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‘Perfect storm’: Pandemic blamed for spike in SA children with eating disorders

The number of children and young people hospitalised in South Australia for eating disorders has jumped by 43 per cent in a year, InDaily can reveal.

Sep 14, 2022, updated Sep 14, 2022
Image: Tom Aldahn/InDaily

Image: Tom Aldahn/InDaily

There has also been a 21 per cent increase in young patients accessing eating disorder services in the public system as outpatients, as well as a rise in adults seeking help for the serious mental health disorder, which has a high risk of suicide.

Clinicians are blaming the “perfect storm” of the pandemic, saying eating disorders “thrive in isolation”, with people feeling “out of control” and increased social media use placing emphasis on preventing weight gain during lockdowns.

There were also disruptions to how services were provided during the pandemic, blowing out wait times.

SA Health data provided to InDaily shows 837 children and young people were hospitalised at the Women’s and Children’s Hospital and Flinders Medical Centre last financial year for treatment of eating disorders, including anorexia and bulimia nervosa.

It’s a 43 per cent increase on the 587 children hospitalised the year before.

Image: Jayde Vandborg/InDaily

Of those, 85 per cent were aged between 13 and 17, with 15 years the most common age.

InDaily asked what age the youngest patient was but SA Health declined to provide that information for privacy reasons.

Data provided by SA Health also shows a 21 per cent increase in children and young people accessing the Statewide Paediatric Eating Disorder Service (SPEDS) as outpatients for the same time frame – growing to 411 patients last financial year up from 340 the year before.

The number of adults seeking help for eating disorders, either as inpatients or outpatients, has also grown each year over the past three years, from 238 in 2019 to 282 in 2021.

So far this year, 185 adult patients have accessed eating disorder services in the public system.

Graphic: Tom Aldahn/InDaily

SA Health says these figures are likely to be an underrepresentation, however, because data for adults receiving treatment via the Medicare-funded eating disorder plan was not available.

An Adelaide-based world-renowned eating disorder expert, Distinguished Professor Tracey Wade, told InDaily the pandemic had worsened eating disorder problems across the globe, with young people especially affected.

“There has been a 15 per cent increase in the incidence of eating disorders around the world since the start of the pandemic, associated with an increased demand for services, particularly child and adolescent services,” she said.

“This has translated to increased wait time for services.

“We think this increase relates to increased use of social media that has placed particular emphasis on preventing weight gain while in lockdown, the perceptions of being out of control, and also the temporary disruptions to how services were provided.”

Wade, a professor of psychology and director of the Flinders University Services for Eating Disorders, said meeting these challenges would require more staff but also “importantly rethinking how we offer services more efficiently and targeted to the needs to the families presenting for treatment”.

the pandemic has undoubtedly created a perfect storm for eating disorders to develop and thrive

Kevin Barrow, chief executive of support group Butterfly Foundation, said “eating disorders thrive in isolation”, with most of the country experiencing some level of isolation due to the pandemic over the past 18 months.

“Changes to schooling, food and exercise routines, a lack of social connection and more time online have placed immense pressure and stress on people,” he said.

“Carers have also been more exposed to behaviours than they might otherwise have been, contributing to a spike in contacts from concerned parents to Butterfly’s Helpline.

“Calls have been longer than before, often regarding more complex and serious eating disorder presentations.”

Barrow said treatment was reportedly much harder to access due to current pressures on healthcare systems “and wait times to see clinicians specialising in eating disorders are lengthy”.

“This is particularly distressing for a young person experiencing an eating disorder as well as for their loved ones, with early intervention key in treating eating disorders,” he said.

“When left untreated, eating disorder thoughts and behaviours can become exacerbated, and it is likely that this was the experience for many during the pandemic.

“While we need further research to determine the prevalence of new eating disorder cases, the pandemic has undoubtedly created a perfect storm for eating disorders to develop and thrive.”

Wade is overseeing an evaluation of South Australia’s Paediatric Eating Disorder Service which is expected to be completed mid next year.

“An evaluation of the first year of operation of the new child and adolescent eating disorder services is being conducted and will inform how well these services are working and any modifications that will be helpful in this pandemic environment,” she said.

It follows revelations by InDaily of infighting between the Women’s and Children’s Hospital Network (WCHN) and Southern Adelaide Local Health Network (SALHN) about how the service should be run and who should oversee it.

The squabble was eventually resolved – with a new model of care finalised last year – but concerns remained about the multi-tiered governance structure of the service, with advocates calling for a “one-stop shop”, rather than services provided at different locations depending on age.

Paediatric eating disorder services are provided via a multi-tiered governance structure:

  • Women’s and Children’s Health Network (WCHN) has clinical governance of outpatient services for children under 15
  • Southern Adelaide Local Health Network (SALHN) has governance of outpatient services for patients over 18
  • An integrated governance of the service delivery for patients aged 15 to 18
  • Governance of paediatric eating disorder inpatients remaining unchanged and with respective local health networks

In a statement, SA Health said WCHN and SALHN clinicians had been “working collaboratively to provide consistent and timely access to services for South Australia’s children, young people and their families”.

“The service has implemented a number of measures to meet increased demand including additional staff across dietetics, nursing and psychology and expanded clinic hours,” SA Health said.

“South Australian children, young people and their families requiring support can access a range of individual and family-based therapies.”

Health Minister Chris Picton said more needed to be done to help people experiencing eating disorders across South Australia.

“Already we have taken action to increase services by funding a new specialist doctor focusing on paediatric eating disorders,” he said.

“This doctor, based out of the Women’s and Children’s Hospital, will help focus on the growing number of young people who need treatment.”

“We are also working with Breakthrough Foundation to restart the stalled project for a new eating disorder service which has been considered for five years now.”

In Opposition, Picton criticised the SPEDS model of care as “a halfway house, which wasn’t what anybody was suggesting”.

Now he says: “We have inherited the governance that the former government put in place with the Statewide Paediatric Eating Disorder Service model of care.”

“This previously had a number of issues and concerns raised by consumers and experts,” he said.

“I want to hear feedback from people with lived experience of an eating disorder on how this model of care is operating through the new Consumer Advisory Committee – as well as clinicians.

“We will listen to this feedback and consider whether what we have inherited is working, and if not then what changes need to be made.”

People requiring support can contact:

Butterfly Foundation Helpline on 1800 33 4673 or they can chat online or email, or call Lifeline on 13 11 14.

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