Anorexia is the deadliest mental health condition. We are treating it completely wrong
Loading
'I refer to it as the 'sick Olympics': eating disorders are quite competitive [with one's own, mental ill-health ideals] by nature, and are fuelled by the healthcare system that is supposed to be there, but is only there to help the people who are the most physically unwell with eating disorders,' she says.
And even then, she found the emphasis to be on physical weight improvement, and not on quality mental healthcare for the underlying causes. Thankfully, after three months in private residential treatment, De Cicco Carr has achieved recovery stable enough to have conceived her first child and be well into a healthy pregnancy.
Anorexia nervosa is considered the mental health condition with the highest mortality rate, in part because only about half of patients respond to treatment methods developed decades ago.
Up to 10 per cent of those with the disease lose their lives to it within 10 years of getting it, and up to 20 per cent will pass away because of it within 20 years.
In Australia, 1.1 million people live with an eating disorder, and 1273 people died of them in 2023, a higher toll than those killed on the roads.
Data provided by Orygen the National Centre of Excellence for Youth Mental Health shows that since 2012, the incidence of eating disorders among those under 19 has increased by 86 per cent.
Meanwhile, progress towards more effective treatments has been hindered by stigma, including the mistaken belief that anorexia nervosa affects only 'young, affluent white females', according to a paper to be published on Thursday in the journal, JAMA Psychiatry.
Associate Professor Andrea Phillipou, a co-author and principal research fellow in eating disorders at Orygen and the Centre for Youth Mental Health at the University of Melbourne, describes anorexia as 'an unbelievably under-funded area of research – a lot of it is [down to] stigma associated with eating disorders: they are still seen as a trivial thing that only affects young, white affluent women'.
Loading
Despite some promising developments, current treatment outcomes are 'unacceptably poor', and a narrow focus on weight restoration is a key reason medical understanding and effective treatment lags.
'Anorexia can be and is life-threatening in a lot of circumstances, and weight restoration is usually the main outcome [of current treatments]; we want to stabilise people and get the weight restored, but this has taken away from the fact this is a psychological condition,' Phillipou says.
'We need to also focus on the psychological aspect driving the eating disorder.'
Because anorexia is one of the few mental illnesses to also require a physical diagnosis, its treatment and research into better approaches has been 'siloed' and held back decades.
Loading
Phillipou describes the paper, co-authored with global experts from King's College, London, and Harvard Medical School, as a call to action for research that treats anorexia holistically, as a physical and as a mental health condition. She says that approach will boost understanding of what causes the condition and in turn promote more modern and effective treatments.
'Recovery rates haven't budged in about 50 years, we're still getting the same poor responses to treatments ... and that's on the treatments, it's not the individual or the family's fault,' she says. 'It's been decades since we've had any innovation in treatments.'
Clinical psychologist Sarah Cox, manager of the Butterfly Foundation National Helpline, agrees with the paper, Anorexia Nervosa—Facts, Frustrations, and the Future, that treatments and research have been stymied by bias and misconceptions.
'A lot of people still believe [anorexia] is a lifestyle choice, but eating disorders are very serious mental illnesses; people can't just make a choice to turn that on or off, they need the right treatment support and compassion,' Cox says.
Loading
On World Eating Disorders Action Day, on Monday, the Butterfly Foundation released statistics stating that one in seven people believe those with eating disorders could 'snap out of it', and one in six people 'perceive eating disorders as a sign of weakness'.
Cox said these ideas must be challenged because they could contribute to patients missing out on early intervention, which could be vital to prevent the illnesses progressing to a life-threatening stage.
She said clinical experience backed up the claim in Phillipou's JAMA paper that anorexia patients were 'often falling in the gap between physical and mental healthcare'.
'Something we hear from people we support is people can slip through the cracks because they might be considered not being of a low enough weight for some treatment options, and being of too low a weight for others,' Cox said.
'Sometimes they are hitting that crisis point before they can join the public or private systems.'
She described the paper demanding a rethink in anorexia research and treatment as a powerful and important step in highlighting reasons that progress for patients had been so slow, 'and trying to point to possible solutions to correct it'.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

Sky News AU
2 days ago
- Sky News AU
‘War on women's sports is over': Trump's trans sports ban calls for Australia to follow
The Opposition has called for the Australian Olympic Committee to follow the US and ban transgender athletes from competing in women's sports. The US Olympic and Paralympic Committee ordered sporting bodies to comply with US President Donald Trump's executive order, which he made earlier this year, keeping men out of women's sports. This move follows controversies from last year's Olympics.

