Access to Eating Disorder treatment for all regardless of weight

Access to Eating Disorder treatment for all regardless of weight

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Fiona Clark started this petition to Eating Disorders Services

This letter is written on behalf of the many ED sufferers that will fail to get the help that they so desperately need. 
 
Imagine going to the doctor with a broken arm. Imagine the doctor telling you that since you’ve got another arm AND two legs that are perfectly fine, you don’t need / can’t have any treatment. Or imagine that you have been diagnosed with cancer. But it’s a slow-burn one that will take a few years to kill you and as there’s no imminent threat of death, you are refused treatment or help. Imagine that... 
 
I have a slow-burning illness that has robbed me of most things in life: bulimia nervosa. It’s a slower killer than its cousin anorexia, but ultimately, the outcome is the same: everyday life becomes an existence, everyday function is compromised, sufferers are trapped in a living hell dominated by obsessive thoughts about food and weight as well as a whole catalogue of physical ramifications together with mental struggles such as depression, anxiety, stress, social isolation, broken relationships, self-harm, despair and in a lot of cases, suicide.  
 
This is reality for me. This is reality for most eating disorder sufferers regardless of the particular presentation: bulimia, binge eating disorder, anorexia or other. EDs make you desperate: you do things that are not part of who you are. The guilt, the shame, the frustration and the negative voices in your head penetrate deeper and become more entrenched with every year of being trapped in the illness making it ever harder to heal. 
 
But healing is what we all long for, it’s what all sufferers dream of: a bit of hope, a chance to get better, a go at a real life. Asking for help is one of the hardest things a sufferer will do and the tragedy is that more often than not, help is refused. I’ve experienced this myself and so have countless other ED sufferers. Mental health services have long been severely under-funded and under-resourced and the pandemic has made the already broken system even more overloaded – it cannot cope with demand. Waiting times are long and treatment not guaranteed even if, a year or so down the line, you get to the top of the list. In the meantime, sufferers are left to fend for themselves with often disastrous consequences. 
 
I can’t put into words the overwhelming shame and embarrassment that sufferers have to overcome to reach out for help. Nor can I describe to you what an utter blow it is when help is refused: the feeling of rejection for someone who already struggles with low self-confidence, low self-worth, body dysmorphia, anxiety, depression etc. And the arbitrary, completely ironic way that help is doled out by is numbers: numbers on the scales. And this is the travesty and tragedy: eating disorders are a mental health issue, but whether or not a sufferer receives treatment from the system depends on their weight and NOT the state of their mind.  
 
The worst culprit is the BMI: if your body presents a ‘normal’ or ‘high’ BMI, you will struggle to be accepted for treatment. Which more or less excludes everyone suffering from bulimia or binge eating disorder. It doesn’t matter how sick you are inside your body or what desperate state your mental health is in, if your BMI isn’t low enough, you’re not deemed sick enough.  
 
Thankfully, there are now voices that call for scrapping BMI as a measurement altogether as it is such a generic, one size fits none approach. There is a vast array of factors that influence and alter it such as bone structure/density, frame size, muscle volume, water retention, physical deformities, menstrual cycle, dehydration, constipation, ethnicity, genetics, medication, metabolism and illnesses such as thyroid. And most importantly of all, the scales don’t reveal your mental state or your brain functionality. 
 
However, there are other ways that numbers determine whether or not a desperate ED sufferer is offered treatment: the treatment itself is based on the sufferer being weighed and the numbers being recorded and discussed and mulled over. This again is completely counterintuitive: a lot of sufferers are either completely weight obsessed and need liberating from the scales rather than reinforcing the ED behaviour, whilst others are completely weight phobic and struggle greatly to get onto the scales. And if you won’t get on the scales, you can’t have treatment. Yes, you read that correctly: if you can’t get yourself onto the scales to be weighed, you are automatically excluded from treatment. How messed up is that?! 
 
Everybody is unique and we can’t be compared by one universal system. EDs ruin lives regardless of body size: you can be sick OR healthy inside any sized body, but in a society that judges people on looks primarily, the anguish and pain of a mental illness is often not seen or recognised. People come in all size bodies and so do eating disorder sufferers: being in a larger body and/or being phobic of the scales shouldn’t mean that you are withheld treatment for the very real and debilitating mental health illness that an eating disorder is.  
 
The reality of our living hell and life-threatening disfunction is often not understood by others as sufferers will go to lengths to appear okay and fit in with what they perceive as ‘expected and appropriate’ behaviours. The shocking truth is though, that EDs have the highest mortality rates among psychiatric disorders which is due both to their toll on the body and very high suicide rates. Suicide: the end of the road for many sufferers - the ultimate cry for help for others. I don’t know how to convey to you the feeling of helplessness, knowing that you can’t go on, being totally convinced that you are worthless and that the world is better off without you. That’s what an eating disorder ultimately does to you.  
 
When you’re in that place, you need help - professional help. And not just to exit the crisis, but to recover from the illness itself. And that help should not depend on numbers: eating disorders are a mental condition and treatment needs to be based on that fact rather than arbitrary numbers on a scale. 
 

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