OVER the last year, the number of women suffering from eating disorders or experiencing relapses has soared.
Big Brother star Nikki Grahame passed away after a long battle with anorexia. Fabulous investigates the hidden victims of the Covid-19 pandemic.
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Rushing upstairs after her daily lockdown walk, Liz* headed straight to her bedroom and turned on the hairdryer. It wasn’t to dry her hair after a rainy stroll, but to warm her body, which was violently shivering.
Over the past 12 months, the 22 year old’s weight has plummeted to such a low that she now struggles to keep warm, her long brown hair is falling out, and she feels weak and dizzy much of the time.
Liz, a furloughed hotel worker from Devon, who is single and lives with her parents, is no stranger to these feelings.
At 17, she was hospitalised with anorexia just days before she was due to sit her A levels.
After 10 weeks of treatment she was well enough to go home, but the following year, at exam time, she was hospitalised again after a relapse and her BMI dropped dangerously.
As time went on, she largely learned to manage her condition – until the coronavirus pandemic hit.
“For the past four years or so, I’ve felt a lot better,” she says.
“I learned to recognise when things were beginning to slip, and to keep myself busy and happy by enjoying time with friends.
“I’d got to the point where my thoughts about food and my body were no longer consuming my life.
“But when I was furloughed from my job in the front office of a hotel last March, I was suddenly faced with a lot of time on my own and soon I was battling constant negative thoughts about myself, obsessing over food and skipping meals.”
In a matter of weeks, Liz had dropped two dress sizes.
“My mum is all too aware about my eating issues and started to worry right away when the weight began to come off,” she says.
“Most of the time I feel so anxious that I don’t want to eat, and the less I eat, the more the thoughts about how little I’m worth buzz around my head.
“Pre-pandemic, I was almost in the healthy weight range, but now my BMI has dropped into the severely underweight category and my periods have stopped. I feel weak and exhausted most of the time and my life is a shadow of what it used to be.”
OVER-STRETCHED AND UNDER-FUNDED
Sadly, Liz is far from alone.
Pre-pandemic, there were an estimated 1.25 million people in Britain struggling with an eating disorder – at least 95 per cent of these sufferers are thought to be female.
Although it isn’t yet known exactly how many people developed a new eating disorder during the past year, a recent study from the University of Northumbria showed that nine out of ten of those with an experience of eating disorders reported a worsening of symptoms during the first lockdown, with a third saying the worsening was severe.
There has also been a 41 per cent rise in the number of children and young people needing treatment, while the private mental health hospital The Priory reported a 61 per cent increase in enquiries about treatment for anorexia.
When Liz contacted her GP for help in May last year, she was told services were strained with so many new referrals.
With a waiting list for support several months long, she is currently getting by with a monthly check-in call from a nurse and is struggling to afford the £50-a-week private therapy that’s keeping her head above water.
“Community services have been absolutely swamped,” says Dr Charlie Bailey, a clinical psychologist who specialises in eating disorders.
“Many more people are developing eating disorders and seeking help, leading to longer waits. The severity of illness in new inpatients is also worsening, partly because clinic appointments have been taking place via Zoom and asking patients to self-report their weight isn’t always reliable.
"We’ve had patients coming in for a check-up only to discover their BMI is three or four points lower than they had reported – leading to a sudden realisation that this person is acutely ill and needs to be rushed to hospital.”
Eating disorder charity Beat has seen an 81 per cent increase in contact to its helpline channels, while fellow charity SEED has seen an increase in referrals of 32.5 per cent.
Actress and former Emmerdale star Gemma Oaten’s parents set up the charity in 2000, when she was hospitalised with anorexia aged 16.
Gemma, now 36, has thankfully recovered, and she and her family have been running the charity ever since.
But it’s been the toughest year ever for SEED, and Gemma has been working 12-hour days from her kitchen table to keep the charity afloat.
“There are thousands of people who rely on us and are desperate for help and support,” she explains.
“But because we haven’t been able to get out and fund-raise the way we normally do, we’re under enormous financial pressure. We are only just scraping by.”
The strains of Covid-19 have created the perfect storm for eating disorders to flourish.
Rates of depression – a condition commonly associated with eating disorders – have doubled during the pandemic.
This alone may have led to a spike in symptoms, but, according to Dr Bailey, there are other factors at play, too.
“Many people are seeking control at a time of great uncertainty, and may see food as one of the few things they can regulate,” he explains.
“I’m seeing a lot of teenagers who developed eating disorders around the time their exams were cancelled, while for adults it might be when they’ve been laid off from their jobs.
“The pandemic has also meant a lot of people have less access to family and friends for support, and they can prove vital for catching things early if they have a history of an eating disorder and are beginning to slide again, or for people who are going downhill for the first time.”
