The Alarming Statistics &Trends
The outlook for those suffering from eating disorders currently in Australia is grim and the statistics are alarming. Anorexia Nervosa is the most serious of all psychiatric illnesses. The mortality rate of eating disorders is between 10-20% with many dying from suicide[1] . Eating disorders have been diagnosed in children as young as 8 with an average age of onset at 17 years.

More detailed information, facts and figures on eating disorders are available at:
The Eating Disorders Foundation of Victoria
The Centre For Excellence in Eating Disorders
 

Anorexia Nervosa
After obesity and asthma, anorexia is the most common disease in females aged 15-24[2]. It is generally estimated that in Australia 2-3% of adolescent and adult females satisfy the DSM IV diagnostic criteria for anorexia and bulimia nervosa[3]. 10% of young adults and approximately 25% of children diagnosed with anorexia nervosa are male[4]. Average duration of anorexia is 5 years[5].

Onset of anorexia is generally in adolescence, with bulimia and binge eating more likely to first occur in late adolescence or early adulthood. The long-term nature of these disorders means that many people carry these conditions well into adulthood.

Bulimia Nervosa
The incidence of bulimia nervosa in the general Australian population is 5 in 100[6]. Bulimia and Binge Eating disorders are by nature, secretive (It is common for people with bulimia to keep their disorder hidden for 8-10 years, at great cost to their physical and psychological health)[7]. It is estimated that only one in ten cases of bulimia nervosa are detected[8].

Binge Eating Disorder
The prevalence of Binge Eating Disorder in the general population is estimated to be 4%[9]. The incidence of Binge Eating Disorder in males and females is almost equal[10]. 20% of 18-22 year old Australian women have symptoms of Binge Eating Disorder[11].

Current State of Eating Disorders in the Community
Eating disorders are most commonly experienced by adolescent females and young women, but also occur in males, people of all ages and across all socio-economic and cultural backgrounds.

Existing financial gaps often prohibit accessibility to ongoing treatment options that lead to full recovery. Such recovery is dependent upon very specific needs requiring a wide range of networks of support to diagnose and define the needs of sufferers and to develop specific programs for appropriate care and treatment. If not treated appropriately young sufferers enter adulthood as dependent mental/medical patients. Appropriate care involves and is dependent upon a collaborative approach between a wide variety of carers that includes professionals from medical, psychiatric, psychological, nursing, social welfare, dietetics, and education, backgrounds as well as recovered eating disorder sufferers and families of recovered sufferers.

The lack of co-ordination between service providers and funding inhibits the development and implementation of effective programs. Appropriate care is dependent upon a trusting relationship between sufferer and carer in a no-time frame, healing environment.

Available in-patient treatment options exist in both public and private hospitals (private health care however is accessible only to those with health insurance) with limited long term success and high recidivism rates due to the lack of ongoing or step-down out-patient support following discharge and other factors such as education for families, and adequate training and support for health practitioners. Weight gained in hospital through re-feeding is often very quickly lost after exiting followed by re-admissions.

Further, government penalties on eating disorder beds results in en-forced discharges and re-admissions. Limits on the number of available beds for eating disorder patients results in sufferers at risk all too often being placed in non-eating disorder beds under the supervision and care of staff not specialised in eating disorder treatment. Punitive treatments implemented through lack of knowledge and understanding of the disorder, and in response to financial imperatives of the service providers result in frustration for carers, as well as in the perpetuation and exacerbation of pre-existing anxiety, depression and low self worth among sufferers.

The journey of recovery from eating disorders is dependent upon a continuous and stable relationship between carer and sufferer that is based on trust, understanding and compassion. Such treatment must be accessible, sustained and ongoing.

The impact of eating disorders extends to the wider community which bears the long term social and economic effects resulting from the impact of the eating disorder - family breakdown, and a general diminishment in participation and connectedness in both the social and employment environments. Families, friends, and carers as well as professionals working in the eating disorder community feel the frustration and desperation felt by sufferers.

Eating disorders are not a life style choice nor are they strictly about food or weight, they are about anxiety, low self esteem, identity and a lack of direction in life. Sufferers of eating disorders express such suffering through their bodies and food where others who such low self worth may use drugs, alcohol or risk taking behaviour as a form of self abuse.

An utter lack of self worth, obsessive compulsive behaviour and a tendency toward perfectionism combine with food restriction and other unhealthy eating and exercising behaviours in a dangerous downward spiral of self abuse and depression that sufferers can not pull out of without appropriate help and support.

Intensive treatment and ongoing support is essential and it must be accessible for the length of treatment required until the sufferer is freed from the domination of their illness and rehabilitated back in to the community, their families, work or study.

The respect, compassion and understanding that sufferers of eating disorders deserve will only be achieved through education programs in schools and the wider community as well as through the funding of more appropriate treatment and early intervention programs.

References

1. The overall mortality rate for anorexia is 5 times that of the same aged population in general (depression = 1.4), with death from natural causes being 4 times greater and deaths from unnatural causes 11 times greater (depression = 7). Risk of successful suicide is particularly high being 32 times that expected (depression = 20). Beaumont, P. The Encultured Body, School of NursingQueenslandUniversity of Technology. 2000. p.80
2. Mortality rates for anorexia nervosa after 20 years are between 15-20%. Ibid. 2000. p.80
3. Ibid . 2000. p.80
4. Paxton, S. 1998. Do Men Get Eating Disorders? In Everybody. Newsletter of Body Image and Health Inc. Vol 2, August 1998
5. Beaumont, P. The Encultured Body, School of Nursing Queensland University of Technology. 2000. p.81
6. Women’s Health Queensland Wide Fact Sheet, 1997, Vol 2.021,. in Sanders et al, 1995, Body Image, Sex Role Stereotyping and Disordered Eating Behaviours, University of Queensland
7. Women’s Health Queensland Wide Inc. and The Eating Disorders Association Inc Resource Centre, 1997, in Understanding Eating Disorders
8. Through the Looking Glass. Newsletter of the Eating Disorders Association of Queensland, Vol 3, Issue 11
9. Wilfley, D., Agras., Telch, W., Rossiter, E., Schneider, J., Cole, A., Sifford, L., and Raeburn, S. 1993. in Howell, P. Information on Eating Disorders for Health Practitioners. EDFV, Victoria. 1999
10. Paxton, S. 1998. Do Men Get Eating Disorders? In Everybody. Newsletter of Body Image and Health Inc. Vol 2, August 1998
11. The Australian Longitudinal Study on Women’s Health, Universities of Newcastle and Queensland. Commenced. 1996

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