Eating disorders affect an estimated 1.6m people in the UK and the numbers are rising. Yet support for sufferers and their families is a postcode lottery, with Kirklees faring badly.

So says Louise Warner, service manager for the Huddersfield-based Womenspace Mental Health and Well Being Project at the WomenCentre for Kirklees and Calderdale. She runs the area’s only self-help organisation, the Eating Distress Support Group.

Louise said: “This is one of the most under-resourced places in the country for services. I meet women who have moved here from being at university in other places and they say there was much more help available to them elsewhere.

“Eating disorders are a massive problem and yet the resources to help people just aren’t there.”

The support group was set up 18 months ago after a gap in local services was identified.

At that time there was little or no specialist help.

“About a year ago Psychological Services took on two psychologists who have a specialism in eating disorders, but I’m not sure how many people, or doctors, know about this,” said Louise.

In fact, while researching this story it proved extremely difficult to track down anyone who could reveal what services are currently available.

A spokesman for the South West Yorkshire Partnership NHS Foundation Trust could not confirm how many psychologists work with eating disorder patients but said; “The Trust’s clinical professionals have a wide range of specialisms and interests and this includes some members of the psychological therapies service who have an interest in eating disorders.”

A further statement, from NHS Kirklees, explained that a community eating disorder service had been commissioned during 2009 and was now fully-operational.

It said: “To access the service, a patient should visit their GP, who will then refer them, if appropriate, to the service for a detailed assessment, treatment and/or specialist recommendation.

“The healthcare pathway for eating disorders is designed to ensure a referral can be responsive, depending on the identified need.

“Where specialist inpatient care is required there is, effectively, no waiting list and patients have access to care quickly.”

However, access to the Women Space support group is immediate and open to all women.

Members range in age from 19 to 47 and have a spread of problems – from anorexia and bulimia to over-eating and self-harming.

Some have other mental and physical health issues. Bulimia is the least understood – sufferers often look well and have an average body mass index and yet among those with the condition in the Huddersfield group is one woman who makes herself vomit up to 60 times a day.

According to the Eating Disorders Research website set up by King’s College in London, anyone can develop an eating disorder, regardless of their age, sex or cultural background, but it is most common among young women, particularly those aged 15 to 25.

Sufferers who ask for help are often referred to a psychiatrist but, as Louise points out, as with any NHS speciality, patients may only see their consultant once every few months.

“People with these sort of problems really need more support than that, which is why we were commissioned to run this group,” said Louise.

While it is now thought that there could be a genetic predisposition to eating disorders and research has shown that women with eating disorders often have thinking styles and emotional characteristics common in autism, the causes are most likely to be as complex as the conditions themselves.

“There is often a link to early nurturing and the relationship between the sufferer and their mother,” said Louise. “I do find that there is often a strong bond between mother and daughter, but I don’t have any desire to place any more guilt on mothers. I’ve got four children and I know how easy it is to blame yourself for what you do or don’t do.”

However, she says one extremely common characteristic of people with eating disorders is that they experience high levels of anxiety.

“I have also noticed that they tend to be very clever, smart. You can see it in them. But they have a need to control every aspect of their lives,” she added.

“They have a neatness of appearance and are concerned with the minutiae of how they look. They have perfectionism.”

The desire to look and be perfect may, she believes, be partly driven by peer group pressure and expectations based on celebrity culture.

“It’s not really known how much is received from the external world, from our fascistic fashion culture and supermodels, and how much is family related, or our inner ‘make-up’, our own uniqueness, but I suspect it’s a bit of both as well as other unknowns,” said Louise.

“Feedback from some sufferers is that when they are eating there is a moment, even a nanosecond, of peace from the chattering mind. We try to adopt an approach that supports being in the now, which can be a relief.”

The Eating Distress Support Group meets once a fortnight at Womenspace, WomenCentre, Estate Buildings, Huddersfield, but also offers a telephone/email link up in between.

Louise says the group helps sufferers to share common experiences and realise that they are not alone. “They are in a position to share with people who are not going to judge them and damn them,” she explained.

“For them, coming out of the closet, sharing the secret, can be an enormous relief,” added Louise.

The women who have used the group suffer from a range and mixture of eating problems.

“But there are a lot of grey areas, where someone might be chucking up for a while and then start over-eating and not being sick,” said Louise. “Their bodies and brain chemistry get so confused and play havoc with their moods.”

Louise, who trained as a psychotherapist as well as community development and family systems therapist, and has a specialism in addiction and eating disorders, says eating disorders are unknown in developing countries where most people can only afford a subsistence diet.

“Here, we don’t need to worry about waste and our relationship with food has changed,” she says.

“I also think that in the West, women’s roles have changed and we have high expectations. We say we are going to have a job and a family and be slim and healthy. We are superwomen and there’s a price to pay,” added Louise.

l For more information about the Eating Distress Group call 01484 536272 or email louise.warner@womencentre.org.uk The website www.eatingresearch.com has a wealth of information for sufferers and their families, as well as links to the latest research.

PEOPLE with anorexia lose obvious amounts of weight but the weight of people with bulimia remains unchanged, allowing them to hide their condition. However, they may have swollen glands, a puffy face, hamster cheeks, tooth decay and dry pale skin. These are more subtle signs.

Weight control may take the form of an obsessive interest in exercise, usually solitary exercise such as running or walking excessive distances.

People with eating distress may do any of the following:

become excessively busy on purpose to avoid food, hunger and meals;

throw large amounts of food away or never fully finish a meal;

hoard or hide uneaten food;

enjoy watching others eat and encourage them to do so;

cook elaborate meals but not take a mouthful themselves;

take a sudden interest in cooking and food preparation and hover around the kitchen while another family member prepares a meal, or show a great interest in ingredients or in how a dish is cooked – steaming or boiling giving them reassurance, roasted or fried prompting trepidation;

‘read’ packets and count and note calories;

study recipe books and food magazines laboriously, and watch cookery television programmes;

come up with never-ending excuses for not eating – ‘I ate earlier’ or ‘don’t worry I’ll have something later’;

adopt dangerous and altered food habits – pile their plate high with vegetables, almost to the exclusion of protein and carbohydrates, and have a fear of fatty and indulgent foods – no cheese, butter, salad dressings or mayonnaise, and certainly no chocolate, biscuits or cake;

constantly chew gum or consume vast amounts of diet fizzy drinks or black coffee to distract themselves from feeling hungry;

adopt food fads – a liking of foods with strong flavours, for example – mustard, chilli, tomato ketchup, Tabasco, Marmite, vinegar.

Watch out also for:

sinks and toilets smelling of vomit;

large quantities of food going missing from cupboards;

someone continually disappearing after meals and making excuses – ‘I’m just going upstairs for something,’ ‘I’m just going to the toilet.’