Sky News AU
2 days ago
- Sky News AU
Liberal senator Claire Chandler calls for Australia to follow US Olympic and Paralympic Committee in barring transgender athletes from competition
Liberal Senator Claire Chandler has called for the Australian Olympic Committee to follow the United States' lead and ban transgender athletes from competition. The US Olympic and Paralympic Committee (USOPC) quietly updated its eligibility rules on Monday, slipping into its 27-page Athlete Safety Policy a section saying it would 'collaborate with various stakeholders… to ensure that women have a fair and safe competition environment consistent with Executive Order 14201'. Executive Order 14201 is more widely known as the Keeping Men Out of Women's Sports order, which US President Donald Trump signed in February. In a letter to governing sporting bodies obtained by US media outlets, USOPC chief executive Sarah Hirshland and president Gene Sykes said the updated policy 'emphasises the importance of ensuring fair and safe competition environments for women.' 'All National Governing Bodies are required to update their applicable policies in alignment,' the letter warned. The move follows last year's Olympics controversy surrounding gold medalist boxers Imane Khelif and Lin Yu-ting, who are not transgender but reportedly failed prior gender eligibility tests. Italian sprinter Valentina Petrillo also became the first Paralympic transgender athlete to compete last year. New Zealand weightlifter Laurel Hubbard was the first openly transgender athlete to compete at the Olympics in 2021. Senator Chandler welcomed the move by USOPC, calling on the Australian committee to take similar steps. 'The Australian Olympic Committee should be doing what all sporting organisations around the world are doing and recognising that female athletes want to have their sporting categories protected,' Senator Chandler said. 'I'm very glad to see sporting organisations finally recognising the need to protect female-only sport, but frankly speaking, it's taken far too long to get to this point. 'We know that World Athletics, World Swimming, World Rugby, all these peak international sporting organisations over the last five years have realised that women's sport needs protecting. It is well past time that Australian sporting organisations start doing exactly the same thing.' The Liberal called for her parliamentary colleagues to revive her failed Save Women's Sports bill, a private member's bill she introduced in 2022. 'My Save Women's Sports bill is just as relevant now as it was three or four years ago, when I first introduced it to the parliament, and it's ridiculous that women and girls in Australia don't have a legal right to their own sport,' Senator Chandler said. 'That bill is still there and if anyone - government, Coalition, crossbench - wants to pick that bill up and try and get it through the parliament, I think that would be a very useful conversation for us as a parliament to have.' While some sporting bodies including swimming, athletics and cycling have banned transgender participating in international women's competitions, others have been more inclusive. Women's Forum Australia head of advocacy Stephanie Bastiaan said it's 'common sense' for all sporting bodies to reform their policies based on women's sex-based rights. 'We know that women are being injured, we know that they're losing spots at the Olympics and in these categories due to the fact these sporting bodies are not protecting them on the basis of biological sex and I think that they need to put their foot down and make sure that it happens,' Ms Bastiaan said. 'This is a great outcome for girls in the US. The Trump administration is to be commended for its proactive approach in protecting women's sport. 'We need the Australian government to follow suit, bringing in legislative reforms that mandate sporting bodies protect the female category on the basis of biological sex, so that all girls - regardless of whether they're playing at a community, state or elite level - have the right to a safe, fair and equal playing field.' Equality Australia CEO Anna Brown said Australian sporting bodies including the AOC had been navigating the issues around transgender inclusion in a 'sensible and practical way'. 'We hope they continue to prioritise inclusion and only restrict participation where there is a clear risk to safety or fairness,' Ms Brown said. She said given the 'tiny number of trans athletes playing in any sport', a case-by-case approach remained feasible and the most effective way to protect individual rights over 'blunt and harmful blanket bans'. 'Sporting organisations across Australia have worked hard to include trans women and to ensure everyone is treated with dignity and can participate safely and fairly,' Ms Brown said. 'As recently as 2023, after extensive consultation and research, the Australian Institute of Sport found there was no case for a blanket ban on trans athletes in any sport, even at the elite level. 'Its guidelines encourage sporting bodies in Australia to start from a position of inclusion and state that any restrictions must be justified on a case-by-case basis, where strength, stamina and physique are relevant, and be no more restrictive than necessary to ensure meaningful competition for everyone.' An AOC spokeswoman did not respond to a request for comment.


SBS Australia
3 days ago
- SBS Australia
US Olympic committee bans trans women from competition after Trump executive order
American transgender women will no longer be able to compete in women's events at the Olympics and Paralympics after a recent policy change by the United States Olympic and Paralympic Committee (USOPC). A new note on the USOPC website regarding the participation of transgender athletes in sports says: "As of July 21, 2025, please refer to the USOPC athlete safety policy." The policy update, which follows an executive order by US President Donald Trump earlier this year, was added to the USOPC Athlete Safety Policy on its website as a new subsection entitled "Additional Requirements". "The USOPC is committed to protecting opportunities for athletes participating in sport," the addition reads. "The USOPC will continue to collaborate with various stakeholders with oversight responsibilities ... to ensure that women have a fair and safe competition environment consistent with Executive Order 14201 [Trump's order] and the Ted Stevens Olympic & Amateur Sports Act." The Stevens Act, adopted in 1988, provides a means of handling eligibility disputes for Olympic sports and other amateur events. What was Trump's executive order? The executive order instructed the state department to pressure the International Olympic Committee to change its policy, which allows trans athletes to compete under general guidance preventing any athlete from gaining an unfair advantage. A memo to Team USA from USOPC chief executive Sarah Hirshland and president Gene Sykes obtained by US television network ABC News and ESPN made reference to Trump's executive order, saying: "As a federally chartered organisation, we have an obligation to comply with federal expectations." Trump's executive order threatens to remove federal funds from any school or institution allowing transgender girls to play on girls' teams, claiming that would violate rules giving US women equal sport opportunities. The order requires immediate enforcement against institutions that deny women single-sex sports and single-sex locker rooms. The order is expected to affect only a small number of athletes. The president of the National Collegiate Athletics Association told a Senate panel in December he was aware of fewer than 10 transgender athletes among the 530,000 competing at 1,100 member schools. Trump's order also calls for the US government to deny visas for transgender females seeking to compete in the US. "Our revised policy emphasises the importance of ensuring fair and safe competition environments for women," ESPN quoted the USOPC letter to governing bodies as saying. "All national governing bodies are required to update their applicable policies in alignment." ESPN also said the officials noted the USOPC "has engaged in a series of respectful and constructive conversations with federal officials" in the wake of Trump's executive order. The move comes as Los Angeles awaits a host role for the 2028 Summer Olympics. The US-based National Collegiate Athletic Association also altered its policy for transgender athlete participation to limit women's sports competitors to athletes assigned female at birth after Trump's executive order.