The challenges of beating eating disorders

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The Eating Disorders Association concerns itself with illnesses recorded since the 17th century, so it seems odd that the charity is only 21 years old. But CEO Susan Ringwood is making up for lost time. Now that the organisation is reorganised under the name beat, she is at the forefront of a manifesto that seeks to change the attitudes of government, medics and individuals towards eating disorders. Why a manifesto now?

“21 years seems to be a “coming of age” for beat,” Ringwood explains. The anniversary coincided with the general election, and she knew that the organisation would have to rally whoever was in power to their cause amidst public sector cuts and resource reallocation. Stating its aims and proposing them to the new government, Ringwood intends to lead the way in improving access to better quality primary care.

The governmentís plans to allocate more power to GPs are particularly relevant to the manifesto. Beat pledges that all GPs will be “up to date” regarding the treatment of eating disorders. “With the publication of the white paper about liberating the health service… GPs are going to have more opportunity to be involved in determining what is delivered.”

Why are so many GPs ignorant about eating disorders, given up to 3% of women have bulimia, and anorexia sufferers have the highest suicide rate of any psychiatric disorder? According to a 2009 beat report, only 15% of people felt their GP “understood eating disorders and knew how to help.”

“We speak to families… who say “I owe my daughter’s life to the intervention of our doctor” but at the same time we… speak to families who say “I was beating [the GP’s] door down and they weren’t acting.” Ringwood is determined to reconcile the “patchy, variable” care offered by primary care services: “There’s too big a range between the excellent GPs, of which there are not enough, and the dreadful ones, of which there are too many.” Her words seem dramatic but are backed up by statistics: 10% of anorexia sufferers die from complications related to their illness.

Neurological imaging is an important part of the deduction that eating disorders aren’t just a cultural phenomenon: “Research… show[s] some people [with eating disorders] have their brains structured in a slightly different way… the pre-frontal cortex looks quite different in someone who has an eating disorder.” Although environmental pressures don’t help, there are hard-wired factors. “Some of these structures predate the starvation, so weíre not just seeing the effects of a starved brain.”

Ringwood seems reluctant to expand on her role as independent advisor to the Model Health Inquiry, established in 2007 after the deaths of three models with eating disorders. Beat didn’t support the inquiry’s proposal to ban models under a certain BMI, since “you can be severely ill with an eating disorder and not be underweight.” Ringwood does however seem disappointed by the lack of enforcements on the modelling industry, which has meant that there has been no “across-the-board uptake” of the inquiry’s recommendations.

She’s more positive about the ‘All Walks Beyond the Catwalk’ initiative, which has involved some of the hippest faces on the London fashion scene: designers Mark Fast and Hannah Marshall and model Erin O’Connor. Have these designers agreed to use larger models for one season only, for publicity? “No, [All Walks] has led a number of designers to continue down that trend and to develop their designs incorporating diversity of body shape and size.” By not attempting to radically change attitudes – simply by pushing the boundaries of what is accepted as ‘normal’ – All Walks has evolved a “life of its own” within the fashion industry.

For Ringwood, inducing it has been “of all things, the one I’m most proud of.” “Emotional resilience” may seem a flowery concept, but it is paramount. Even if we can’t change those biological factors predisposing people to eating disorders, we can remind ourselves that there is no single cause – and it’s not the skinny minnies flaunted in glossy adverts by any means. Ringwood emphasises how there is no one way to treat eating disorders either. The charity’s role is to “keep the pressure on.” I get the feeling she won’t let the coalition ignore it.

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