Eating disorders soaring among under-18s in lockdown, psychiatrists warn

The number of children and young people diagnosed with an eating disorder reached “crisis” point during lockdown, psychiatrists in Scotland have warned, with referrals almost tripling from what they were before the pandemic.

NHS data obtained by Scotland’s Royal College of Psychiatrists (RCPsych), via a Freedom of Information (FoI) request, reveal there were 615 referrals for conditions such as anorexia and bulimia in people aged under 18 in the 2020-21 period.

This was up from 456 in 2019-20 – a rise of 34.8 per cent – and 217 in 2018-19.

The College also found that Grampian, one of NHS Scotland’s 14 regional health boards, saw the most significant increase – from 28 in 2018-2019 to 70 in 2020-21.

Dumfries and Galloway, Lanarkshire and the Western Isles did not provide figures, which experts noted as “disappointing” in their findings.

RCPsych said Covid’s impact on healthcare, such as a shift to virtual appointments, the loss of support structures, staffing shortages and less access to community services, helped to fuel the crisis.

It comes after specialists from England’s RCPsych issued a warning back in February about a “tsunami” of eating disorder patients being diagnosed during coronavirus due to various triggers, including people feeling out of control and mental illness thriving in the isolation of lockdown.

Now, RCPsych in Scotland is calling on the country’s new minister for mental wellbeing, Kevin Stewart, to ensure any new funding for Child and Adolescent Mental Health Services (CAMHS) covers young people with eating disorders.

Mr Stewart said in a statement he understood the pandemic “has been an especially challenging time for children and young people” and the Scottish government has “prioritised the health and wellbeing of children and young people as we have worked through the restrictions”.

Due to the “devastating impact” eating disorders can have on individuals and families, he added it is essential that “rapid intervention is available”.

Rob Donaldson’s 17-year-old daughter is currently being treated at a young person’s unit after being diagnosed with anorexia in 2019. She was first admitted to hospital in April 2020, shortly after lockdown began, having struggled to cope when her weekly face-to-face treatment was moved online due to restrictions.

Mr Donaldson, from Dundee, told a PA Scotland reporter he found the dramatic rise in younger eating disorder sufferers “worrying”.

Explaining how the pandemic has had a “huge negative impact” on his daughter’s anorexia, he said: “We were receiving outpatient care at home, and attending weekly family-based therapy sessions, but all of a sudden that stopped. Therapy took place on video calls, and it simply did not work for her.”

Without school and being isolated at home, Mr Donaldson said there was “nothing to motivate her to eat – the illness thrived”. Just a few weeks into lockdown, his daughter deteriorated and was admitted to an inpatient unit for young people.

The family then felt the effects of restrictions, too, as Covid regulations meant they could not visit the unit for the first three weeks – “this was a huge shock for us all,” Mr Donaldson said.

His daughter was well enough to come home by late summer but by mid-November was very ill again and was admitted to a specialist young person’s unit in Glasgow, more than 100 miles from home, as this was the only bed available.

“While she remains in hospital battling anorexia on a daily basis, I have some hope, that as we ease out of lockdown, there will be more reasons to fight and make some steps towards recovery, like getting back to school, learning to drive and going out with family and friends,” he said.

RCPsych insisted that as Covid restrictions ease, there should be a return to face-to-face consultations as soon as it is safe to do so because these types of appointments often work best for patients with eating disorders.

Dr Ereni Skouta, vice-chair of the CAMHS faculty at RCPsych in Scotland, said: “While it’s disappointing that not all health boards responded with figures, what is clear from the data is that action is needed now.

“The truth is, CAMHS services were already struggling to cope pre-pandemic but now we’re seeing a worrying trend and a huge increase in the number of children and young people presenting with deadly eating disorders.”

The College is also seeking a firm guarantee that details on Scotland’s new national transition strategy for all young people with mental illness is released as soon as possible.

Mr Stewart, the mental wellbeing minister, said the Scottish government will “shortly announce the next steps in improving services, having considered the recommendations from the National Review of Eating Disorders Services”.

The inquiry considered services available, the wider support system and the impact that the pandemic and associated restrictions have had on eating disorder patients and their families.