Identity Disorders on the rise – Gender, and now Eating

Kiwi teens dying to get noticed as eating disorder cases rise by 50 per cent 9 October 2016
Lauren was diagnosed with Anorexia Nervosa, the third most common chronic illness for young women, behind obesity and asthma.
It is linked to the highest death rates of any psychiatric disorder.
A Sunday Star Times investigation reveals the number of young people being seen by eating disorder services nationwide has increased by 50 per cent since 2011.
And parents who have children with eating disorders say it is an unseen epidemic, with sufferers outside of the main centres struggling to get diagnoses and support.
Last year alone, Ministry of Health figures show there were 1088 diagnoses of people under the age of 30 by specialist teams. This includes eight in children aged nine and under.
The Ministry say this is likely in part due to improvements in eating disorder services, with a $26 million cash injection provided by the Government in 2009.
But critics say a lack of specialists trained in Family Based Therapy – the internationally-recognised best practice for adolescents – mean sufferers in some areas of the country are still waiting months for an assessment or are not receiving specialist treatment, and that more GP training is needed to help identify anorexia in patients.
Eating disorders are thought to partly be caused by genetics, which the landmark Anorexia Nervosa Genetics Initiative (ANGI) study – with a New Zealand arm at Otago University – is aiming to clarify. But most begin with some form of weight loss or diet, whether caused by teasing, a traumatic life event, or peer pressure.
ANGI researcher and psychologist Dr Jenny Jordan says a perfectionist personality, added to childhood trauma, body-image based bullying, and being bombarded by pop culture messages equating thinness with beauty, created a “perfect storm” for teen girls to develop eating disorders.
Research had already shown most people had feelings of irritability when they dieted, but those with eating disorders felt calmer when hungry and “in control.” ANGI will explore if there genetic disposition for such traits.
The disorder predominantly affects teenage girls in New Zealand.
The majority are aged 10-19, Ministry of Health figures show, with age 20-29 the next most vulnerable age group. A total of 1354 cases among all age groups were reported to the Ministry in 2015, increasing year on year from 897 in 2011.
Last year, there were 1088 diagnoses nationwide for people under the age of 30. That’s up from the 738 in that age bracket in 2011.
But the true number of young people – both boys and girls – affected by eating disorders is likely much higher, investigations by the Sunday Star Times reveal.
The Ministry of Health statistics provide the number of patients seen within a DHB area by specialist mental health teams. But people are seen in a range of public and private settings by specialist and general teams, in-patient or day-based. These are not all captured, and record-keeping varies.
One leading doctor said the true number may not even be known within individual hospitals, as patients are treated on different wards and can accidentally be coded under the wrong criteria.
For example, in Wellington Hospital patients under the age of 16 will likely be treated on the pediatrics ward, where there are no dedicated beds for children with eating disorders. If they are entered into the system incorrectly, only a manual count would catch the error.
New Zealand research has shown half of all cases of anorexia start before the age of 19, and the average age of onset for anorexia and bulimia is 17. But clinicians report this is getting younger – last year alone, eight children under the age of 9 were seen by specialist eating disorder services.
Hall said she was seeing more, and younger, patients every year.
Around half the patients she was referred were so unwell they required hospitalisation immediately.


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