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    Oxford’s Failure with Eating Disorders

    Jaya Rana discusses the inefficiency of Oxford's support system for students with eating disorders.

    CW: detailed description of eating disorders.

    So much of the typical university experience centres around food and drink – this is perhaps the case even more so at the University of Oxford. With not only a culture of club nights, takeaways and kebab vans (which most universities propagate), at Oxford, we socialise through college formals, balls, crew dates, welfare teas and so much more. For those of us who have a history of disordered eating, this can prove pretty anxiety-inducing. Not to mention, with the highly anticipated June 21st rapidly approaching and the social eating that will come with this, the pressure to get the perfect body is more extreme than ever.

    While many people restrict their eating due to having a perfectionist nature and a desire to meet the current beauty standard, others link their disorder to a need for control and order, emphasising that it has nothing at all to do with body image. It is generally accepted that Eating Disorders are worsened, and in some cases, entirely caused, by stress. This places Oxford students at a higher risk considering the elevated academic pressures we face in comparison to our friends at other universities. Rather than being expected to complete a couple of essays or problem sheets a term, we are confronted with at least one per week. It is therefore unsurprising that disordered eating is so prolific at our university. According to a survey organised by the SU in 2016, at least 1200 students at the University of Oxford are struggling with an ED, and these are only the ones who have spoken out. Given the fact that the number of people seeking help for mental illnesses since Covid has increased exponentially, it is a fair assumption to believe that there are far more than 1200 students suffering from EDs now.

    Studies carried out by the National Institute for Health Care Excellence and Beat recognised that between 1.25 and 3.4 million people in the UK suffer from EDs and that the average age of onset for anorexia nervosa is 17 years old. This, paired with the anxiety of leaving home, and the pressure to have improved oneself physically (a culture cultivated by lockdown), we need support from our university now more than ever. The rise of TikTok alongside the increase in ‘at home’ blogger/influencer content means that a lot of what we have seen on social media during lockdown has been about food and exercise. Namely, many ‘what I eat in a day’ videos promote undereating, as well as unsustainable and unattainable workout regimes. Beat has seen a 140% rise in the number of people accessing support since 2020. EDs have the highest mortality rates among all psychiatric disorders, and research suggests that the earlier treatment is sought, the better the sufferer’s chance of recovery.

    For these reasons, it is shocking, and frankly devastating that, having used the Oxford University’s Counselling Service myself, I can attest to specific instances in which I have been told that the University simply doesn’t have the facilities or support to help me deal with an ED, and that, while they’re happy to listen and to provide support in other aspects of my life, it is simply beyond their remit. Given the prevalence of EDs, not only among our age group but with the elevated risk (due to the intensity of our workload), it is hugely distressing to know that there is not a single counsellor or therapist in the Service trained in one of the most common psychiatric disorders.

    While the Counselling Service offers personal and group therapy for dealing with issues such as anxiety and body image, it was made explicitly clear to myself and to other students that EDs should not, and indeed, must not be discussed in these sessions. The counsellors told us that they want us to separate body image issues and Eating Disorders, as they are too much to handle together, and because they are not trained in working with EDs. To me – and evidently, to many others using the Counselling Service – EDs and body image problems are not something which can ever be separated: they are two expressions of the same thing. The conversation surrounding food in any form was strictly prohibited in our therapy sessions, and this rule was extended to our private communication with one another as well; we were told that we mustn’t mention food to each other in any way.

    Considering the intrinsic link between body dysmorphia/body image issues and restrictive eating, this forced segregation is unhelpful and potentially dangerous. By banning any talk of food and EDs in sessions with students who are openly seeking help and advice, and simultaneously offering them no alternative forum to discuss these issues, the university forces us to internalise our EDs and to battle them alone. Bearing in mind that the Service’s therapy groups only operate in term-time and that we are encouraged to engage in only one form of counselling (i.e. to leave any one-on-one therapy), we face over a month with no professional help for our EDs during the vacation. Our one support network, namely, our friends suffering from similar conditions, also becomes unavailable to us. This March, my group were given an ultimatum by our councillors: to either leave group therapy halfway through our course of treatment or to disband our group chat and private communication.

    Some people may be asking why we don’t simply seek help outside of the university. For the majority, for whom private healthcare is not an option, the NHS waiting lists are simply too long to ever be practical, and this itself is evidence of the national Eating Disorder crisis we face in the UK. For instance, the waiting time at Cotswold House for ED services is 25 months as of 2020 (noted from the Facebook page ‘End the Eating Disorder Crisis’). Expecting someone to suffer alone for over two years is simply not acceptable, and often, life-threatening. Beat has been running a campaign to End the Eating Disorder crisis, by urging the Vice-Chancellor to recognise this huge issue in the university. Through an open letter, Beat urges the Counselling Service to hire a trained dietician and for college nurses to be educated in managing Eating Disorders.

    According to a Beat student survey in 2020, 70% of students who engaged with the University Counselling Service expressed feeling that their counsellor or nurse did not have sufficient experience or knowledge of EDs. From both personal experience and those of many of my friends, I can confirm that counsellors in the Service have explicitly stated that such issues surrounding EDs are ‘too complex’, and support simply cannot be provided by the university.

    This is a plea to the University to please listen to your students. We are struggling, and sufficient support is simply not being provided. For those of you who would like to support this cause, please sign Oxford Beat Society’s open letter to the Vice-Chancellor, urging her to consider the issues stated in this article more seriously.

    Beat provides information and support for anyone affected by an eating disorder. You can call their student helpline at 0808 801 0811, or visit them at beateatingdisorders.org.uk.

    Image Credit: BeatEDCharity via Wikimedia/ License: CC BY 3.0

    Correction: The University Counselling Service disputed the claim that the University has no counsellors trained in Eating Disorders. They have a medical consultant with extensive professional experience of working with patients with eating disorders, whilst other staff members have substantial experience of working therapeutically with eating disorders in young adults. They also stated that their service should not be seen as a specialist eating disorder treatment unit and should not be judged against such a standard.

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