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Your illness worsens – so care is cut off. This is the scandal playing out in eating disorder treatment

Patients I’ve spoken to in the east of England were desperate for help, with dangerously low BMIs. On what possible grounds were they discharged?

Last week, I had a long conversation with a woman who is trying desperately to loosen the awful grip of an eating disorder. She wanted to remain anonymous; for the sake of this article, I’ll call her Jane. She is in her 30s and lives in Norfolk. Her illness, first diagnosed when she was a teenager, is known as the restricting type of anorexia, meaning that she has a long history of drastically limiting her food intake to the point of self-starvation.

Over the past 10 years or so, she has spent some of her time as an NHS inpatient. She told me about her first stay in a specialist ward, where there was “a massive turnover of staff. We all knew we needed therapy, and we couldn’t get it.” She was once moved to a residential facility hundreds of miles from home, in Scotland: “You’d hear people screaming and being held down while they were fed.” And again and again, she talked about the impossibility of coping with the repeated switch from this kind of 24/7 care to the woefully inadequate visits she received when she was allowed to go home.

John Harris is a Guardian columnist

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Brianna Ghey’s mother warns tech bosses more children will die without action

Exclusive: Esther Ghey says she believes social media use left her daughter vulnerable, while killers were able to access violent content online

The mother of Brianna Ghey has called for her murder to be a “tipping point” in how society views “the mess” of the internet, warning that a generation of anxious young people will grow up lacking resilience.

Esther Ghey said technology companies had a “moral responsibility” to restrict access to harmful online content. She supports a total ban on social media access for under-16s – a move currently under debate in certain legislatures, including Florida in the US.

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Beware the mix of food and fear – the truth about ultra-processed foods is still emerging | Amelia Tait

Research on UPFs should be a wake-up call – but if people miss out on nutrients in a quest to avoid them, is it really helping?

If you consumed a lot of news last year, you’d be forgiven for thinking that strawberry yoghurt wants to murder you. Since last spring, a new obsession has spread across Britain: have you heard? Don’t you know? UPF is our new food enemy. What is UPF? It is ultra-processed food. What is ultra-processed food? It can include cereal and sausages and fruit-flavoured yoghurts and instant soup. How exactly can I determine if something is ultra-murderous? Anecdotally, my friends don’t seem to know the definition of UPF – but they do know they should be afraid of it.

Another person who, by his own admission, hasn’t quite mastered the definition is Chris van Tulleken, the infectious diseases doctor who wrote the bestselling book Ultra-Processed People: Why Do We All Eat Stuff That Isn’t Food … and Why Can’t We Stop? At the beginning of his book, he forgoes “a long formal scientific definition” of UPF, instead arguing it can be boiled down to this: “If it’s wrapped in plastic and has at least one ingredient that you wouldn’t usually find in a standard home kitchen, it’s UPF.”

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‘A pile of dirt makes me drool’: why some people crave and eat inedible things

From chalk to rubbers and clay, there are a variety of reasons why those with pica syndrome yearn to eat non-foodstuffs. But is this dangerous?

Mary (not her real name), a 20-year-old from Ireland, has just kicked her habit – of eating firelighters. “I got through a box of individually wrapped ones every six months for most of my adolescence,” she says, “but during exam season I would go through a box every three weeks. I would allow the firelighters to dry out in the box after opening them, as that was how I preferred them.”

Mary has pica (pronounced pike-a) syndrome, often classified as an eating disorder that involves consuming non-food items. But even within this condition, her version is unusual, leaving her feeling isolated. “I haven’t heard of anyone else experiencing anything like it,” she says. “Internet searches have led to poison hotline phone numbers or pregnancy forums, because expecting mothers often crave the smell of firelighters. But someone else must eat them like I used to.”

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So many Indian women struggle with their body image. We need to talk about why | Pragya Agarwal

It is easy to blame Bollywood and the media for unrealistic expectations of beauty – but there are deeper social factors at work

When Indian actor Aishwarya Rai, once Miss World, walked the runway at Paris fashion week for L’Oréal this month, the online space and many Indian newspapers exploded with comments about her weight.

People took to social media to say she had “let herself go”, that she shouldn’t have worn this or that, that she should have taken better care of herself. She faced similar comments about her “baby weight” soon after giving birth to her daughter 12 years ago.

