Eating Disorders

Matt Warman Excerpts

Tuesday 16th October 2018 Westminster Hall

[Matt Warman (Boston and Skegness) (Con)]

I thank you, Sir Roger, and congratulate the hon. Member for Bath (Wera Hobhouse) on securing this important debate. She began, rightly, by saying that eating disorders are about so much more than stigma. It is right that we focus on treatment, because eating disorders—as all of us in the room know—are conditions that are often dismissed initially as girls trying to look like celebrities. They often end with a third of sufferers recovering, but a third of sufferers live with them for the rest of their lives and a third do not make it at all. Those figures are truly shocking and would be shocking for any condition, whether mental or physical.

The stigma arising from eating disorders is not solely about looking slim. It is about the pervasive effect of that eating disorder. It is a condition that quickly stops people being able to function in the way that they would wish to function. It a condition that stops people leaving the house. People end up being stigmatised because they are not behaving as they would like to, not able to fulfil a function within society and, often, not even able to work or go out. The stigma arises because of the condition, and it is the condition on which, clearly, we should focus.

I commend the work that charities such as Beat have done to raise awareness of eating disorders and to ensure that people are not stigmatised; that GPs in particular do not greet people who show up suggesting that they are worried about their attitude to food by saying that it is not a problem and that they might just allow themselves to go away and get better. We need to focus on NHS training but also to acknowledge, as my hon. Friend the Member for Angus (Kirstene Hair) did, that there has been some progress in England, if not sufficient in Scotland yet. However, this is not a party political matter.

We have seen not only some positive work by the NHS and charities, but some of the damaging effects of social media, as the hon. Member for Strangford (Jim Shannon) said. Social media presents a huge opportunity to promote the positive body image that we would all like to see of what being healthy in the 21st century looks like. In reality, at this stage on this front social media does far more harm than good. It is far too easy to scratch the surface of the internet to find images that reinforce deeply negative perceptions of body image, reinforcing behaviours that are profoundly harmful. If social media companies can do a huge amount to take down child abuse images and other images that we as a society decide are profoundly harmful, it is reasonable to ask what more could be done automatically or more rapidly to take down images that all too often end up with people losing or taking their own life.

[John Howell]

My hon. Friend is making a powerful point about social media, but perhaps he needs to go one stage further, to look at the role of the advertising industry and the images that it puts forward, which encourage young people to achieve a fantasy position for themselves and their body image.

[Matt Warman]

I absolutely agree with my hon. Friend and, in fact, that was the point that I was coming on to make next. Clearly, not only do some sites encourage profoundly self-harming behaviour, but the advertising industry puts forward exactly that pervasive image to which he referred. We should look to regulators and Government for action to tackle that in a sensible way that promotes a genuinely healthy lifestyle without promoting unhealthy or unreasonable expectations, but we should not pretend that it is anything other than very difficult. Tackling such issues should not bleed over into not being positive about people who struggle with their weight, who would often like to see a more positive image of people who are larger. None of us wants to see an advertising regulator that ends up prescribing an ideal weight, although we need to prescribe a greater sense of health.

I agree absolutely with what the hon. Member for Bath said about no sensible and properly trained doctor in the modern NHS using BMI alone to assess whether a person has an eating disorder. However, too often it does become the single defining characteristic. Too many doctors have not been provided with all the tools and do not have the services to which they might refer their patients. Too often BMI becomes the measurement of last resort, and it is right for the NHS to seek to tackle that and for this House to do all we can to encourage the Minister and the NHS itself.

The hon. Lady mentioned family therapy. My understanding is that family therapy, in particular for young people and adolescents, is the only clinically proven therapy. It has been shown to make a real difference. It is incredibly intensive in resources and in the pressure on the family and patient, but it works. We should do more to reduce the stigma—to come back to the point of the debate—so that families accept that they might have someone in their midst who needs help not just from the NHS but from them—their family and friends.

As the hon. Lady said, however, it remains the case that eating disorders do not stop when someone is 17 or 18. In all too many cases, triggered by stress, they can emerge or return when a patient gets older. With that in mind, we should commend the work of places such as the Maudsley, which have tried to push family therapy beyond the point where everyone is expected to live at home and to say, for example, that the university setting could be a kind of family that encourages people to get better. What happens when people are older? As I said at the start of my speech, there are of course a number of functioning older adults who need all the help with which we can provide them, and that is about more than antidepressants.

If the Government could do two things, the first would be to encourage social media companies to look more closely at what can be done to tackle those images that go beyond the kind of advertising that my hon. Friend the Member for Henley (John Howell) said we need to look at and go way into a territory that is not healthy for anyone. My second ask, when it comes to funding research and spending some of that £1.4 billion that we are allocating to eating disorders over the coming years, is for the extension of family therapy—the one method that we know works. With the help of science and innovation, we should be looking at whether we can go further with that therapy. The stigma around the condition is a hugely important issue, but we must focus on tackling the illness itself.