Eating Disorders

I requested the debate because in the city of Norwich there are two eating disorders associations. There is first the Norfolk Eating Disorders Association, which spends a lot of time consulting and counselling people in its open surgeries. It is full not only of patients and people who are suffering but of carers, who have a major problem as well. Families and friends come independently and get advice and so on from the association, which is fanning out into Yarmouth and other parts of the county. The other major eating disorders association is the national one, which represents those with problems across the country and has a phone line system, counselling and so on. It has recently changed its name from the Eating Disorders Association to ““beat””. I remember the meeting in which we said, ““Stop being negative about disorders. Let’s get after it and do something about it.”” That is why I am here—to urge the Minister to consider the problem and what we can do about it. Some harrowing pictures have been produced of individuals who have lost weight and had problems with eating. I do not want to discuss them too much, because the problem is not just about the physical body. There are also mental problems for individuals who use food as a comfort in trying to tackle their daily problems. It controls one aspect of their lives if they use food to try to cope with the emotional difficulties that they are going through. There may be several causes of eating disorders—we just do not know. One thing written in the National Institute for Health and Clinical Excellence guidelines, which I will discuss, is that more research needs to be done. I hope that the Government will respond to that. Eating disorders primarily affect young women aged 18 to 25, but of course not always. They also affect older women, and an increasing number of men are afflicted by anorexia nervosa or bulimia nervosa. There are cross-governmental issues that we need to consider to get a whole-society approach to the problem. Low esteem among our young people is often a problem, and reports from various organisations and UNICEF studies have put Britain at the bottom of league tables. We can argue about the figures until the cows come home, but we know that they can be better. That is the message that we have all received. There are a lot of unhappy young people out there—as well as old people in here—and for many of them that sadly leads to the problems in question. We must link the issue with balanced school meals and sport activities so that young people can get some esteem and pride in what they are doing. There is nothing like running around and getting a few endomorphines in the body to feel better and healthy instead of continually having to worry about weight. The media have a lot to answer for. The problems came into the public radar in the ‘90s when Kate Moss and co. introduced to the wider media the phenomenon of ““heroin chic””. Today we have Posh Spice and Nicole Richie, who my researchers tell me is Lionel Richie’s daughter—I cannot keep up with it myself. She evidently sells the ““size zero”” phenomenon, and the debate arises from such celebrities. Magazines are filled with pictures of skinny bodies, and they are on the bottom shelves. One does not have to go very far down the road from here, to Westminster station, to see magazines such as Zoo and Nuts, which hit esteem on two important levels. They treat women as objects, with no worth, and they feature page after page of unrealistic bodies, semi-naked—so I am told; I do not know myself, of course. We know the type of imagery that is used. There are also lads’ mags and papers with similar content. The media influence how people feel they should look. There is increasing incidence of eating disorders among men. Men can and, I am told, should, look good, live up to the Adonis-style body image—I do not mean the Minister of that name—purchase beauty products and so on. We must ensure that the resources and treatments that we get for tackling eating disorders are relevant to both male and female patients. Family upheavals also play a part in developing low esteem and affecting a person’s state of mind. Eating disorders are serious illnesses and need to be treated as such. To take patients and put them in psychiatric wards, as happens to some young people, is the worst thing that can happen. I had a meeting on Saturday in the Forest of Arden with cancer consultants and asked them, ““What would you do? Would you know what to look at?”” They said, ““Well, not really, we are cancer experts, but we think that the worst thing in the world would be to stick young people with this problem into a psychiatric ward.”” Sadly there are a lot of a cases in which that happens. The people affected need special psychological treatment, help and support, so we must stop the habit of dumping the problem somewhere else. The NICE guidelines reflect that and are highly praised by the charities to which I have spoken. They cover getting help early, getting good information about the illness to the patient and their family, giving access to counsellors and self-help groups, including for families, and recognising that patients may be ambivalent towards their treatment but that they persevere anyway and should be encouraged to do so. Psychological interventions such as group therapy and cognitive behavioural therapy should be made available, as well as dietary counselling and an annual physical and mental health review. Pharmacological interventions are helpful only for morbid conditions, which are rare. The physical aspects of illness must be managed, including by reducing the laxatives that people tend to take and gradually increasing their calorie intake. There must be regular dental checks and dental hygiene advice—people who vomit, for example, need that care and attention. The problem is deep-seated and needs the involvement of a large number of people in repairing it. We need to screen vulnerable groups by assessing their body mass index and asking them to consider their relationship with food. We must be honest about it. Such things need to happen in schools, too, and people need to know that they are happening. We do not need celebrities to tell us how our bodies should look, although Princess Diana did a good job by reflecting openly on her problems with bulimia, bringing it higher up the agenda. The guidelines are not being implemented sure-footedly across the country, and not all GPs are aware of them. They do not all diagnose eating disorders when they should. We need to do something to inform GPs, and I shall make a suggestion about that. Health professionals might not know the symptoms or what to look for, and they may not have an understanding with the patient. A particular case in my constituency has hit the media waves. A young woman, Catherine Scott, died. She weighed six stone and it was recorded on her death certificate that she died of a liver-related disease. The implication was that she was drinking and that that was the cause. She had been under the care of her local GP for several years. Her family complained about her treatment and, after advice, the death certificate was changed to show that she had died from bulimia. It is interesting that they had to fight to get that put on the death certificate. The family, of course, were very hurt. They have been down here, and they met the Minister at a reception. They have carried on fighting, through the Healthcare Commission, and they have now gone to the ombudsman. They feel that the GP should have picked up the problem much earlier, but instead the young woman died. That cannot be right. The worst thing, which a newspaper picked up on, is that the GP has now fallen out with the family and taken them off the surgery’s list. That is severe. I understand that some patients, and some constituents, can be difficult, but trying to get rid of the problem in that way is an overreaction. Parents and carers need a lot of support and help. I hope the Minister will look into the case of my constituent, Catherine Scott. Many people with eating disorders can be treated as out-patients, as long as the illness is recognised early. Although in-patient treatment is rare, it does happen, but a psychiatric ward is the worst place for treatment. The places where I have seen the best treatment are outside hospitals in private areas in nursing homes and so on, funded and supported by the NHS. Young people who receive the necessary care and attention in such places seem to recover. Eating disorders are recognised, and the Government are beginning to move on that front. There is good work on that, but more remains to be done because many young people are slipping through the net and not receiving counselling or therapy. We need a crusade to ensure that that does not happen. The problem of eating disorders must be addressed because they can be treated and eliminated. No one should die because of misdiagnosis, but I am sure that there have been other cases of misdiagnosis. The problem is not just about weight; it is about the emotions that young people go through. There may be problems at school or in the family that need intense understanding by the counselling service. The local health community must review its practice to ensure that every surgery has a doctor who knows something about the disorder. We could start with one or two specialists in every GP area, as happens with diabetes. One member of staff should have some expertise to enable the problem to be picked up early. When patients have finished treatment, they must be monitored and not just dropped back into society. Some young people go through an unhappy phase when they are under pressure, and they should be followed up to ensure that there is no relapse or recurrence. We should get busy on this. We could score highly, because we know what to do. The NICE report said that we need more research and some money. We have good guidelines, and it would not cost much to put those into operation in every GP practice and prevent the sadness, illness, break-up of families and the continual remaining problems when someone, sadly, dies.