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The mum of reality TV star Nikki Grahame has detailed how her daughter's battle with an eating disorder has deteriorated during lockdown.
Sue Grahame, 66, said that lockdown has been “hellish” and has really “floored” her daughter.
Nikki, 38, who was a contestant on the seventh series of Big Brother UK in 2006, has battled anorexia since childhood, spending much of her younger years in and out of hospital due to the condition.
Speaking to the Daily Telegraph, Sue said her daughter’s condition has got so bad she checked herself into a specialist facility for life-saving care earlier this week.
Two of Nikki’s friends have also set up a GoFundMe page to help raise money for the treatment she needs - with the total now at just over £67,000.
“She has been battling for most of her life and as you can see, Nikki is now in a very bad way so we need to do something quickly,” they wrote earlier this month.
Sue said: “This last year has just about floored her… From the first lockdown, it was hellish. She struggled because she couldn’t go to the gym.
“Then in December she fell down and cracked her pelvis in two places and broke her wrist. I stayed with her for three or four weeks because she couldn’t do anything.”
Sue continued: “We’ve been on this road a long time, 30 years on and off, and I’ve never seen her this bad. I’m frightened that I’ll die and she’ll have no one to support her. I don’t want her to go through any of this alone.”
How the pandemic has impacted demand for eating disorder services
Eating disorder charity Beat says demand for its helpline has soared by 170% since the start of the pandemic.
"We know the pandemic has been particularly difficult for people affected by eating disorders," says Tom Quinn, Beat's director of external affairs.
"It is not surprising, as those affected and their families have had to cope with extreme changes to their daily routines, support networks and care plans, all while also dealing with the additional stress the pandemic has brought."
In 2020, the Priory Group, the largest independent provider of eating disorder services in the UK, saw a 46% increase in the number of enquiries it received regarding treatment for eating disorders at its private clinics, compared to 2019.
This included a 61% increase in the number of enquiries about anorexia nervosa, a 26% increase in the number of enquiries about binge eating disorder and a 16.5% increase in the number of enquiries about bulimia nervosa.
Orri, a specialist treatment centre for eating disorders in people aged 16 plus, has also reported experiencing a surge in enquiries over lockdown.
"As a Specialist Eating Disorder Treatment service, we noted an increased sense of urgency and fear from both individuals suffering and their families during lockdown," explains Kerrie Jones, CEO and founder of Orri.
"We saw a 90% rise in enquiries during the first lockdown in 2020, a 30% rise in enquiries from parents of children aged under 16, and a rise in Avoidant Restrictive Food Intake Disorder related enquiries."
Other sobering statistics, according to an Observer analysis of government data, reveal there were 19,562 new referrals of under-18s with eating disorders to NHS-funded secondary mental health services in 2020, a rise of 46% from the 13,421 new referrals in 2019.
Discussing the significant increase in eating disorder referrals, Priory consultant psychiatrist Dr Lorna Richards explains how focusing on food and weight, either by over-eating or restricting food intake, can be seen by those with eating disorders as a way to “cope” with the pandemic.
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She cites a number of "pandemic" factors for the increase, including “fear and uncertainty, fuelling anxiety symptoms”, a feeling of not being in control, social isolation, and changes to people’s routine and home lives.
“There has also been widespread concern about lack of activity, and about weight gain during periods of lockdown, which have seen the nation both dieting, and exercising, en masse,” she continues.
“Eating disorders have thrived in this environment, as the focus on eating and weight control becomes a way of coping.”
Dr Richards, who specialises in adult eating disorders and has been involved in the development of NHS national guidelines and policy around eating disorders, says that for some people, focusing on food, either by restricting, over-eating or using other weight control measures such as purging and over-exercising, can be used as a way of “coping” and provide “a sense of control or mastery”.
She added: “Since the early summer of 2020, I have seen a huge increase in referrals from people with pre-existing disorders who have deteriorated since the pandemic emerged.
“I have also seen an increase in new patients - specifically people who, during the first lockdown, were starting to develop eating disorders for the first time.
"For those who are vulnerable to developing an eating disorder, there have just been too many challenges and they are ongoing.”
Jones says the pandemic and social restrictions have exacerbated the risk for those most vulnerable, particularly for young people, who are reliant upon social engagement, routine and input from a broad range of caregivers.
