I wrote this article for the Evening Echo and it was published in that paper on the 8th November 2007. It remains an issue that I believe is repeatedly overlooked despite its importance.

No longer the exclusive domain of high-fashion supermodels and Hollywood starlets, an estimated 200,000 Irish people currently suffer from eating disorders. Bodywhys, the eating disorders association of Ireland, estimates that such disorders result in 80 deaths annually.

Binge Eating, the most prevalent disorder, affects up to 168,000 Irish people (4% of the population) leading to widespread obesity and related health problems. Against the stereotype of eating disorders binge eating affects as many men as women.

The less common, but perhaps more deadly, anorexia and bulimia are on the rise with children as young as nine showing symptoms. Nationwide 7,000 families experience the horror of watching their son, daughter, brother or sister slowly starving in front of their eyes. Some 500 of these families will pay the ultimate price for the lack of support services: these parents will bury a child, due to medical complications or suicide. In fact suicide accounts for half the deaths associated with anorexia and the suicide risk among girls with anorexia is 200 times higher than normal.

We live in the mist of a hidden tragedy. Lurking in plain sight on our television screens, our magazine stands and our internet sites the message is the same: to be beautiful, even to be acceptable you must be thin. The size zero has become the adolescent hero.

The response to this crisis has been slow, substandard and short-sighted. The public health service has only three designated specialist beds based in St. Vincent’s Hospital in Dublin while there are only sixteen specialist private beds split between St. John of God’s and St. Patrick’s Hospitals also in Dublin.

The three public beds that do exist are reserved for over 18s leaving the youngest and most vulnerable victims with no public beds at all. Outside of Dublin there are no specialist beds available to sufferers of any age. Even the small number of sufferers best placed to get a specialist bed, those based in Dublin and over 18, have no guarantee of a bed as the long stays required for successful treatment result in a very slow turnover of the few beds available. The number of beds, both public and private, is clearly inadequate to the task and desperately needs to be increased.

Added to this scarcity of beds there is no service designed to manage cases of eating disorders which arise in children and adolescents. The lack of such a body to coordinate and respond to this growing crisis is one of the great weaknesses of the current system. The average age for the onset of anorexia is 14 while for bulimia it is 17 and early intervention and treatment is recognised as the most successful method of dealing with eating disorders. The absence of any service to manage and respond to cases of child or adolescent eating disorder means that early diagnoses and treatment is non-existent in Celtic Tiger Ireland.

The 2006 report on the Mental Health Policy, ‘A Vision for Change’, recommended eight reforms to improve eating disorder services:

1. Health promotion initiatives to create greater community and family awareness of eating disorders
2. Support for voluntary agencies promoting awareness of eating disorders
3. Modules on eating disorders for those training as health professionals
4. The establishment of Community Mental Health Teams (CMHT) to manage child and adolescent eating disorder cases at a local level
5. The establishment of a National Centre for Eating Disorders based in one of the national children hospitals to deal with complex eating disorder cases
6. The creation a specialist team in each of the four HSE regions to deal with eating disorders
7. The creation of a six beds eating disorder unit in each HSE region under the management of the specialist team
8. The provision of community based consultation, advice and support.

The ‘Vision for Change’ report provides a road map for the future but we now require the immediate introduction and funding of the suggested reforms to begin to tackle this problem in any meaningful way.

The curse of an eating disorder can hit anyone. No one is immune. Only one thing is certain: when it hits, there is currently no real State support. It is left up to voluntary organisations, like Bodywhys, to fill the vacuum left by the absence of frontline State services. In this day and age this is just not good enough. The need to tackle the growing problem of eating disorders is not a party political issue, it is a moral issue. In today’s world we cannot shield our children or our teenagers from the pressure to be a size zero. The best we can do is to provide world class local services dedicated to early diagnoses and treatment to save those who fall victim to that pressure.