk about what such programmes have to offer?

[Lord Evans of Rainow (Con)]

I am most grateful to the noble Lord for that very kind invitation. I would be delighted to attend the APPG.

[Baroness Cumberlege (Con)]

Does my noble friend agree that community pharmacies are able to provide men, and indeed women, with advice on healthy lifestyles, including on diet? Will he urge the Government to introduce in England a properly financed “pharmacy first” service, as in Scotland, which we know works well, so that services such as those provided in Scotland can be provided in England by all pharmacies so that people can have access to them?

--- Later in debate ---

[Lord Evans of Rainow (Con)]

I thank my noble friend for that excellent question. There are over 11,000 community pharmacies in England. All provide advice on healthy living; that is already part of their terms of service. People know and trust their local pharmacies, but people do not always know just what pharmacies are able to do and how skilled pharmacists are in diagnosing minor illnesses. Specifically on “pharmacy first”, we want to go further. We are exploring what more pharmacies could do, learning from the “pharmacy first” approach in Scotland, including enabling the supply of some prescription-only medicines without a prescription.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the focus of the Question, and of some of the Minister’s answers, has understandably been on young people; admittedly, eating disorders frequently start in early years but they are lifelong disorders. They can go away and then flare up again when adverse life events cause them to do so. Following on from my noble friend Lord Brooke’s question, can the Minister say what particular kinds of therapy the Government are planning to invest in—he spoke earlier about investment—and what research they have done into the efficacy of different therapies at different points in people’s lives?

[Lord Evans of Rainow (Con)]

I am most grateful to the noble Baroness for that excellent question. I do not want to mislead the House that this is all about young people. She is right: disorders start in early life but continue through adult life. The Government are taking steps to expand the number of practitioners who can deliver evidence-based psychological interventions intended to treat those with an eating disorder. This includes expanding the number of individual trainees and qualified practitioners who are competent to deliver cognitive behavioural therapy for eating disorders, as well as the Maudsley model of anorexia nervosa therapy in adults.