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Hope Virgo: Eating disorders, hidden in plain sight

Hope Virgo, author and founder of #DumpTheScales explores the topic of eating disorders amongst children and young people as part of our series of think pieces on children and young people's mental health.

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Content warning: This article discusses the topic of eating disorders which some people may find upsetting.

When you look around a room of children what do you notice? What would you be looking for if someone said X number of these kids have an eating disorder? Would your eyes, like so many, be hunting for the underweight white kid? Assuming that a child can surely only be impacted if they come from a broken home, or look a certain way? 

The scary reality in this current climate that despite more people talking about eating disorders, they are still an illness that is massively misunderstood, and one that carries huge amounts of stigma. We often think of it as a white girl’s illness or something that only impacts people who are underweight. We think it’s a phase, or a choice, or a vanity exercise when in fact eating disorders are extremely serious mental illness. They impact people of all ages, races, ethnicities, genders, and sizes with only 6 per cent of people with an eating disorder are underweight.  

Alongside these stigmas, we also don’t often realise the actual impact of living with an eating disorder may have. We often think they are someone being picky, or fussy. Or something an individual will grow out of. Someone choosing to be difficult without considering the horrible dialogue that will be going on in their head and the wider impact it is having on their family.  

I developed anorexia when I was 12 years old and lived with it for four years before anyone realised something was going on. To me it began as this reassuring voice, a friend, numbing the pain, taking me out of the reality of growing up. But I didn’t realise at the time how dangerous it was. How much the guilt was going to overtake me when I ate anything. My story isn’t a unique story, but one that impacts millions all over the U.K. Full recovery is possible, but current treatment and interventions are not set up to support this. Each day I am inundated with people reaching out for help who have been turned away from services for not being thin enough, turned away for being too sick and people of all ages stuck in limbo unable to see a way out. Eating disorders are manipulative, insidious illnesses and extremely serious. 

They have the highest mortality rate out of any psychiatric illness with 1 in 5 people with an eating disorder ending the life by suicide, but they have often been forgotten and left out of all discussions. Eating disorders are treatable and we need to be doing what we can to ensure people get the best chance of life.   

Eating disorders have almost trebled between 2007 and 2019, but the pandemic has seen a further surge in cases. According to NHS Digital's 2019 Health Survey for England, 16 per cent of those aged 16 and up (19 per cent of women and 13 per cent of men) screened positive for a possible eating disorder in the previous 12 months. In the most recent 2022 NHS Digital Child Mental Health Survey, the rate of a broader measure of possible eating problems was an alarming 12.9 per cent in children aged 11 to 16, 60.3 per cent in 17 to 19 year-olds, and 62.2 per cent in 20 to 23 year olds. 

This is a national emergency that must be addressed as soon as possible.  

What these statistics fail to show is the heartbreak behind them. That these numbers tell the stories of pain, sadness, fear, and loss of so many. Of families, friends, children, and those that are caring for them who have been hit by a hurricane as an eating disorder tears through them.   

We know that there have been decades of stigma and underfunding and it is these things we must continue to challenge, but beyond that what can we all do to start to help support these young people with eating disorders, and those who may be heading down that route?  

Before I share some concrete ideas for you, I want to emphasise that eating disorders are a serious mental illness, there is more research coming out showing that they are caused by a genetic predisposition with an energy deficit. Yes, we have contributing factors from society, and it is these things we need to be mindful of from a preventative perspective, but we need to always look at the whole picture with eating disorders.    

So for starters we need to scrap the dangerous health initiatives such as calorie labelling on menus. We need to find a way to bring together messaging around health in such a way that it is not shaming or triggering. For too long diet culture has been infiltrating a lot of these messaging which is not safe or in fact healthy for anyone. And on top of this we are allowing wellness influencers who in some cases do not have a qualification in nutrition to dictate what we should be eating and what exercise we should be doing. Whilst we cannot say this causes an eating disorder, it creates a toxic environment for so many, and can be very triggering. When working with young people we need to be talking about these sorts of accounts online, we need to make sure that our communities are safe. We need to make sure we have diverse bodies pinned up and that we don’t have signs saying, ‘take the stairs and you will burn X calories.’ And beyond this we need to champion health as not being a particular body type.   

Secondly, let’s chat about the rather debated topic of weighing young people in schools. Whether in physics lessons, or in the school nurse office, this is a categoric no for me! I know there is a public health push to do this so if you feel you can’t push back on this what are you doing in your schools to create a safe place for young people? How are you checking in with them after they get weighed? How are you communicating with carers about this because sending an email saying ‘your child has a BMI of X which means they are obese’ is one hundred percent not the way to do it! Think about educating young people on how inaccurate BMI is as a form of measurement, think about offering blind weigh-ins, think about scrapping them altogether because the harm this initiative causes is catastrophic.   

Thirdly, education for all carers, young people, teachers, whole communities. I know that so many people shy away from talking about eating disorders because of fear of getting it wrong, triggering someone, but we know that the way to heal, the way to prevent is to talk about this. Teach everyone about the signs to spot, teach people how to have a conversation about eating disorders, and teach people how to communicate. By normalising these conversations, it will help people be able to speak up at all levels and will also help decrease the shame that is so often associated with the illness. And within this education, we need to be challenging the stigmas, and providing hope to everyone.   

Finally, as a campaigner I know the power of contacting your local MP. With all mental illnesses we need to be making as much noise about them, sharing stories and pressing on the government to support change!  

This article and views reflected within it were provided and written by Hope Virgo, author and founder of #DumpTheScales.