Given the lack of publicly funded services for people with eating disorders in Ireland, the continued roll out of national eating disorder teams is encouraging.  

According to the Department of Health, 385 people had an eating disorder diagnosis treated by specialist services in 2023. As we know, anorexia nervosa involves self-induced weight loss leading to a body weight at least 15% below the normal expected weight for the individual’s height and age. Such individuals perceive themselves as too fat and have an intrusive dread of being overweight. Achieving their unrealistic weight expectations typically involves marked restriction of food intake, self-induced vomiting and purging, excessive exercise, and use of laxatives or appetite suppressants. The features also include endocrine problems involving the hypothalamic-pituitary-gonadal axis, leading to amenorrhoea in women and loss of sexual interest and potency in men. Most worryingly, a 33-year cohort study by Theander revealed an alarming 18% crude mortality rate for severe cases of anorexia nervosa as a result of the combined effects of suicide and medical complications.¹ These figures make anorexia nervosa, which disproportionately affects women, the most lethal disorder within psychiatry. 

Eating disorders also affect a relatively young sector of the population. According to the Department of Health, more than two-thirds of referrals to the National Clinical Programme for Eating Disorders last year were for people under the age of 18. The HSE offers treatment in four main contexts: community eating disorder teams, beds in the public system, specialist beds from private providers funded by the HSE, and under the Treatment Abroad Scheme, of which 14 people have availed since 2020. At present, there are 20 dedicated eating disorder beds across the four CAMHS inpatient units, while adults with an eating disorder requiring inpatient care can be referred to the HSE’s 66 acute inpatient mental health approved centres across Ireland. 

On May 5, 2024, Minister for Mental Health and Older People Mary Butler announced a new eating disorders team for adults in CHO7 (Kildare/West Wicklow, Dublin West, Dublin South City and Dublin South-West). In line with the Model of Care for Eating Disorders, the new team is one of a number of new supports under an additional €10 million funding allocation for mental health announced in January. According to the Department of Health, there are now 12 eating disorder teams across the country, employing 100 people of whom 80 are eating disorder clinicians and 10 are consultant psychiatrists.

Acknowledging that “historically there has been a lack of publicly funded services for people with eating disorders in Ireland”, the Minister said that last year, €8.1m was spent by the HSE on eating disorder services and a further €4.5m was allocated for treatment through the Treatment Abroad Scheme for those in need of specialist treatment.

According to the Department of Health, it takes on average 12-18 months to establish a multidisciplinary team led by a consultant psychiatrist and that, while funding for adult and CAMHS eating disorder teams has been in place for several years, recruitment faltered during the pandemic. We are told that a review of bed capacity across all mental health facilities (including adult eating disorder beds) has already occurred and is being considered by the HSE, while a review of the Model of Care for Eating Disorders will take place later this year. It’s all food for thought.