Opinion: Decision to offer only palliative care to people with anorexia makes their lives seem worthless, writes Melissa Todd
05:00, 06 October 2023
As the government quietly withdraws treatment for people with anorexia, Broadstairs writer and dominatrix Melissa Todd questions the humanity of allowing patients to “starve to death” when the condition – while complex – is fixable.
In among the endless deluge of dreadful news here’s a story you might have missed: the government have announced, rather quietly, that will now only offer palliative care to people diagnosed with anorexia.
That is, they will no longer fund talking therapies or stays in mental health units: they will allow anorexics to die.
There has been a huge increase in cases of eating disorders since lockdown, chiefly among the young. The government say they will still treat children. But many sufferers struggle for years, through their mid to late teens. Will we nurture them until their 18th birthday, then shrug and watch them starve to death?
Some argue this new scheme is barely distinguishable from the current regime, except perhaps a little kinder.
Anorexia already has the highest mortality rate for any mental health disorder. Already it’s often impossibly difficult to receive treatment.
First, you need be below an extremely low weight before they will even countenance seeing you.
Next, they won’t see you if you have any other issues, which probably excludes around 90% of sufferers, for most of them will also be suffering depression, anxiety, suicidal ideation: very few anorexics claim to be perfectly happy in every particular, other than wanting to be thin.
In short, people suffering eating disorders are already being left to die. Perhaps recommending palliative care is more honest, more kind, than forcing them to endure punitive, traumatising, barely evidenced therapies, where they put on a bit of weight and are immediately discharged with no further support, and relapse soon after. In truth, it will probably mean no change at all.
“Will we nurture them until their 18th birthday, then shrug and watch them starve to death?”
A dear friend of mine suffered from anorexia in his mid-teens. For three years he struggled, his weight dropping below 7st, despite being 6ft 3.
There was a change in his personality before his appearance. He slept as long and as often as possible. He became secretive and withdrawn, spending hours curled in a ball in his room. He disappeared into a black hole, depressed, uncommunicative, unreachable.
Then the exercising began. He took up running daily, and became agitated if he couldn’t get out. He became secretive about food, taking it to his room, refusing to eat at the table with his family. He started purging soon after.
He was taken to QEQM and put on the paediatric ward, rather than the psychiatric ward. They didn’t know what to do with him. He turned up at a packed A&E and couldn’t stand. Old folk were tutting at his taking up a chair, but he couldn’t support his own weight.
His heart was eating itself, his organs packing up. His dad was told that if he didn’t have a feeding tube up his nose by the weekend he would die.
Ben being male made him more unusual and therefore more problematic. While men are the fastest rising group of people to develop eating disorders, it’s still perceived as a female disease, and most of the units were filled with young women and girls, and Ben was perceived as a threat. Imagine the other way round. Imagine saying of a young woman, we can’t have her in here, because she might make people uncomfortable, so never mind if she dies. It wouldn’t happen.
The staff on the paediatric unit were marvellous, but weren’t trained in handling eating disorders. They just kept giving him more food, and wouldn’t countenance the possibility of a feeding tube. They piled his plate up with treats, without ever understanding the psychology, hoping the sight of food would eventually make him weaken.
At last Ben was put into a secure unit in South London for six months. It was a psychiatric unit, not just for eating disorders, but every kind of mental illness, so he was often kept awake by screaming and thumping of walls and furniture.
But he fought through it, and is now at university, happy and healthy. Eating disorders are fixable, with the right treatment. It’s time-consuming, but it works.
The government have committed to reducing the UK’s suicide rates, suggesting suicide prevention lessons become a compulsory part of the curriculum, and attempting to get the Online Safety Bill through parliament, which aims to bring self-harm content in line with communications that encourage suicide, which is already illegal.
But eating disorders are surely a form of slow suicide. And this new rule makes the lives of anorexics seem valueless, at a time when they’re already engaged in a life and death struggle with their own self-worth.