Naomi Milsom, 45, a school receptionist from York, has been suffering with anorexia for 14 years, and says she feels that social isolation has played a large part in the recent worsening of her condition.
The pandemic has also meant a lot of people have less access to family and friends for support.
“Pre-pandemic I would eat out with mates and it would be good for me not to know the exact calories of what was in my food and be able to relax a bit with my friends,” she says.
“But now, having almost every meal at home all the time, I’m really restrictive about what I eat.
“Even though I feel hungry and long for nice meals, I can’t bring myself to eat them.”
Naomi, a single mother to daughter Xylia, 19, says being furloughed from her job also made things worse.
“It knocked me sideways and made me feel like I’ve gone back to square one – my eating disorder has spiralled out of control since then.
"Although my weight hasn’t plummeted to what it was when I was at my worst, I definitely feel as bad mentally as I did 14 years ago when I was treated as an outpatient at hospital.
“Losing the routine of work was like having the rug pulled from under me – there were no set routine eating times, so I found myself cutting back on meals more.”
According to Northumbria University’s study, the reduced availability of GP appointments and the fact many clinics closed during lockdowns have left some sufferers feeling like “a burden”, “an inconvenience”, or “forgotten” by the government and NHS.
Signs and symptoms of anorexia
- if you're under 18, your weight and height being lower than expected for your age
- if you're an adult, having an unusually low body mass index
- missing meals, eating very little or avoiding eating any foods you see as fattening
- believing you are fat when you are a healthy weight or underweight
- taking medication to reduce your hunger (appetite suppressants)
- your periods stopping (in women who have not reached menopause) or not starting (in younger women and girls)
- physical problems, such as feeling dizzy, dry skin and hair loss
“I felt guilty even trying to see a doctor,” confesses Naomi. “I feel bad bothering them about my eating, because there is so much going on in the world.”
Losing the routine of work was like having the rug pulled from under me.
A major trigger for Naomi has also been the national emphasis on weight loss and exercise.
“While I was on furlough, I would end up watching daytime TV where all they seemed to do was talk about how everyone should lose weight to help beat Covid,” she says.
“Then Boris Johnson kept saying you’ve got to exercise and eat healthily. In an anorexic’s mind, that means: ‘Well, I can’t treat myself.’
"So as well as restricting my calorie intake to well below a healthy level by eating very small meals, I was doing an intense workout plus an hour’s walk at lunchtime each day.
“I ended up feeling weak, ill and totally exhausted. Xylia tries to encourage me to eat more, but it’s hard.”
Psychologist Dr Dawn Branley-Bell headed up Northumbria University’s research, as well as a follow-up study about the government’s Better Health campaign, and says lessons should be learned.
“Daily televised briefings with frequent messages on losing weight were highly triggering to a lot of people.
“We’ve looked closely at the language used in the government’s Better Health campaign and some of it was fat-shaming, such as terms like ‘putting on the Covid pounds’, which can be very upsetting for certain parts of the population.
“But the rise in eating disorders during the pandemic has been so much worse than we even imagined it might be.”
'PAINFUL MENTAL TRAUMA'
One surprising element of Dr Branley-Bell’s study was that rather than being a source of stress, many sufferers have seen social media as a comfort during the pandemic.
“The majority of participants were talking about how social media has been a lifeline for connecting with a friend or eating disorder charities,” she says.
“The only negative was a fear they might stumble across a post about diet and exercise.”
For Naomi, following female Instagrammers in recovery gave her a sense of hope during her darkest periods.
She has paid £60 for three sessions with a private dietician, but couldn’t afford them long-term so is relying on charities for support while on the NHS waiting list.
Her daughter is there for her, but finds Naomi’s illness frustrating sometimes.
Where to find help
ALWAYS speak to your GP, as services and availability vary greatly depending on where you live.
SEED’s helpline is open weekdays 9.30am-2.30pm. Call 01482 718130 or visit Seedeatingdisorders.org.uk.
Beat’s helplines are open 9am-8pm on weekdays and 4pm-8pm at weekends. Call 0808 801 0677 or 0808 801 0711 for the Youthline. Visit Beateatingdisorders.org.uk.
Gemma agrees that social media can sometimes be judged too harshly when it comes to eating disorders.
“I didn’t get anorexia at the age of 10 because I looked at a Twitter page or at TikTok, because those things didn’t even exist back then,” she says.
“For many people, their eating disorder is linked to painful mental trauma that they feel they can only escape by undereating or overeating.
“An eating disorder is often about control – something coronavirus has taken away for so many of us.”
As lockdown restrictions are eased, there is hope that a return to relative normality may help calm the symptoms for some sufferers. But for charities and doctors hoping to help the backlog of people awaiting treatment, their work may only just be beginning.
*Name has been changed
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