Doctors Telling Eating Disorder Patients to Come Back When They’re Thinner


Young people who suffer from eating disorders are being prevented from being referred to the appropriate mental health services that are appropriate for their treatment, a survey has found.

According to the findings in a survey commissioned by a UK charity called Beat, a third of those who participated reported that say their general practitioner (GPs) failed to identify and diagnose their eating disorders – including both anorexia nervosa and bulimia nervosa– while half of those who participated in the survey rated the care they received as either “poor” or “very poor.”

Andrew Radford, chief executive of the charity Beat, said, “We know early intervention and speed in referring people with eating disorders is critical if they are to make the best possible recovery.” He went on to say that, “It takes great courage for sufferers of eating disorders to come forward and often the first person they talk to is their [general practitioner]. Unfortunately many of our respondents identified poor care from their doctor with many [general practitioners’]not knowing what the real signs and symptoms are.”

Involving 1700 patients with eating disorders ranging in age starting at 10 years old, the survey found that 1,267 of which actually sought help from a doctor.

The results of the survey found that 16 per cent of eating disorder sufferers waited to receive help on average 5 years after recognising their first symptom, and 15% waited between one and two years following their first symptom before getting help.

Furthermore, 63 per cent of respondents reported to have reached out to more than one GP for help.

Nevertheless, a disproportionate amount of people reported having little confidence in their general practitioner (GP). The survey showed that 66% of people who sought help from their GP either disagreed or strongly disagreed that their GP knew how to assist them with their eating disorder (36% and 30%, respectively).

The charity BEAT said GPs lacked knowledge about the importance of early intervention, with the condition becoming harder to treat as it became more embedded.

Not only bereft of the appropriate knowledge, Radford says some patients were told access to the necessary services were contingent on their weight which ignored the mental health aspect connected with these disorders.

As Radford said, “Eating disorders are a competitive disorder – to say to someone you are not ill enough for treatment, you need to be thinner, you are basically saying go away, make yourself more ill.”

BEAT is calling for increased training for medical students specialising as GPs, so they are better able to spot psychological and behavioural symptoms of eating disorders.

Radford also said that, “We know that early intervention and speed in referring people with eating disorders is critical if they are to make the best possible recovery.

“It takes great courage for sufferers of eating disorders to come forward and often the first person they talk to is their GP. Unfortunately many of our respondents identified poor care from their doctor with many GPs not knowing what the real signs and symptoms are.”

In December, draft guidance from the National Institute for Health and Care Excellence warned GPs not to tell patients to come back for help when they are thinner.

How many people in the UK have an eating disorder?

The Costs of Eating Disorders – Social, Health and Economic Impacts report, commissioned by Beat and produced by PwC in February 2015, estimates that more than 725,000 people in the UK are affected by an eating disorder – using a more robust methodology than previous studies.

The National Institute of Health and Clinical Excellence estimates around 11% of those affected by an eating disorder are male.

Recent research from the NHS information centre showed that up to 6.4% of adults displayed signs of an eating disorder (Adult Psychiatric Morbidity Survey, 2007). This research suggested that up to 25% of those showing signs of an eating disorder were male.

The Health and Care Information Centre published figures in February 2014 showed an 8% rise in the number of inpatient hospital admissions in the 12 months previous to October 2013. The Costs of Eating Disorders report found that this is indicative of the trend in increasing prevalence over time: a 34% increase in admissions since 2005-06 – approximately 7% each year.

Which eating disorder is the most common?

The latest version of the DSM (Diagnostic Statistic Manual of Mental Disorders) cites the main eating disorders as anorexia, bulimia and binge eating disorder (BED), eliminating EDNOS (eating disorder not otherwise specified).

Before the latest change in diagnostic criteria, it was estimated that of those with eating disorders, 10% were anorexic, 40% were bulimic and the rest fall into the EDNOS category which included BED.

At what age do people develop eating disorders?

Although many eating disorders develop during adolescence, it is not at all unusual for people to develop eating disorders earlier or later in life. In fact, we are aware of cases of anorexia in children as young as 6 and some research reports cases developing in women in their 70s. Outside of the stereotypical age bracket, people are less likely to be appropriately diagnosed due to a lack of understanding and awareness of eating disorders in these age groups.

How long do eating disorders last?

Research carried out in Australia suggests that the average duration of anorexia is eight years and five years for bulimia. However, these illnesses can also become severe and enduring, lasting for many years and having a hugely debilitating effect on the sufferers and their families. The sooner someone gets the treatment they need, the more likely they are to make a full recovery.

Is it possible to recover from an eating disorder?

Yes. We are lucky enough to work with some very inspirational people and we hear some very uplifting stories of recovery. Research suggests that around 46% of anorexia patients fully recover, a 33% improving and 20% remaining chronically ill. Similar research into bulimia suggests that 45% make a full recovery, 27% improve considerably and 23% suffer chronically.

How devastating are eating disorders?

Anorexia has the highest mortality rate of any psychiatric disorder, from medical complications associated with the illness as well as suicide. Research has found that 20% of anorexia sufferers will die prematurely from their illness. Bulimia is also associated with severe medical complications, and binge eating disorder sufferers often experience the medical complications associated with obesity. In every case, eating disorders severely affect the quality of life of the sufferer and those that care for them.

How should people with eating disorders seek help?

The first port of call for a sufferer should always be their making an appointment with their GP. The Beat Helpline is available for support and information, and can give people suggestions for how to approach their doctor. After seeking advice from your GP, it can be useful to search Beat’s HelpFinder to find specialised eating disorder help near you.

Do eating disorders run in families?

Eating disorders are complex with no one sole cause, but we know from research that individuals might be predisposed due to their genetic or biological make up.

Some research has found that female relatives of anorexia sufferers were 11.4 times more likely to suffer from anorexia compared to relatives of unaffected participants. For female relatives of those with bulimia, the likelihood of developing bulimia was 3.7 times that of those with unaffected relatives.

It is not yet clear how much of this link between family members is genetic and how much is due to environmental factors.

How can you tell if someone has an eating disorder?

You cannot tell if someone has an eating disorder just by looking at them. While it is true that some sufferers of anorexia are severely emaciated, some are not, and the majority of eating disorder sufferers do not have anorexia. Those suffering from bulimia may be within the normal weight range or may be overweight, while those with binge eating disorder are often overweight.

Professor John Morgan at Leeds Partnership NHS Foundation Trust designed the SCOFF screening tool to indicate a possible eating disorder. A score of two or more positive answers is a positive screen.

SCOFF questionnaire:

  • Do you ever make yourself Sick because you feel uncomfortably full?
  • Do you worry you have lost Control over how much you eat?
  • Have you recently lost more than One stone in a three month period?
  • Do you believe yourself to be Fat when others say you are too thin?
  • Would you say that Food dominates your life?

How to talk to somebody with an eating disorder

How to tell someone you have an eating disorder

About Benjamin David 35 Articles
Benjamin David founded Conatus News in 2016. He currently works as an editor for Parliamentary Review.

1 Comment

  1. One terrible problem is that BMI forms part of the medical definition for anorexia nervosa (and thus commissioning for much-needed resources).
    I have seen patients destroyed by ED be dismissed as ‘healthy weight’ just because they’d just had an 18,000 calorie binge.

    And these definitions plight those battling EDs. Psychiatrists are obsessed with categorising eating habits (and these generally change through a sufferer’s life, and may change simply because of physical damage – such as no longer being able to induce vomiting) – instead of prioritising support for the individual.

    Much-needed article to raise the profile of thjs.

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