"In December last year, The Royal College of Paediatrics and Child Health alerted parents to look out for eating disorders in their children," she explains.
"A combination of factors were noted, including social media use, health insecurity around COVID-19, and bearing witness to family difficulties, such as financial insecurity.
"Social media was found to negatively impact people because of the unrealistic ideas it perpetuates of body image."
That being said, Jones says there are many reasons why someone might develop an eating disorder.
"When we experience challenges and don’t have the necessary tools to overcome them, we can look outside of ourselves for ways to cope. Eating disorders are one such way," she explains.
"Eating disorders serve as a maladaptive coping mechanism. They provide a false sense of security and control when otherwise we would feel out of control.
"They also serve to numb overwhelming emotions, such as anxiety or sadness, by distracting and narrowing our focus onto things like food, calories, clothing size or body weight.
A common misconception is that eating disorders are all about food and body size, but Jones says they are often a symptom of more complex, underlying emotional causes, and serve as a red flag that something isn’t quite right in someone’s life.
"The pandemic introduced previously unimagined fears and realities for so many people, and within that, specific challenges for those who were in need of - or currently accessing - help for an eating disorder," she explains.
"Eating disorders thrive in isolation, and the secrecy and shame that is often felt when suffering can keep people trapped within the cycle of their illness.
"So many aspects of the lockdown mimicked the isolative, restrictive and chaotic nature of an eating disorder. You can appear incredibly high-functioning on the outside, whilst deeply struggling on the inside."
Dr Richards adds:“We all need a degree of certainty and security, and the more things that are uncertain to us or feel unsafe, the more we feel a need to ‘control’.
"We do it in different ways. Some might be more obsessionally tidy, or ‘helicopter’ around their children, or try to maintain control in relationships or the workplace.
“Those with eating disorders turn to controlling their diet or using food in unhealthy ways like binge eating, purging or exercising. It can provide a structure, routine and focus for the day, as well as a distraction from anxious thoughts.”
Signs that someone may be unwell with an eating disorder
According to Beat, symptoms will vary depending on their exact diagnosis, but can include:
- Limiting what foods you eat, either in quantity or variety
- Eating large quantities of food over a short period of time (bingeing)
- Vomiting, taking laxatives or diuretics, fasting or exercising excessively (purging)
- Avoiding eating with other people
- Withdrawing socially
(A full list is available on Beat’s website.)
How to support someone who has an eating disorder
"It can feel overwhelming to have a loved one diagnosed with an disorder, and it’s important to remember that neither they or you are to blame," says Quinn.
"It can be helpful to educate yourself about their diagnosis where you can – their treatment team should be able to help with resources, or there are plenty available on Beat’s website."
Quinn suggests first asking how they’re feeling and what they’re thinking.
"Encourage them to share their feelings if they feel comfortable – try not to assume what they may be going through," he says.
"They might tell you they want to be ‘left alone’, or that you can’t do anything to help, so here it can be helpful to remind them you can hear they’re upset and how difficult things are, and you’ll be there to help them if they need you."
Jones says it is vitally important to intervene if you feel someone is struggling.
"Pick a time when tensions aren’t running high and when the other person appears receptive," she advises.
"Approach the topic gently, keeping in mind that despite how they appear, eating disorders are not about food. Rather, food is a symptom of much more complex, underlying causes, with emotional distress often at the root. Focusing on food behaviours in isolation may cause someone to become defensive or to deny their experience."
Keeping lines of communication open is very important, says Jones.
"Be aware that you may need to return to the conversation time and time again depending upon how ready they are to talk," she says.
The other way you can help is by informing yourself about eating disorders.
"There are many myths and misconceptions around eating disorders which, if acted upon, can cause more damage than good.
"The person themselves may be very confused and scared by what they’re experiencing, and demonstrating a degree of understanding may serve to bridge the distance between you and your loved one."
Finding specialist help is also important.
"An eating disorder psychotherapist, psychologist or specialist clinic, combined with a specialist dietitian, can help individuals to understand more about their eating disorder and take important steps towards recovery," she advises.
Quinn points out that supporting a loved one through their eating disorder may not always be easy.
"So do also try and make time for yourself if you can. Looking after yourself will put you in the best position to support them," he adds.
For more information and advice about eating disorders visit the support services offered by BEAT.