UK woman with anorexia nervosa refused help as she wasn't thin enough to receive treatment

UK woman with anorexia nervosa refused help as she wasn't thin enough to receive treatment
Photo credit: Chelsea Salt / Facebook

This article deals with mental health issues, including eating disorders.

A British woman suffering from the eating disorder anorexia nervosa was refused help by her local NHS clinic as she was not considered thin enough to undergo treatment.

Chelsea Salt, a 27-year-old from the coastal town of Grimsby, had been in a good place prior to the stringent, ongoing measures implemented in response to the UK's COVID-19 outbreak. 

After battling the eating disorder on and off for seven years, Salt found herself falling back into old patterns as she became increasingly anxious during the UK's lockdown, the Grimsby Telegraph reports. 

The eating disorder anorexia nervosa is characterised by an obsessive fixation on maintaining an abnormally low body weight through starvation or excessive amounts of exercise, an intense fear of gaining weight and a distorted perception of the body. 

The 27-year-old decided to seek help from her local NHS Community Clinic in York, where she now resides.

During her appointment, Salt was informed that her body mass index (BMI) - a method of deducing a person's healthy weight range based on their weight, height and age - was too high for her to be classed as an anorexia patient, and she was refused treatment.

NHS guidelines state that adult patients can only be diagnosed with anorexia if their BMI is below 17.5. Salt's BMI currently sits at 20.

Speaking to Newshub last year, Kellie Lavender, an eating disorder specialist from the New Zealand Eating Disorder Clinic, confirmed that BMI is not helpful as a diagnostic tool. 

A person's weight is very subjective, as fluid retention, bone density and muscle mass can all influence the number on the scales. 

Lavender reiterated that reliance on the BMI model as a form of diagnosis means legitimate patients are often written off because they are not technically 'underweight'.

"Someone can be very healthy and have a BMI of 30. It's a very unhelpful diagnostic tool. Healthy weight ranges do have to be considered within treatment, but that is much more complex than BMI alone," Lavender said.

"Eating disorder patients don't just have to look 'underweight'. Diagnosis and recovery can't always be detected by looking."

According to the National Institute for Health and Care Excellence - an executive, non-departmental public body of England's Department of Health - BMI is just one of 14 signs that may indicate an eating disorder.

Salt told the BBC she was made to feel like "a fraud".

"You start questioning yourself, like maybe there's nothing wrong with me and it makes it harder to move forward," she said.

In a statement to the Grimsby Telegraph, Liz Herring of the Tees, Esk and Wear Valleys NHS Foundation Trust said the health and wellbeing of its patients was "central to all we do".

"We're sorry to hear Ms Salt's concerns about the care and treatment she has received," Herring said.

"[We] would encourage her to raise these with us as soon as possible."

Eating disorders have the highest mortality rates among psychiatric disorders. Anorexia nervosa in particular has the highest mortality rate of any psychiatric disorder in adolescence.

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