Early Intervention - NEDAW musings

Today is officially the last day of Eating Disorder Awareness Week. Before it passes over I feel the need to talk about the focus for 2017 as set by B-eat which is Early Intervention.

The topic is a difficult one for me, most of all because any focus on early intervention felt very lacking all those years ago when I became ill. It was more of case of waiting for sufferers of eating disorders to reach a point of acute danger before offering any substantial help, sometimes pushing so far that there was no in between from being given no care to then suddenly passing a line whereby you are an emergency  case. Weight was always the quantifier, and so often it felt like you had to lose more in order to get any kind of recognition or treatment. Messed up is having to push yourself to get worse just so you can get better.

This is still happening. But I have also noticed progress, with some being taken seriously at an early stage, where the outcome of recovery is more likely. The sooner the better, as more quality of life can be preserved. Unfortunately despite the change of direction funds are still being squeezed, with the NHS budget out of breath and gasping. Mental health beds are continuing to be cut, and so it’s still a struggle for many treatment facilities to take anyone beyond those at great medical risk. It’s further down that some head-way can be made I feel, using outpatient and day patient resources to stop further admissions down the line if at all possible.

I can’t stress how much those with diabetes and eating disorders need early intervention. The danger that someone omitting insulin can be in despite presenting as a normal weight is immediately life threatening. This HAS to be recognised. So often I hear that anorexia has the highest mortality rate out of any psychiatric condition, yet I’d take a wager that ED-DMT1, particularly involving insulin omission would overtake if it had an official diagnosis and the appropriate studies and statistics were available.

The need for early intervention AND timely recognition of ‘diabulimia’ symptoms alongside understanding of its seriousness must go hand in hand. Recently updated NICE guidelines are definitely a step towards that as type 1 diabetics are now listed as in need of urgent attention under eating disorder care guidelines.  If untreated the long term complications of ED-DMT1 can be so devastating, I won’t list them as we all know, the end of the line being loss of sight of limbs.

I do wonder where I might be now if I’d had help earlier. It’s hard not to dwell on that somewhat, 15 or so years down the line. I am definitely not the only one either. 

They have two patients with type 1 diabetes in the day-patient program I attended 3 years back now. They are getting trained up on the right way to deal with them, the NICE guidelines nipping at ankles with the worry they could get into trouble. This is the same unit that would hear nothing about that kind of specialist input while I was there. They told me they did not need training, and I felt like they were collectively sighing whenever I spoke of diabetes. I came out of that program far worse than when I went in. So yeah, that’s difficult to swallow. 

But I’m trying to let it go. 

Looking at younger people that are so vulnerable these days makes my heart sink. Even more so those I spot dabbling in eating disorder behaviours. I want to shake them or hug them and tell them to stop, but of course that would sound completely patronising and it’s not my place. I worry about the increasing coverage of diabulimia in the news being used as the catalyst for ‘ah maybe I will try that?’ thinking, but that’s the underside of creating awareness. Sensationalist reporting that focuses on weight and pounds lost certainly have a lot to answer for there, EDAW has once again shown that the media will never learn.

The emphasis needs to be on saving those years, months, hours that can be eaten away by an eating disorder. Of the lives that have been lost because help has come too late. 

Early intervention. To those who can act, make it mean something, please.