- Significant increase in referrals for all types of eating disorder, both among new patients and those whose conditions have either worsened or relapsed
- 61% increase in enquiries at private clinics around anorexia and 26% increase in binge eating disorder (BED) enquiries
- Priory Consultant, Dr Lorna Richards, says BEDis just one significant issue that has emerged under lockdown
- People focusing on food can be a way of trying to exert control over an uncertain situation, she says
An expert has spoken of a significant increase in eating disorder referrals – and explained how focusing on food and weight, either by over-eating or restricting food intake, can be seen by people with eating disorders as a way to “cope” with the pandemic.
Dr Lorna Richards cited a number of factors for the rise, including “fear and uncertainty, fuelling anxiety symptoms”, a feeling of not being in control, social isolation, and changes to people’s routine and home lives.
“There has also been widespread concern about lack of activity, and about weight gain during periods of lockdown, which have seen the nation both dieting, and exercising, en masse” she said.
“Eating disorders have thrived in this environment, as the focus on eating and weight control becomes a way of coping.”
Last year, Priory saw a 61% increase in the number of enquiries it received about treatment for anorexia nervosa at its private clinics, compared to 2019, and a rise of more than a quarter (26%) in the number of enquiries it received regarding treatment for BED.
Dr Richards specialises in adult eating disorders at Priory Hospital Woking and Priory Life Works and has been involved in the development of NHS national guidelines and policy around eating disorders.
She says that for some people, focusing on food, either by restricting, over-eating or using other weight control measures, such as purging and over-exercising, can be used as a way of “coping” and provide “a sense of control or mastery”.
She added: “Since the early summer of 2020, I have seen a huge increase in referrals from people with pre-existing disorders who have deteriorated since the pandemic emerged.
“I have also seen an increase in new patients - specifically people, who, during the first lockdown, were starting to develop eating disorders for the first time. For people who are vulnerable to developing an eating disorder, there have just been too many challenges and they are ongoing.”
Dr Richards comments came as Sir Simon Stevens, Chief Executive of NHS England, spoke of a growing number of young people being referred for eating disorders needing urgent help.
He told the commons health and social care committee: “The area, frankly, in mental health services where we are seeing a real pressure, is increasing urgent referrals for eating disorder services.”
Dr Richards, who treats adults, said: “Inpatient treatment has also been more challenging due to infection control measures; patients haven't been able to have leave or visitors, and staff need to wear masks. It's difficult, but sometimes inpatient treatment is the best way to provide the level of care that people need.”
What is binge eating?
Dr Richards says: “We all need a degree of certainty and security, and the more things are uncertain to us or feel unsafe, the more we feel a need to control. We do it in different ways. Some might be more obsessively tidy, or ‘helicopter’ around their children, or try to maintain control in relationships or the workplace.
“People with eating disorders turn to controlling their diet or using food in unhealthy ways like binge eating, purging or exercising. It can provide a structure, routine and focus for the day, as well as a distraction from anxious thoughts.”
She said shopping habits had also changed, with families doing large online shops, and this had an impact. “For someone with BED, this can feel overwhelming and increase the likelihood of binge episodes.”
Dr Richards added: “BED affects adults of both genders. Bingeing means eating an objectively excessive amount of food and there's an element of compulsion to it, so you feel like you can’t control yourself.
“There are two key triggers: when people are restricting their intake in an attempt to lose weight, this triggers a hunger response with an increased risk of overeating when food becomes available.
“The other trigger is psychological: people may binge eat to manage difficult emotions or indeed to numb them. When people are planning a binge, it can be a fantastic distraction from other things that are going on. It's usually done in secret and there's a huge amount of shame, with people believing that others judge them as greedy and lacking all self-control. The shame that everyone with an eating disorder feels often prevents them from accessing help.”
Dr Richards' advice:
- Anyone who notices that they're focusing more on eating and weight, whose eating habits or weight have changed or is concerned in any way should reach out for help
- Children, young people and adults can consult the Beat charity’s website and local support groups, and should speak with their GP who may refer them for online therapy
- Eating disorders are serious illnesses and can lead to significant problems with physical and mental health, as well as relationships, and the ability to study or work
- The longer you leave it, the more entrenched the eating disordered way of thinking and behaving becomes; it's harder to make changes and you're less likely to fully recover
Watch videos of Dr Lorna Richards talking about eating disorders · https://www.youtube.com/watch?v=aDJi6-91GkQ&t – Dr Richards on eating disorders during the pandemic · https://vimeo.com/336104400 - Dr Richards on eating disorders and self-identity |
About Priory and MEDIAN
Priory is the UK’s leading independent provider of mental health services. We treat more than 70 conditions, including depression, anxiety, addictions and eating disorders, as well as children’s mental health, across our nationwide network of sites. We also support autistic adults and adults with a learning disability, Prader-Willi Syndrome and brain injuries, as well as older people, within our specialist residential care and supported living facilities – helping as many people as possible to live their lives.
Priory is part of the MEDIAN Group, one of Europe’s leading providers of high quality mental health and rehabilitation services. The MEDIAN Group comprises 290 facilities with 5,000 beds caring for 28,000 people in the UK, 120 facilities with 20,000 beds caring for around 250,000 patients in Germany, and 15 facilities with 2,000 beds caring for 13,000 people in Spain, with more than 29,000 employees overall.