To be outraged that obesity is being addressed whilst people are dying of anorexia a subject never mentioned by the government?

[milokaimilo]

My daughter has been struggling with anorexia for 4 years. We have travelled miles to find any kind of treatment for her. Not enough funding they say, not enough people suffering from it they say. The fact that 1 in 100 teenage girls will have some kind of eating disorder, the fact that 10 of those will die before anyone takes any notice. I've campaigned, shouted, cried in the face of the doctors who sit there patronising me and telling me I'm over reacting when my daughter weighs just 4 stone with a height of 163cms. Please sign the anorexia awareness register or contact BEAT or something to help raise awareness.

Today it's my daughter, tomorrow it might be yours. 4 years ago, my life was normal, now I don't have one and my daughter wouldn't be here if I was shy! :(

More people are affected by obesity. It makes more sense to throw more resources at that problem.

That said, I agree that anorexia is under-recognised. Like bulimia, It can be easy to hide (from anybody & everybody) much easier to hide than morbid obesity out of sight, out of mind. On top of which almost nobody in our modern culture openly admires voluptuousness, whereas thinness is widely often spoken of in fawning terms. Some people aren't aware that it's even possible to be too thin.

I think this 'fat bastards' comment needs to be nipped in the bud so we can just get on and offer support for the lady and her daughter.

What's the difference between 'I'm such a fat bastard today!' and 'I'm such a fat cow today!'? Just a matter of how comfortable one is with curse words?

Also, I think the way it was originally used was fine. The woman who used it did so in relation to people who stuff themselves and kill themselves intentionally that way (because they don't watch the calories). In other words, someone couch potato who eats solely iced doughnuts all day long and whinges they can't lose weight. Personally, I think that's perfectly reasonable to be scolded for. The adage 'eat less, more more' isn't hard to comprehend. Look at the majority of diet programmes - those people are totally delusional as to what they eat and how much.

Before I was in fully-fledged anorexia, but still on the downhill slope, I went to my GP. It was a deliberately concealed cry for help as I purposefully brought my food diary with me and was at pains to tell him about it and said that he could look at it. Thing were recorded in freakish detail - '8 sips of milk, last sip rather large gulp though', '3 squares chocolate, but may have dropped some shavings on floor'. The guy, leaning back in his chair the whole time, just said 'you should just put on about 8kgs...men like a bit of meat on women' - I was 18/19 at the time.

I later ended up taking up to 40 laxatives a day - they now cease to work, so I have to go a bit crazy on natural fibre - god help me when I'm 80 and constipated. Sorry, TMI!

So, yes, fully agree with others - help for anorexia/bulimia is pathetic. I'm sure you do this already, but, please avoid letting your daughter see, feel or sense how outraged you are at the system. She may translates her mother's anger as being directly her fault, and she's going to regress further.

Is it the elephant in the room at your house, or do you talk about it openly? If the latter, have you tried a reasoned approach to things? Nothing pissed me off more than people I barely knew grabbing my upper arm and saying 'omg, look how skinny you are! I need to feed you up' - also, it's a dangerous thing to say because it reaffirmed how "fabulously skinny and in the minority" I was. Instead a reasoned 'why do you do this? What do you hope to gain? Is this really sustainable?' helped me far more. I would also try to diminish it - I know that sounds really inconsiderate on my part. But, treating it as a smaller thing than it is may help her diminish it as a demon in her own head. It evidently rules every waking thought, so you almost have to outwardly live in denial.

Does she have a compromise weight? I hated people fighting with me on my weight. However, some spoke to me about finding a 'still thin', but heavier weight and maintaining that instead. Bit by bit, she may see that, actually, "I was bloody ridiculous before and now I'm happier". If this can be reasoned, I would actively help her e.g. exercise with her, demonstrating that the voices in her head aren't imprisoning her and that she doesn't have to bear the constant exercise-starvation cycle on her own.

I wouldn't take scales away either. For me it was all about numbers. I'm OCD. Lack of scales would make me very anxious so I'd go overboard on starvation and exercise to be on the safe side.

Sorry if you've heard these tips before. If you have, I didn't mean to be patronising.

I'm not talking about cardiovascular fat burning exercise though, I'm talking about body building, essentially. Its a very different thing. And the calories used to achieve it would have to be replaced with good proteins and fats. Otherwise it wouldn't work. Please dont misconstrue what I am saying, I am not talking treadmills and tape measures, I'm talking rebuilding their bodies into a healthy lean machine not a force fed, artifically fattened up body that feels wobbly and awful to them that they vow to lose as soon as they have freedom to do so.

They may come out of there with the same issues of control and perfection, but a healthier focus.

Or not! I might be wrong but I'm not sure you have understood exactly what I am proposing in terms of body composition. Bear in mind that a girl coming out of hospital weighing 8 stone with 15% body fat but 45kg or more of lean mass will be a hell of a lot healthier with a hell of a lot better bone density and brain mass than an 8 stone girl with barely 30kg of lean mass and a body fat percentage which makes her feel disgust, regardless of what issues they may or may not have addressed in terms of counselling.

