[Sandra Osborne in the Chair] — Eating Disorder Awareness — Backbench business

Part of the debate – in Westminster Hall at 1:58 pm on 14 February 2013.

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Photo of George Howarth George Howarth Labour, Knowsley 1:58, 14 February 2013

It is a pleasure to serve under your chairmanship, Mrs Osborne.

I congratulate Caroline Nokes on raising this issue and in particular on her comprehensive survey of some of the problems experienced mainly by young people but, as she said, not exclusively so. She presented her case clearly and did a very good job.

It is important for us to send a message from this place today: quite naturally, human beings come in all shapes and sizes. There is no perfect body or shape, each one of us is different; we are genetically predisposed to look a certain way. It is important for us to say that as loudly and as often as we can, to counteract the loud noises often experienced in the media by young people about what they should look like.

Before I move on to the specific area that I want to cover, it might be worth giving an example not of a constituent but of someone I know through my family friendships: a young woman who is now in her 20s and has been studying violin since the age of five. She is a talented and well trained young musician and was offered a contract to play at an international festival in, as it happened, the south of France. The contract specified what body size she should aim to be—that says so much about where we have gone with the issue—by the time of the event. That was outrageous, and agents who become involved in such contracts should be ashamed of themselves.

I want to speak about an eating disorder that affects young people with type 1 diabetes. It is informally known as diabulimia, but the medical profession does not recognise that title and, to be fair, it is not an accepted name. In so far as I use it, I do so as shorthand to describe a quite complex phenomenon. I pay tribute to Diabetics with Eating DisordersDWED—and particularly Jacqueline Allan who provided me with briefing to enable me to take part in this debate. Diabulimia is a condition, although not officially recognised as such, that affects mainly but not exclusively young diabetics. For clarity, I emphasise that I am talking about type 1 diabetes, which people are born with a predisposition to, and which has nothing to do with lifestyle. Some people are born with something that is likely to trigger diabetes at some stage, and too often we confuse type 1 with type 2 diabetes when they are absolutely not the same.

Sufferers of type 1 diabetes are exclusively prone to suffer diabulimia. If a young diabetic does not take their insulin, their level of blood sugar—glucose—increases, as medical science has known for a long time. However, young people have discovered that when that happens, the glucose cannot be converted into energy, and in turn the glucose is removed through the natural process of urination. Consequently, necessary calories are also lost, so manipulating their insulin intake may lead to rapid weight loss. If the intake of insulin, which is needed to stay alive, is manipulated, diabetics can achieve rapid weight loss. That information is circulated all the time in the social media on Facebook and Twitter, and young diabetics who want to lose weight are learning from other young diabetics how to lose weight rapidly. I will move on shortly to the consequences for those young people.

First, it is important to give some context for diabetes and associated problems. Young female diabetics aged 15 to 30 have a nine times higher death rate than their non-diabetic counterparts, which is an alarming statistic. According to a BBC report last year, of the 26,000 avoidable deaths from diabetes, the highest increase is among young women in that age range, which bears out the point made by the hon. Member for Romsey and Southampton North. According to the Joslin Diabetes Center and DWED, having type 1 diabetes increases the chances of developing an eating disorder twofold, and 40% in that age range regularly manipulate or omit taking their insulin, which they need to survive, in order to lose weight.

At first glance from the perspective of young people who want to lose weight, that seems like a way of using their condition as a means of doing so easily. However, the problem for people with type 1 diabetes is that deliberately increasing their blood sugar levels may have serious consequences and lead to early death. In the long term, as the hon. Lady said, there is a risk of fertility problems, which are common in relation to other eating disorders, but for diabetics there is also a risk of loss of limbs, kidney damage, blindness, heart damage and many other serious complications.

There may also be serious short-term consequences. When a type 1 diabetic stops taking sufficient insulin to balance their blood sugar levels, the body produces ketones, which are highly acidic and dangerous, and above a certain point might lead to diabetic ketoacidosis or DKA, which is always fatal if not treated quickly.

The health system is very poor at dealing with this problem because it is not officially diagnosable and the reaction of health professionals is often confused, at best, which might lead to courses of action that can have serious consequences, including death. Sufferers report being told that diabulimia does not exist—it does not exist as an official medical term—and consequently they have been discharged with no treatment. Sometimes they have been designated as non-compliant. If the health professional does not recognise what they are looking at, they assume that there is a problem with lack of co-operation from the patient and simply discharge them, which may have dangerous consequences. I will give an example in a moment.

In other cases, such people have been diagnosed as anorexic or bulimic, and treated for a condition that they do not have, often with fatal consequences. DWED reports that sufferers have sometimes been treated by eating disorder specialists who have little or no knowledge or understanding of diabetes, or by diabetes specialists who have little or no understanding of eating disorders.