When I was studying at university in 2013, I was suffering from the beginnings of what would become bulimia, and was spending around £150 a week at the supermarket on binge foods. I had by this point given up on counting calories, but my daily binges would have easily sat in the top end of the 1,200 to 11,500 calorie average. I regularly ran out of money and was lucky that my parents - sympathetic, though confused by my seemingly inexplicable poverty - would help me with money for food.
Food, of course, is a necessity, but to me it was also a vice. The endless cycle of buying food I knew I didn’t need or want, making myself ill, running out of money and doing it all over again felt like something I would never escape. The financial burden only heightened my stress, thereby encouraging the disordered behaviours that I unwillingly used to cope with stress in the first place.
Many eating disorder sufferers who find themselves in dire financial situations often come from low-income backgrounds to begin with. Experience of poverty is a stressor which can play a role in the development of eating disorders. Many of the eating disorder survivors I spoke to about this could see a parallel between their upbringing and their relationship to food now: turning to food as an inexpensive comfort in childhood became bingeing and purging in adulthood, only now this was accompanied by weight gain and financial debt. Considering that only 10 per cent of eating disorder sufferers have anorexia, it is perhaps not surprising that bingeing features so heavily in these stories.
The average time between the beginning of an eating disorder and the beginning of treatment is three and a half years, according to a 2017 Beat report. This assumes that the person with the eating disorder accesses treatment at all; for people on low incomes, often physical and mental recovery cannot be their first priority, because of that negative financial impact. The high cost of eating disorders has long gone ignored, but can include a whole range of expenses including binge foods, laxatives, diet teas or pills, clothes of different sizes (as a result of weight fluctuations), gym memberships, or memberships to dieting groups.
Louisa, a bulimia survivor, told me: “Being on a low income and being a single mum definitely added to my depression, and I always eat to comfort myself.” She relates this back to growing up with little to eat, saying, “When my mum was a single parent we were very poor and she would sometimes tell us there wasn’t going to be any food soon….You can get into weird emotional cycles with food and worrying about poverty.”
A woman called Kimberly had a different experience - for her, it wasn’t about the food so much as the clothing. She said, “I found myself spending most of my free time shopping at thrift and discount stores. I would go out and buy myself clothes that were too small as a sort of incentive to not eat or get rid of any calories that I did. Whatever clothes I owned that were bigger than a certain size I donated or gave to friends, even if they fit.”
None of the people I spoke to had ever accessed specific treatment for their eating disorder. Not because they weren’t interested, but because they felt it wasn’t available to them.
Recovering from an eating disorder requires a time commitment and, in the case of inpatient treatment in particular, a financial commitment in the form of time off work. Disturbingly, the longer the delay between eating disorder symptoms and finally receiving treatment, the greater the cost on the person with the eating disorder and on their family; Beat estimates the average additional expense of an eating disorder on a family is £32,000 a year, a figure that encompasses “special” food and income lost from missing work.
Even once treatment begins, some families incur the cost of travel to inpatient centres hundreds of miles away. So for those who can’t or won’t access treatment because of financial stress, this can drive them into a vicious cycle of debt, anxiety, and exacerbated symptoms of their disorder.
In data published by NHS England about their mental health spending last year, it became apparent that over 44 per cent of NHS clinical commissioners had “spent less than or equal to the amount of ‘additional’ funding they received for eating disorders” for the 2016-17 period. Many NHS eating disorder services are still failing to meet the four-week maximum wait time, and Beat believes that fewer than half of eating disorder patients are properly informed about their options for treatment and recovery.
Even as a student with a relatively stable support system, I struggled to access treatment, and had no hope of affording to go private. During Eating Disorder Awareness Week, it's worth noting that until the reality of the financial stress of eating disorders is taken seriously, many will continue to suffer in silence, trapped by the very habits that once helped them to cope with serial poverty and stress.
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