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Everything Now review – this witty teen drama is a sweet, nuanced look at anorexia

There’s a real bounce and energy to this beautifully acted Netflix coming-of-age tale about a 16-year-old with an eating disorder – who’s on a mission to live wildly

Everything Now is a coming-of-age story with several twists and a lot of angst, all of which it carries with more intelligence and style than your average teen drama. Sixteen-year-old Mia Polanco (Sophie Wilde, star of recent cult horror film Talk to Me) has just been released from a private eating disorder treatment centre, where she has been an inpatient. She doesn’t so much leave as burst out of its doors. She has a lot to catch up on, but when she suggests going to the cinema or bowling, her group of friends has to inform her that life has changed. Sex, booze and parties are the new bowling. “How can I have missed so much in seven months?” Mia asks, before establishing a “Fuck It Bucket List” of activities, from going on a date and having her first kiss to breaking the law, clubbing and beyond.

Mia’s anorexia is the main character here. Everything Now is responsible about it, but not toothless. Her illness recedes into the background then roars back. It is not rational or linear. One episode, later in the series, assumes the perspective of her brother, Alex, which emphasises just how consuming her experience has been for everyone who loves her. Netflix faced criticism for its 2017 film To the Bone, which also told the story of a young woman in treatment for an eating disorder, but with considerably less tact and nuance than this. Everything Now is sometimes sad and often stressful – not least because teenagers really would save themselves a lot of problems if they had a simple conversation about what they were thinking – but it is also funny, and defiantly blunt.

Everything Now is on Netflix now.

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Laura Waldren wins Papatango new writing prize for Some Demon

The playwright and actor’s debut drama about life on an eating disorder unit will have its world premiere at the Arcola theatre in London next summer

The Papatango new writing prize has been awarded to Hull playwright Laura Waldren for a drama about life in an eating disorder unit.

Waldren said that Some Demon, her first full-length script, was “a very difficult, personal but important play to write” about what she described as “still deeply misunderstood illnesses”.

In the UK, Beat can be contacted on 0808-801-0677. In the US, the National Eating Disorders Association is on 800-931-2237. In Australia, the Butterfly Foundation is at 1800 33 4673. Other international helplines can be found at Eating Disorder Hope.

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If I’d been given palliative care when I had an eating disorder, I would not be here today | Dorothy Dunn

My own recovery from the ‘hopeless’ stage of this condition shows we must never give up on patients

The leaking of NHS documents last week describing how patients with longstanding eating disorders could be offered palliative care under new guidelines in the east of England was shocking but not unexpected. The very fact that these severe and enduring eating disorder (Seed) treatment pathways exist at all is scandalous.

A running joke among service users is that the Seed treatment pathway is where you go when services have given up on you. Outpatient services seemingly don’t know how to treat these patients other than to manage terminal decline. But inpatient services don’t, either – the fact that palliative options are even on the table shows that.

Dorothy Dunn is a freelance journalist

Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here.

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Some English patients with eating disorders sent to Scotland for treatment

NHS England data shows 84 patients were sent hospitals in Scotland in 2020-23 due to lack of beds near their homes

Vulnerable eating disorder patients from England are being sent hundreds of miles from their homes to Scotland for treatment, as the number of available beds south of the border has dropped in two years.

Data from NHS England, which included the financial years 2020-2021, 2021-22 and 2022-23 and up to the end of May 2023, shows that 84 patients were sent from England to Scotland. The total cost of this was almost £9m. In the financial year 2022-23, 29 patients made this trip, costing more than £3.4m. The Guardian spoke to a young woman who had been sent more than 400 miles from Sussex to Glasgow, an eight-hour drive.

For more resources, Beat has this directory of eating disorder support services in the UK, and also runs helplines across the four UK nations. The RCP also has helpful resources for children and young people and their families. In the US, more resources are available from the National Eating Disorders Association. In Australia, contact Butterfly.

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‘You are still overweight’: how a doctor’s health advice triggered Sarah’s eating disorder

Experts say dietary guidelines from Australian government bodies are too weight-centric – a ‘huge disconnect’ between science and policy

Sarah Cox was admitted to hospital and placed on a feeding tube because she was malnourished, yet hospital staff discharged her with a weight loss plan. “I was told: ‘You’re still overweight, you still need to lose weight.’”

Cox says her eating disorder began after she was told by her GP to lose weight and that her body mass index (BMI) was too high at every appointment she attended throughout 2018-19, despite displaying no indicators of poor health such as blood test abnormalities or high or low blood pressure.

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