I do see what you are saying I am just trying to point out that in the head of an anorexic replacing one type of baby obsession with another wouldn't necessarily provide any relief but would just prolong the controlling behaviour. I would also point out that for an anorexic it may not just be about fatness, that word can be confusing it is often about size too. So 8 stone is 8 stone whether that be fat of muscle. Anorexics often find muscle building just as scary as building fat.

I really do see what you are saying in that clearly just piling on the pounds and then kicking them out isn't the best but I just wanted to point out that a) people need to be helped to release the control rather then replace it with another body, counting, perfecting obsession and b) its essentially not about fatness in the first place.

Tatty - that's great advice - especially from a health/biological perspective. However, a sufferer will not see it like that. On one hand it's likely to be that she won't equate the rising scale number with muscle gain and, secondly, for me at least, seeing ribs and jutting bones was like a gold star. Even just holding fluid in my stomach would send me off the rails.

The diet change is great. Most sufferers will eat utter crap that bears no nutritional value. So, if someone's going to severely restrict their intake, at least what they eat should be nourishing. Also, it's a small step in the right directing - so she shouldn't feel that diet change was a huge, uncontrollable deviation from her entrenched regime. Following it up with, 'yes, it's fine if you just eat that small amount. We won't get angry/frustrated/etc. Honestly, if that's all you want to eat, that's perfectly fine and we're happy for you to do that'

Haven't read further than the OP yet, but I think the reason for this, OP, is that anorexia is very much a disease that has its roots in the mind, whereas obesity (generally speaking) isn't. Anorexia, and the long-term repercussions of it affect a relatively tiny percentage of the population, whereas the most common causes of obesity and the long term repercussions affect a very large percentage of the population - and growing.

There would be little point in throwing billions of pounds into public awareness campaigns for any condition that statistically is unlikely to affect the majority of families.

I actually feel the opposite way to you. I feel that many people have a lack of ability to control their eating (and a compulsion to over-eat and therefore become dangerously obese) due to their emotional/mental state (so I suppose it's the direct opposite of anorexia, yet probably far more common) and yet they receive virtually no help and support, no counselling or therapy (other than pointless and patronising lecturing about 'healthy eating' and 'portion control' and 'exercise') from the NHS.

The only time they get proper medical help is when they are so dangerously fat and so utterly, utterly miserable that they cannot leave the house, by which time the only hope is a gastric band, as diet alone can never help them, and even NLP therapy is too little too late.

I hope your DD gets well soon. x

Tatty, the decision to feed an anorexic patient via a tube is always taken only as a last resort.
The reason being that introducing food to a a person who has suffered long term starvation can be very dangerous. The is a complication known as " re-feeding syndrome" which is a biochemical reaction which can be fatal unless managed very carefully.

      The concept of healthy weight gain with  muscle growth, via moderate exercise and a healthy diet is used as the long term answer in all the clinics I'm aware of.

Unfortunately tough, in an acutely physical ill patient sometimes tube feeding is the only way to keep them alive long enough to get to that point.

Illness and death through anorexia are much rarer than through obesity. Denying your hunger is a lot harder than giving into it. Thus there are a lot less anorexics than there are morbidly obese and funding reflects this.

Further - lifestyle can also lead to creeping obesity that is completely unrelated to any mental condition. These are the 'fat bastards' who have let it all slip over a number of years, and they respond well to advertising and awareness campaigns pointing out their lifestle choice errors.

With respect to 'fat bastard' comments on here. I think there should be more of it to be honest. The creeping flabbyness of our society is a bad thing and should be discouraged whenever possible. A good dose of social stigma is more effective than a thousand 'put the fork down' campaigns. When did it suddenly become acceptable to be fat?

This much I can guarantee, if you reduce kcal intake then your weight will reduce. Giving someone the skills, self confidence or therapy required to achieve this is however a different thing.

Op I agree that AN services are a disgrace. Mental health care in this country as a whole is in decline but unfortunately you already know this.

I'm sure there isn't an ED unit in the land that solely refeeds; psychoeducation, individual (eg: motivational enhancement therapy), family meals and family therapy featured fairly prominently at Phoenix when my daughter was there. Rhodes Farm has a reputation for being a bit harsh.

Thankyou for all the supportive comments.

I'm a mental health nurse at an NHS inpatient unit with teenagers with eating disorders. We have teens receiving their entire nutrition via an NG tube because if we don't they will die. There is little point offering therapy if the child isn't alive to understand it. There's also little point offering therapy to teens that are half dead from malnutrition - Their bodies are instarvation mode and they simply aren't able to work cognitively.

With severe cases we feed teens (via NG if needed) until they are at a weight that is physically safe and they are not in danger of death. Only then do we start any work on the causes for the problem. Before this point their brains are simply not able to work.

There are some services out there that can and do work very hard for young people with eating disorders, but just like many mental health services, funding is limited (and currently being cut).

I hope you find some help for your daughter.

Complete aside but how did I do that? Crossing out a long line of text it was completely undeliberate! Wish I knew how to do that on a consistent basis.

Okay... I just did it again, and figured out this is what you do
to get example of long stretch of text crossed out

You do double dashes space text ("example...") space double dashes. Did everyone else know that and not me??

Forgive me the digression.