Services in Northern Ireland that treat people with potentially fatal eating disorders are lagging behind the rest of the UK, according to campaigners.
A leading charity which helps people with eating disorders said there is still work to be done to ensure people here get the same level of treatment as elsewhere in the UK.
It is the latest damning indictment of the health inequalities facing patients in Northern Ireland — coming after a growing row over access to cancer drugs and concerns over waiting times for hospital appointments and treatments here compared to the rest of the UK.
Government figures show the number of people sent outside of Northern Ireland for specialist treatment has reduced.
According to figures from the Department of Health, Social Services and Public Safety, 10 people were sent to England for treatment in 2011/12 compared to 41 in 2007/08.
While Ann McCann, founder member of Eating Disorder Association NI, welcomed efforts by health bosses to improve services here, she said no-one should have to travel outside of the province to get the help they need.
She said: “Imagine someone who is seriously mentally ill having to leave their family and go to a hospital in England. It is unthinkable, it really doesn’t work.
“Families must be part of the solution so it is difficult when a person is sent away from their home.
“It can be extremely challenging when that person comes home and many would suffer a relapse.
“It’s almost impossible for them to come back and return to ordinary life.”
She continued: “In the past there really were no specialist services in Northern Ireland and it was a great problem but there has been work done and that isn’t the case anymore. However, we are continually trying to catch up with services in the rest of the UK.”
Ms McCann said the service desperately needs more funding and that GPs should receive more training on how to deal with sufferers.
“There are specialists but people only tend to be referred to them once they are quite seriously ill,” she explained.
“We need people to get help before they are in the grips of an eating disorder because once it gets to that stage it is much more difficult for them to recover.”
Ms McCann’s comments have been reinforced by extracts from a powerful book detailing the experiences of Emma Scrivener who suffered as a child and an adult. She said: “Anorexia doesn’t happen overnight. It’s often slow and imperceptible.
“However, once started, it’s like a juggernaut — gaining its own momentum.”
She has provided a remarkable insight into the thoughts of someone with an eating disorder.
Ms Scrivener said: “Anorexia is about what gives us identity and worth. It’s about life and death and everything.
“This is what needs to be addressed as well as physical health.”
So what is anorexia and how does it affect people?
Anyone can develop an eating disorder, regardless of age, sex, cultural or racial background, although the people most likely to be affected tend to be young women, particularly between the ages of 15 and 25. Not everyone will have the same symptoms.
Anorexia nervosa means loss of appetite for nervous reasons but this is misleading because in reality the person has lost the ability to allow themselves to satisfy their appetite.
They focus on food in an attempt to cope with life, not to starve themselves to death.
Ultimately the disorder itself takes control and the chemical changes in the body affect the brain and distort thinking, making it almost impossible for the person to make rational decisions about food.
The term Bulimia Nervosa literally means ‘the hunger of an ox'. The hunger, however, is an emotional need.
After binge-eating a large quantity of food to fill the emotional or hunger gap, there is an urge to immediately get rid of the food by vomiting or taking laxatives (or both) or by working off the calories with exercise in an attempt not to gain weight.
Bulimia is more difficult for others to notice as the person tends not to lose weight so dramatically, or the weight fluctuates.
People with bulimia may have demanding jobs that require them to be out-going or self-assured even when they feel inadequate inside.
As with anorexia, people who develop bulimia become reliant on the control of food and eating as a way of coping with emotional difficulties in their life.