State must face eating-disorder rise

An Cailín Rua

MORE SUPPORT NEEDED The level of support services in Ireland for eating disorders – like most mental-health difficulties – is abysmally deficient.

An Cailín Rua
Anne-Marie Flynn

Last week, news broke of the death of Nikki Grahame, a former UK Big Brother contestant. At just 38, Grahame was probably best known for her hilarious tantrum-filled stint on the then still-fresh reality show in 2006. A number of her outspoken utterances in the Diary Room – “Who IS she?!” – made their way into common parlance and internet memes and established her as a millennial pop-culture icon.
Grahame died with anorexia nervosa, having lived with the eating disorder since she was a child. She’d just been admitted to a private treatment facility, following a desperate fundraising campaign by family and friends.
Disordered eating – including anorexia, bulimia and binge eating – is a mental-health issue. These are complex psychological disorders that affect every single aspect of a person’s functioning, and they are more common than most of us know. And it will come as no surprise to read that the level of support services in Ireland for eating disorders – like most mental-health difficulties – is abysmally deficient.
Reporting from and an investigation by investigative platform Noteworthy shows that since 2018, just €137,000, or 3.4 percent of the €4 million of development funding allocated to eating-disorder treatment facilities in Ireland was spent, with the remainder diverted to cover other areas of mental-health provision.
This is against a background of a worrying growth trend of hospital admissions among people under 18. In 2019, such admissions represented almost 30 percent, an increase of almost 65 percent on the previous year. Women accounted for the majority of admissions at 84 percent, and this figure rises to 96 percent among under 18s. It is any surprise that women’s health is, once again, treated with such disregard?  
This is not to say that men don’t suffer with eating disorders. Quite the opposite. In fact, men can be placed at a disadvantage because of stigma attached to the false perception that EDs are ‘women’s illnesses’. This can delay their seeking treatment, and if they do seek help, according to the Bodywhys website, no medical guidelines exist specifically for men with eating disorders.
So two issues are at play: the prevalence of eating disorders and the lack of support for those dealing with them.
It is suspected that the increased focus on health, fitness, bodybuilding and gym culture is contributing to a rise in disordered eating. It’s not hard to imagine – try scrolling through Instagram without finding a ‘before and after’ weight-loss post, or workout video, or something quietly suggesting your normal body isn’t good enough.
Straight-size people have taken to posing in unflattering positions to show that they too have ‘normal’ bodies with ‘rolls’ (while the rest of us eye-roll). Meanwhile, people who do have larger bodies are discriminated against, rendered invisible in marketing campaigns, treated deplorably online, and excluded from shopping clothing ranges that most people take for granted. We even regard the words ‘thin’ and ‘fat’ as positive and negative.
Why? Why are we so afraid of fat, and of bigger bodies? Social media platforms – yet again – must shoulder responsibility, both for facilitating bullying, and elsewhere, for enabling pro-anorexia ‘communities’ to thrive. All the while, we refuse to talk in real terms about eating disorders.
Lockdown, it is suspected, has not helped. As our worlds have shrunk, our relationships with food, body image and exercise are more prominent. Who hasn’t talked about baking or home workouts over the last year?
Speaking before her death, Nikki Grahame’s mum said Nikki had been struggling with the closure of gyms – ‘she needed to know she could exercise’ – and with “terminal loneliness”. How many more Nikkis are in our midst, and how are we failing them?
It is notable that Grahame’s family had to fundraise for access to treatment. Many people in Ireland are struggling with similar barriers – the help is just not there.
While studies reveal that eating disorders have the highest mortality rate of any mental illness, the truth is, they do not kill people in themselves. The lack of care for them does. If we are encouraging people to come forward and seek help, we need to ensure that there is help is there and available to them when they do.