Eating disorders are serious mental illnesses, prevalent in over 7% of the population. The significant and debilitating impact of eating disorders can often be ignored and misrepresented; however, with eating disorders having the highest mortality rate among psychiatric disorders, there is a growing call for more to be done to improve the way the system responds to and supports people with eating disorders.
It is fair to say that the role of local authorities in supporting people who are experiencing eating disorders is at present fairly undefined and lacking in political drive. That being said, local authorities of all tiers are arguably in the strongest position to do more, both in breaking down the stigma that exists around eating disorders and improving the way people with eating disorders are supported by the system.
1. Raise Awareness Within Staff Teams
Arguably, staff working in a local authority will come into contact with eating disorders, but can local government truly say we have done enough to support those staff in knowing how best to respond?
Do staff in councils have an idea of where to refer people to get additional help? Do they have an awareness of how an eating disorder can impact upon the families of those suffering? An understanding of the stigma that exists? An appreciation of the severity of eating disorders?
It is essential that local authorities enable staff to have awareness of eating disorders – this will make a tremendous difference to the lives of millions across the UK. Not only this but will help change understanding and aid prevention.
2. Get the Messaging Right
Whilst raising awareness is important, this must be underpinned by messaging that is not stigmatising. Local authorities need to ensure that from their local plans to their joint strategic needs assessments, when talking about weight the focus is on being healthy as opposed to simply losing weight.
With many local authorities having an increased focus on obesity, it is essential that messaging on the subject is done in a way that is helpful to everyone. We need to rework the messaging so that it is no longer focusing on calories, but on healthy living and healthy eating.
We need to move away from messaging that reinforces a fear of certain foods or promotions that incentivise counting calories as a method for responding to consuming food that is deemed ‘bad’. This type of content can be triggering to so many people with eating disorders, but it can also put unnecessary pressure on individuals which could lead to the development of an eating disorder. There is also little evidence that shows that messaging which encourages counting calories is effective. Local Authorities instead need to incentivise healthy living and healthy lifestyles.
3. Scrutinise Healthcare Partners
Local authorities have a huge role to play in ensuring that services in their local community are working safely and effectively.
Scrutinising local healthcare providers and commissioners to ensure they are delivering eating disorder services that are fit for purpose is something that councillors should not be shying away from. When was the last time the local health and wellbeing board looked at eating disorder provision? Do local decision makers truly understand what support is available to people who have an eating disorder?
Despite NHS guidance, too often individuals are turned away from receiving essential support because they aren’t skinny enough to be considered at risk. This leaves the individual feeling like they aren’t worth getting that support, feeling like a “fake”, potentially losing more weight to hit that target and in some cases feeling suicidal.
We know that early diagnosis is a critical element in the success of treatment for eating disorders and by the time ‘obvious’ signs of eating disorders have manifested, it is likely that the illness will have become ingrained in the individual, and therefore much more difficult to treat. If we want to prevent people getting more unwell, save the NHS money, prevent hospital admission and save lives, local authorities need to act as community leaders ensuring that their local NHS services have fully implemented NHS guidance on eating disorders.
4. Interface with the Fitness & Leisure Industry
The issue of eating disorders is not just something that local authorities with a social care and health portfolio should focus on. The majority of local authorities in the country will have a fitness and leisure portfolio and with nearly 7,000 fitness facilities in the UK this presents a fantastic opportunity to make a positive difference.
Local Authorities need to be promoting healthy living and healthy exercise messaging and recognising that exercise can have a hugely positive impact on a person’s recovery as well as on mental health.
In addition to encouraging staff within the local fitness and leisure industry to receive eating disorder awareness training, local authorities could work in partnership with the industry and health services to develop and deliver awareness campaigns that not only challenge the stereotypical view that to have an eating disorder you need to be stick thin but encouraging people to use exercise in a healthy way to manage their mental health.
5. Join in the Conversation
If you work in a local authority or are a local councillor and want to know more about eating disorders then join in the discussion: have an open dialogue with healthcare professionals and experts by experience about what more local authorities can do.
You can also join in the campaign to #DumpTheScales which was launched in 2016 by Hope Virgo to challenge the dangerous perception that eating disorders are just about body mass. You can find more information here: https://www.change.org/p/eating-disorders-are-not-just-about-weight-dumpthescales
As catalysts of change, and system leaders, local authorities need to do more to champion the issue of eating disorders. By raising awareness, improving messaging, scrutinising health partners and working with the local leisure industry, local government as a whole could drastically change the way the health and social care system responds and ultimately improve the lives of people who are experiencing eating disorders.
Lucan, S. C. & DiNicolantonio, J. J., 2015. How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative. Public Health Nutrition, 18(4), pp. 571-581.
Puhl, R. M. & Heuer, C. A., 2010. Obesity Stigma: Important Considerations for Public Health. American Journal of Public Health, 100(6), pp. 1019-1028.
Walls, H. L., Peeters, A., Proietto, J. & McNeil, J. J., 2011. Public health campaigns and obesity – a critique. BMC Public Health, 11(136), pp. 1-7.