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Hospital admissions for eating disorders surge to highest in eight years

The Guardian logo The Guardian 15/02/2019 Sarah Marsh
a person standing in a room: The eating disorder charity Beat estimates that there are more than 1.25m people living with an eating disorder in the UK. © PA The eating disorder charity Beat estimates that there are more than 1.25m people living with an eating disorder in the UK.

There has been a dramatic rise in hospital admissions for potentially life-threatening eating disorders in the last year, prompting concern from experts about a growing crisis of young people experiencing anorexia and bulimia.

Figures seen by the Guardian show year-on-year rises in hospital visits, with admission numbers more than doubling from 7,260 in 2010-11 to 16,023 in the year to April 2018. The latest figure is up from 13,885 the year before – the highest spike in eight years.

Experts said the surge in numbers was down to the failure of NHS services to tackle anorexia and bulimia at an earlier stage, before people become so unwell that they need to be admitted to hospital.

The figures, obtained by the Guardian from NHS Digital, come as the UK’s leading eating disorder charity, Beat, said that calls to its helpline had surged from 17,000 in 2017-18 to an estimated 30,000 in 2018-19.

FILE - This Friday Aug. 14, 2009 file photo shows a sign outside one of London's National Health Service hospitals. Several British hospitals say they are having major computer problems Hospitals in London, northwest England and other parts of the country are reporting problems with their computer systems as the result of an apparent cyberattack, Friday May 12, 2017. (AP Photo/Alastair Grant, File) © Getty FILE - This Friday Aug. 14, 2009 file photo shows a sign outside one of London's National Health Service hospitals. Several British hospitals say they are having major computer problems Hospitals in London, northwest England and other parts of the country are reporting problems with their computer systems as the result of an apparent cyberattack, Friday May 12, 2017. (AP Photo/Alastair Grant, File)

Concern has also been raised about the number of young people experiencing problems due to exam and societal pressure, which can be exacerbated by social media.

Over the last four decades, the reported prevalence of eating disorders has increased, although there is no indication as to whether this is due to more awareness of the problem or more people experiencing eating disorders. Beat estimates that there are more than 1.25m people with an eating disorder across the UK.

The latest data shows that admissions with a primary or secondary diagnosis of an eating disorder are at their highest level in at least eight years. Previously, analysis showed a surge in the number of teenage girls and women in their early 20s was behind the dramatic rise. The admissions for those aged under 19 for anorexia went from 1,050 in 2010-11 to over 2,025 in 2016-17.

“Rising hospital admissions show that outpatient services are failing to treat enough people with eating disorders soon enough. The government and NHS can readily address this by offering more intensive community care,” said Beat’s chief executive Andrew Radford.

Dr Dasha Nicholls, chair of the eating disorders faculty at the Royal College of Psychiatrists said the increase in admissions could reflect one of three things: increases in numbers of people seeking treatment for eating disorders, increases in the severity of their illness, or a lack of community services to support people to be treated out of hospital. “We know that adult outpatient services are under-resourced and are therefore unable to meet the need for outpatient and day patient treatment adequately,” she said.

“We also know that referrals to newly established and existing children and young people’s community eating disorders services have been much higher than anticipated and resourced for, and are also increasing year on year.”

This point was reiterated by Matt Blow, policy manager at YoungMinds, who said the rise was “worrying” and a reminder of the importance of early intervention.

LONDON, ENGLAND - AUGUST 25: Catherine, Duchess of Cambridge and Prince William, Duke of Cambridge during a visit to the YoungMinds mental health charity helpline, partner of the Heads Together mental health charity on August 25, 2016 in London, England. (Photo by Luca Teuchmann/Getty Images) © Getty LONDON, ENGLAND - AUGUST 25: Catherine, Duchess of Cambridge and Prince William, Duke of Cambridge during a visit to the YoungMinds mental health charity helpline, partner of the Heads Together mental health charity on August 25, 2016 in London, England. (Photo by Luca Teuchmann/Getty Images)

Ilona Burton, an eating disorder campaigner and broadcaster, said over the last 10 years eating disorders have been spoken about more. She agreed the rise was due to “more awareness” but also pointed to an increase in people experiencing problems due to societal pressures. “A lot of it is also due to the pressure young people are under now – not so much social media, [but] exam pressure, pressure to perform … a lot of it is high achievers with eating disorders. Striving to perfectionism is a big issue,” she said.

The role of websites such as Instagram has also come under scrutiny. Instagram was recently urged by experts to follow its self-harm picture ban with a focus on anorexia.

Sankt-Petersburg Russia, March 6, 2018: Apple iPhone X on office desk with icons of social media facebook, instagram, twitter, snapchat application on screen. Social network. Starting social media app. Photo taken at company office © Getty Sankt-Petersburg Russia, March 6, 2018: Apple iPhone X on office desk with icons of social media facebook, instagram, twitter, snapchat application on screen. Social network. Starting social media app. Photo taken at company office

The Guardian has discovered thousands of hashtags and accounts promoting anorexia, including diaries of weight loss, alarming pictures and comments on target weights.

Research conducted for the Guardian by Jennifer Grygiel, a social media expert and assistant professor of communications at Syracuse University, showed there were 3.4m images and posts under terms “anorexia” or “thinspiration” over the past year. This included 13,700 on Facebook, 2.1m on Twitter and 560,000 Instagram posts.

Instagram, in particular, said it would focus on removing graphic images of self-harm as part of a series of changes made in response to the death of British teenager Molly Russell. The 14-year-old committed suicide and her father Ian Russell said he believed the social media site was partly to blame. The family found material relating to depression and suicide on her account after her death.

Instagram is understood to be continuing to review its policies. Its focus on images of cutting is based on recent reviews carried out with experts who viewed them as holding the biggest potential to unintentionally promote self-harm.

However, leading charities and experts said Instagram did not go far enough and young people also faced being confronted with pro-anorexia images due to inadequate policing on the site.

Grygiel said: “Social media platforms are being used around the world to not just build supportive communities for those struggling with eating disorders, but also to openly promote ideas such as pro-anorexia.”

“We need these global platforms, especially Instagram, to take more proactive steps to stop social media from hurting people, especially teens who are looking more and more to unmonitored content on Instagram as they construct their identity and understanding of societal beauty norms and aesthetics.”

An NHS England spokesperson said: “More people than ever before are receiving treatment for eating disorders quickly and closer to home, with NHS England investing an extra £30m every year and as part of the long term plan, the NHS is firmly on track to meet ambitious targets to treat children and young people, with 70 community treatment teams covering the whole of the country.”

  • Research contributed by Jennifer M. Grygiel.

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