A rising tide of young people are being referred for urgent help after being diagnosed with eating disorders during the pandemic, leaving services struggling to cope.
Children as young as seven are among those who have been referred to under-pressure eating disorder support services in Suffolk in the past year, with numbers doubling since the start of the pandemic.
In the latest board papers from Norfolk and Suffolk Foundation Trust (NSFT), it was revealed just 25% of patients under 19 who were deemed in need of 'urgent' care were being seen within the guideline one week time frame - against a target of 84%.
And only half of those classed as 'routine' were being seen within the four-week period set out by the trust - against a target of 95%.
The report stated "a significant and maintained increase in referrals is impacting on service delivery".
Stuart Richardson, deputy chief executive at Norfolk and Suffolk NHS Foundation Trust said: “We are working with our partners in the NHS and in community organisations to help meet the increased demand we are seeing for eating disorder services, to ensure children and young people receive the care they need.
“It’s important that people with eating disorders get help as early as possible and we encourage anyone with concerns about themselves, or someone they care for, to speak to their GP.”
'You lose control over everything'
A student from the University of Suffolk, who suffers with anorexia and has received treatment and support from NSFT and charity Wednesday's Child, said the pandemic made coping with her illness much more difficult.
She said she was very isolated and would "torture" herself by completing the one-hour of daily exercise.
"The only thing that made me feel better was exercising and restricting, and I felt like I had to go out and get my exercise every day," she said.
"You lose control over everything in the pandemic."
More schools and families are seeking support
Debbie Watson founded Wednesday's Child, a social enterprise company based in Suffolk which works with young people with eating disorders, after her own 20-year battle against anorexia. She said the service's referrals are up 100% on this time last year.
She said since the pandemic the age of those being referred to the service has lowered significantly.
"Usually it is high school and up, so aged 13 and upwards," she said.
"But certainly over the pandemic we have had referrals for a seven-year-old, and a couple of children aged nine and 10, so those on the cusp of going up from primary to high school."
Miss Watson said parents referring children at these ages said it could be down to a culmination of factors, such as worrying about the move to high school and the anxiety of not finishing their primary school years properly.
She said enquiries are no longer coming just from distressed people who themselves are trying to get help for an eating disorder, but also from parents and schools.
This means the messaging is getting across that other people have a role to play in helping those with eating disorders, which gives Miss Watson hope.
"Naturally, we have had more enquiries from concerned parents who think they have noticed patterns in their youngster during lockdown, as they have seen them more often and they have picked up signs that they are more worried about," she explained.
"We have also seen more enquiries from schools particularly since children returned, who say it is pretty clear they have young people with eating disorders, and they are going to need some help for that young person, but also for their staff, who may not understand the illness enough."
Miss Watson said eating disorders were definitely on the rise before the pandemic, but for those who might have been on the cusp of an eating disorder, or just generally started to struggle with controlling their emotions and being able to get a handle on their life, the pandemic threw them into a tailspin.
"Eating disorders love to deceive that person into thinking it's about gaining control and it is an illness where it can manifest when people are trying to cling onto something and manage their emotions," she explained.
"They feel like that illness is in fact saving them and becoming their friend."
Why acting fast is key
The time it takes to get help for treatment in Suffolk concerns Miss Watson, who said early intervention is "vital" to avoid the illness progressing.
"It is really worrying that people aren't able to access the help as quickly as they want," she said.
"If an eating disorder is allowed to manifest and those kind of neural pathways start to be disrupted by the illness, it becomes a much more difficult illness to unravel and unpick. So the earlier you can get somebody into support, treatment, and guidance, the better."
Miss Watson said the other issue is that even when people are going forward with treatment, there are often barriers to get that help and support.
She said: "Anecdotally what we are seeing at our referral system is that people have been given a year or 18 months on a waiting list to get help, and we have others who say they have been told their BMI is not low enough to be seen, so they are not considered poorly enough, and in some cases people say they are actively considering restricting further to lose more weight to get themselves bumped higher on the list, and that's the toxic nature of the illness."
Miss Watson said she thinks BMI is an outdated metric which needs to be scrapped as it inspires weight stigma and contributes to eating disorders.
She said: "There was the BMI report by the Women and Equalities Committee and the tragic news of the death of Big Brother star Nikki Grahame at the weekend. These two things are a reminder that we have got to have a much greater conversation around eating disorders, we've got to ask why we don't understand it more as an illness, and what more can we do to educate teachers, GPs, frontline healthcare professionals who might have those first opportunities to spot the early warning signs. And that conversation is vital."
Miss Watson said one of the answers is getting all organisations to work together to make the changes and to be sure they can change the patterns of support.
You can support Wednesday's Child and help it be sustainable by visiting its website here.
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