Psychiatrists have warned of a “tsunami” of eating disorder patients amid data showing soaring numbers of people experiencing anorexia and bulimia in England during the pandemic.
Dr Agnes Ayton, the chair of the Eating Disorder Faculty at the Royal College of Psychiatrists, said the number of people experiencing problems had risen sharply with conditions such as anorexia thriving in the isolation of lockdown.
She said: “We expect the tsunami [of patients] is still coming. We don’t think it has been and gone.”
She also noted that in Oxford, where she works, about 20% of people admitted were usually urgent referrals but this proportion had shot up to 80%.
Separately, data released on Thursday shows huge rises in waiting times for young people and children, with a 128% increase in the number waiting for routine treatment compared with last year.
There has been a fourfold increase in the number of children and young people waiting for urgent treatment from October, November and December 2019 compared with the same months a year later.
In that period, there has been a 41% increase in the number of children and young people completing treatment and an 86% increase in the number of children and young people completing urgent treatment.
Only 72.7% of children and young people started treatment within one week of referral – the lowest percentage achieved for three years.
Ayton said there was no comparable data for adults, where numbers are also rising. She said services were struggling to cope due to “chronic underfunding” of services and “reduced capacity due to pandemic and infection control”.
She said eating disorders were rising due to people feeling out of control, and that they also thrived in the isolation accompanying the pandemic lockdowns.
She also said there were “unhelpful” messages around “weight loss and exercise” targeted at those with obesity “but triggering to those with existing difficulties”.
She added: “I think social isolation seems to have a major effect on people’s mental health.
“Not just eating disorders but also anxiety and depression and alcohol use. I suppose to some extent anxiety and eating disorders are closely linked, so there is that.”
Ayton said it was “a real worry”, adding that the huge rise in people with such a low body mass index that they need urgent help could be due to a reluctance to come forward early enough.
“Some people don’t want to see their GP or they don’t feel they deserve to come forward as they think that other people with Covid are more deserving,” she said. “There is a lot of shame related to eating disorders.”
Private facilities have also seen a rise in people coming forward. Dr Lorna Richards, a psychiatrist specialising in adult eating disorders at the Priory Group, ascribed the rise in such disorders to several factors, including “fear and uncertainty, fuelling anxiety symptoms” and changes to people’s routine and home lives.
“There has also been widespread concern [among the general population] about lack of physical activity, and about weight gain during periods of lockdown, which has seen the nation both dieting and exercising, en masse,” she said.
“Eating disorders have thrived in this environment, as the focus on eating and weight control becomes a way of coping.”
She said that for some people, focusing on food – either by restricting, overeating or using other weight control measures such as purging and overexercising – can be used as a way of “coping”, and to provide “a sense of control or mastery”.
As the pandemic took hold last year, Priory Group noted a 61% increase in the number of inquiries about treatment for anorexia nervosa at its private clinics, and a rise of 26% in the number of inquiries regarding treatment for binge eating disorder.
Richards specialises in adult eating disorders at Priory’s Woking hospital and Priory’s Life Works centre and has been involved in the development of NHS national guidelines and policy around eating disorders.
She said: “Since the early summer of 2020, I have seen a huge increase in referrals from people with existing disorders who have deteriorated since the pandemic emerged.
“I have also seen an increase in new patients – specifically people, who, during the first lockdown, were starting to develop eating disorders for the first time.
“For those who are vulnerable to developing a disorder, there have just been too many challenges – and they are ongoing.”
