Zoe Daniel (Goldstein, Independent) Share this | Link to this | Hansard source

I rise today to point to the increase in eating disorders in my election of Goldstein and nationally. In the south-east region of Melbourne, the Alfred Child and Youth Mental Health Services, the Australian Research Council and the Monash hospital, as well as private clinics, estimate its prevalence as being almost one in nine adolescents, mainly for girls between the ages of 12 and 17 years. Some even estimate that in Bayside, in my electorate, it could be as high as one in seven, depending on their individual cohorts. That's potentially three in every classroom. Anecdotally, I hear stories of girls not eating their school lunches and adolescents sneering at their peers for eating bread.

While eating disorders were on the rise prior to COVID-19, the pandemic has heightened the situation and the predisposing risk factors, specifically social isolation, lack of structure, pausing of sport and recreation, food insecurity, disruption of daily activities, fear of contagion, heightened family stress, decreased structure around eating, and increased use of screens for schooling and social interaction. Statistics are hard to come by, but we do know that the prevalence of all types of eating disorders has increased significantly, almost doubling during the pandemic in some age categories. The most accurate statistics we have were collected prior to COVID-19, and it's highly probable, based on the number of referrals clinicians specialising in this field have received over the last two to three years, that they present a flattering picture. The number of people in Australia with an eating disorder at any given time is estimated to be around one million, or approximately four per cent of the population. Eating disorders, when combined with disordered eating, are estimated to affect 16.3 per cent of the Australian population.

Eating disorders have been on the rise for a decade, and experts in the field attribute this to what they call anxiety-provoking media, which promotes unrealistic and modified images, especially on social media. They say the increase in social media exposure at a young age—10 years and up—and a range of sociocultural and demographic issues, such as idealised thinness, have increased the prevalence of disordered eating and eating disorders. Females tend to have four times as much risk factor for developing disordered eating around puberty as males. This is occurring on our school grounds as much as it is in the home.

In Goldstein, we've seen the incidence of body dissatisfaction increase drastically over the last five years. Experts say that clusters of disordered eating are occurring within school groups at particular year levels and within particular school environments. A lot of these are from higher socioeconomic environments, but not exclusively so. Recently, in some cohorts of 15 to 20 people, experts say we've seen almost 50 per cent of the social group develop disordered eating or engage in some form of restrictive eating. Academic pressure from schools and social pressure also affect restrictive practices that trigger disordered eating. Adolescents can feel out of control in their home and school environments and need something to create a sense of reward and control. Managing their eating and reducing calories is one way to achieve this.

In addition, I've been advised by a local paediatric dietitian and nutritionist that right now there is a common trend among students at senior schools in Goldstein of not eating lunch or at least of eliminating all bread or carbs in particular. Many adolescents are competing with one another on social platforms like TikTok on who can consume the smallest number of calories within a day or a week. Comparisons with peers are also being made on MyFitnessPal. Often parents and teachers are oblivious to this. This is a disturbing snapshot.

We have to do something, and this brings me to the treatments that are currently available. There are two main ways to seek treatment for eating disorders: publicly and privately. The public system is based mainly on someone presenting with medical instability who needs urgent medical care. Specialist ED wards are set up in most major hospitals to stabilise and renourish sufferers as quickly as possible. They're largely not geared to equip patients or families with support on how to continue to treat and support the patient when discharged. Patients and families can feel like they're left in the deep end with no support, and so begins the merry-go-round of in-out admissions, often lasting years.

This creates whole-of-family impact, affecting the mental health of parents and other children, affecting work and school, and draining finances. One mother in my electorate is herself on medication for depression and anxiety. She told me she's left her job to feed her daughter, and the family may yet have to sell the family home to fund private treatment. This is a dire and hidden example of the impact of eating disorders and the lack of effective programs in communities.

Day programs like the Butterfly Foundation program have been set up to help support the public system and to allow access to specialised intensive group based support, but waitlists are long and group support is not adaptable. It's a great program, but it only supports the patient for 12 weeks. After that, they're told to maintain weight markers and try to stay well. The follow-up is limited. The Alfred Child and Youth Mental Health Service also offers a specialist support system but almost exclusively with a family based treatment model. Family based treatment is based almost entirely on weight restoration, without psychological or behavioural support. The feedback is that it's bit of a one-size-fits-all model of treatment.

Service providers in Goldstein are trying to do the best with what they have under a very under-resourced system. Privately, there are a select few who specialise exclusively in eating disorders, and some private clinicians feel overwhelmed with trying to manage conflicting issues that they're often not trained to deal with. It's critical that multidisciplinary teams are formed in the private setting to help with the effects of eating disorders. Carers can be left with the responsibility of connecting clinicians, which is time-consuming, expensive and frequently ineffective. Additionally, wait lists have skyrocketed during the pandemic and most carers and patients are told they'll have to wait months to see a specialist.

So what do we need to do to fix the system? We need funding to be directed to the vulnerable and at-risk populations and we need multidisciplinary eating-disorder-specific clinics. We need education and resources to be properly rolled out in schools, not just a one-off session with Eating Disorders Victoria on body image in year 10. We need dietitians and psychologists employed in schools in high-risk populations. Wellbeing coordinators should not be expected to carry this burden.

We need a task force to be set up now to create a nation-first eating disorder hub, a one-stop shop for prevention, treatment, management, family care and support, and relapse prevention. A hub would promote primary prevention by funding experienced clinicians, dietitians and psychologists to educate and inform teachers and parents with children entering transitional stages on what red flags to be aware of; reduce the waiting time to access specialist treatment; increase the effectiveness of routine treatment with continuous monitoring, like we have for type 1 diabetes; and increase support for families.

Eating disorder treatment is expensive. The time to treat effectively is estimated at three years minimum, which is why recovery and relapse is common. We have an opportunity post COVID to get on top of this life-destroying condition and stop the rise before it becomes more of an epidemic than it is. Eating disorders and disordered eating are becoming the norm among some cohorts in my electorate, and there are families in Goldstein willing to offer their own time and resources to make a hub become a reality. They don't want others to feel lost in the system, isolated, alone and without any way of getting the treatment they need.

I am seeking state and federal collaboration to create an environment where our children grow up accepting and liking themselves, where families and carers feel connected and safe and where eating disorders do not reach the predicted one in five in the next five years.