July 4, 2008

Publication: Irish Farmers Journal Supplement

Date: Saturday, July 5, 2008 Page: 20

Headline: Thousands dying to be thin

The Government estimated two years ago that 200,000 people suffer from eating disorders in Ireland. Why then, are there only three specialist public beds (all in Dublin) to cope with an escalating problem? The estimated figure of ; 200,000 people who suffer with eating disorders was outlined in the Vision for Change report produced by the Department of Health and Children in January 2006. It also stated that anorexia nervosa has an extremely high death rate of 20% for long-term sufferers. The report estimated at least 80 deaths annually as a direct result of an eating disorder.

At the time of the report, there were only three public beds in the psychiatric unit of St Vincent's Hospital for the treatment of eating disorders (referring to anorexia nervosa, bulimia nervosa and binge eating), with two eight-bed units in the private sector. "The private sector is better catered for, with a general lack of facilities for public patients," the report stated – also saying that the HSE was funding the treatment of some individuals in the UK. Since then, no additional beds have been provided in the public health service, while there has been an increase in the number of private beds, from eight to 16, in St Patrick's Hospital. Another eight-bed unit is provided in St John of God's Hospital, Dublin for patients aged 18 and over. These two private services take HSE-funded public patients in some cases. Dr John Griffin, a consultant psychiatrist, who heads up the eating disorder unit at St Patrick's, has been calling on the Government to carry out a national survey to figure out the extent of the problem since he started working in the area more than 30 years ago.

His private eating disorder unit is full all the time, with a long waiting list. "The numbers have steadily increased in the past three decades," he says. There has been an alarming increase in the number of males suffering from an eating disorder. Dr Griffin's percentage of male patients has risen from 5% to 15-20% since the 70s.


He also warns of "dreadful and sinister" pro-ana and pro-mea Internet sites that promote starvation as a lifestyle choice, where women of all ages post skeletal images as "thinspiration". These sites are easy to join, where you can ask for tips and support from women who are losing weight fast. "Vulnerable people are logging onto these sites," Dr Griffin says. "I always say to parents, just make absolutely sure you know what your kid is logging onto on the Internet. These sites are dangerous." Social networking sites, such as Facebook and MySpace, have come under pressure to ban their pro-ana entries. The world's first use of the law to tackle the "pro-ana movement" and the growing problem of anorexia may be seen in France, where a draft law proposes a two-year jail sentence to punish any "incitement to excessive thinness" in the media. The prison term is raised to three years, with a €45,000 fine if the person dies. Dr Griffin thinks these measures are extreme, but points to a greater awareness of the severity of eating disorders.

There are many medical complications caused by anorexia and bulimia, he says. Hypokalamia – low blood potassium that causes irregular beating of the heart caused the death of American singer Karen Carpenter. Serious dental problems are the result of enamel decaying from constant purging. A previous patient of Dr Griffins who suffered from bulimia spent 32,000 old Irish punts replacing all the teeth in her mouth. Bulimics tend to be slightly older than anorexics, says Dr Griffin. They will binge and vomit five or six times a day and/or use huge amounts of laxatives. "I had a girl in here the other day who admitted to taking 100 Senocot per day… but her weight was stable. Bulimics tend to start at eight and a half stone and end up at the same weight, because they eat huge amounts of food that's absorbed before they can get it back up."

Dr Griffin is also critical of the Government's failure to tackle this problem head on. "The Departments of Education and Health need to get together and prepare a CD or DVD for kids, not in fifth year, but for fifth and sixth class in primary schools, before they become anorexic or bulimic, and tell them it's okay to be normal. An ounce of prevention in medicine is worth a tonne of cure."


Director and founder of the Eating Disorder Resource Centre of Ireland (EDRCI) Suzanne Morgan says critical sufferers of eating disorders are facing death because of five-month waiting lists for treatment, and diose who cannot wait that long are forced to travel to the UK for treatment. "We are very, very under-resourced," says the psychotherapist. "The real figure is much, much higher, as a lot are ashamed of coming forward because of the stigma attached." She echoes Dr Griffin's concern about the increase in the number of men and boys suffering from an eating disorder. "One of fastest triggers with boys is bullying and teasing at school because of weight issues."

The age of sufferers has dropped dramatically in recent years also, she says. "I had about 10 phone calls from parents in the past year, with kids as young as seven experiencing food, body and weight issues. Two years ago, I hadn't heard of cases that young." A report last October referred to a five-year-old Irish girl who refused to play with Bratz dolls because she thought they were too fat and feared she would get fat by playing with them. The little girl preferred to play with Barbie dolls instead.

Ruth Ni Eidhin, Communications Officer with Bodywhys – the Eating Disorders Association – criticises the lack of action by the Government. RECOMMENDATIONS NOT TAKEN UP "The Vision for Change report recommended the development of four regional six-bed units for die treatment of adults with eating disorders," Ruth says. "It also recommended the development of a specialised centre for the treatment of children and adolescents with eating disorders, to be attached to one of the national children's hospitals." The situation persists, with only three public beds in Dublin for adult sufferers. Bodywhys receives some funding from the HSE, but not enough to cover running costs of the rapidly-expanding organisation. Extra funding has been provided by the Department of Community, Gaeltacht and Rural Affairs, the Dormant Accounts Fund, Vodafone Ireland, The Health Promotion Unit, The National Lottery and People in Need. Research by St John of God's Lucena Foundation last year found that almost 11% of more than 3,000 second-level students surveyed in 52 Irish schools, aged between 12-18 years had significant eating concerns. Compared with other psychiatric disorders, it also found that eating disorders have the highest mortality rate, resulting from medical complications of illness and by completed suicides.