If I ask you to think of someone with an eating disorder what springs to mind?

Most likely, a gaunt teenage girl, bones protruding, looking extremely skeletal and maybe a slight tint of yellow to her skin.

I wouldn’t blame you if you did get that image, in fact the majority of society does; but does it shock you to know that actually out of the 1.6 million people currently diagnosed with an eating disorder in the UK only 8% have have anorexia. It shocked me.

But yet even though there are so many other illnesses we still feel the need to judge the severity of an eating disorder on how thin someone is.

I developed anorexia when I was 13 years old and the anorexia became like having a best friend with me all the time. It gave me value and a sense of purpose that I wasn’t getting from anywhere else. I didn’t realise how dangerous what I was doing was or that I had anything wrong with me at all.

Fast track to when I was 17 sitting in bed in a mental health hospital: my heart had nearly stopped, my hair was thinning, and I was about to begin the hardest year of my life. I had to fight to accept I had anorexia, and then fight to recover. After that year in hospital I was discharged and knew what I had to do to maintain my recovery.

Yet the thing about mental illness is that if you don’t manage it in the right way, and if you aren’t aware of your coping mechanisms and triggers, then there may be a point at which it returns. Unfortunately for me, in 2016 after being out of hospital and managing my recovery, I relapsed.

The frustrating thing was that I knew what was happening. I was determined to not end up in adult services as an inpatient so I knew I had to do something. I referred myself to adult services and got an appointment at an eating disorder unit. I had thought that this would be the hardest step but then I was told “I wasn’t thin enough for support.”

I left the appointment not sure what to do. I had wanted someone to take my relapse seriously and give me some help. Yet now I felt like a fake. When this happened I came very close to ending my life as I didn’t see a way out of any of this. Luckily I had a fantastic support network around me, who knew about illness. Others aren’t so luck and unfortunately, this is not something that just happened to me; the more I shared my story, the more I realised that this is a frequent occurrence on the NHS.

People with Eating Disorders are being discriminated against and refused treatment based on their BMI contrary to the NICE guidelines that acknowledges this problem. Knowing how crucial early treatment is and hearing how other people had experienced similar treatment by healthcare professionals, I began the campaign #DumpTheScales.

A campaigning calling on the NHS and the government to make sure that people with eating disorders can access support no matter what their weight. Judging someone on their BMI is far too simplistic.

The solution here is simply to implement the policy established by the NICE guidelines and to improve early intervention. It will provide treatment to those with Eating Disorders regardless of their weight and BMI. Aligning with the fact that Eating Disorders do not discriminate on the basis of weight and can affect everybody.

It builds on the need for early intervention as recommended by NICE which will not only inevitably impact Eating Disorder rates of recovery but also the mortality rates.

It will encourage others who feel they might be discriminated against in their search for treatment due to their weight/BMI due to current practice to reach out for support helping to de-stigmatise how Eating Disorders are treated.

We all have a role to play in this across society to educate clinicians, policymakers, the public, and the media on the realities of Eating Disorders being primarily a mental health issue – not just a weight issue.

#DumpTheScales makes it sound so simple; and the fact we have NICE guidelines in place telling us that BMI should not be a factor in diagnosis makes us think things are changing, but a parliamentary select committee recently heard from a number of witnesses who reported that GPs were overly reliant on low BMI as an indicator of an eating disorder. It is clearly not right that people are being turned away because of their BMI, nor is it consistent with current recommendations.

From my work on the ground I see this on a day to day basis. I hear countless stories of people who want to recover but aren’t being taken seriously because they are not “thin enough”. We wouldn’t turn someone away from cancer treatment because they weren’t sick enough and so we should not be doing that with eating disorder treatment either.

Where do you come in? And what can you do right now to help?

  1. Education is key! We need to work together to de-stigmatise eating disorders. This could be anything from getting involved in awareness training (Maudlsey Learning offers one day eating disorders awareness training course), to diversifying your images that you use.

  1. We know that funding is an issue so it is about sign posting people to other organisations where they can get support. Interim support is essential so the individual does not feel left in the lurch (also this will help them feel like they are being taken seriously)

  1. It is about being a compassionate clinician or Doctor explaining that you know they are struggling but right now there isn’t support available. Don’t focus on their BMI or talk about numbers but focus on their mental state. Focus on what you can do, whether it is offering them a follow up in a few weeks or suggesting some online support groups or E-Learning.

Just today I met a woman who has a daughter, aged 9 with an eating disorder. How this is okay? We have a role to play to challenge this. To make sure that everyone can get that support.

Hope Virgo, Author and Mental Health Campaigner