When John Prescott spoke recently about his struggle with bulimia he presented the media with a problem. Here was a succulent story: the bluff, gruff former deputy prime minister, one-time ship's steward and trade union activist, the man who punched an egg-thrower in the jaw, revealing he "took refuge in stuffing [his] face", gorging on tins of condensed milk, burgers, chocolate and crisps, before making himself throw up. How to squeeze out every last drop of juice, while at the same time displaying appropriate respect for the 1.1 million people who, according to the Eating Disorders Association, suffer from eating disorders in the UK alone? How, if you'll pardon the expression, to have one's cake and eat it?
The Sun's Trevor Kavanagh invoked the time-honoured tradition of assigning diagnoses (or retracting them) according to the needs of the observer: Prescott had been misdiagnosed; he wasn't bulimic at all. "Bulimia," Kavanagh told us, was "no laughing matter", but Prescott was "more likely just a greedy incompetent, who gobbled every treat going". How Kavanagh could know something many bulimics manage to keep secret from their most intimate companions will have to remain a mystery.
Though the broadsheets exercised greater restraint, a gleeful amazement was seldom far beneath the surface. Armando Iannucci wrote in the Observer that he would have thought "the likelihood of ever having to say the sentence 'John Prescott binged on condensed milk' was scientifically less than, say, the chances of a giant papier-mache Courtney Pine falling on Suffolk." Why? The recent death from anorexia of prominent academic Rosemary Pope also provoked astonishment. But eating disorders are not caused by stupidity.
I was going to write about some of the blogs, but I find I just can't face it. If "John Prescott is not bulimic, he is just a greedy pig" got past the moderators, one can only imagine the comments they had to censor.
When I think of bulimia, I think of pain. Pain and little else. Though I've written extensively about mental health and tried to be open about my own issues, I have never talked about my struggles with food because I've never found the courage. Shame, humiliation, disgust. There is nothing in those hateful blogs that bulimics won't have told themselves a thousand times over already, and that is the real pity of it.
My experience of full-blown bulimia lasted for less than six months, a fraction of what most with the illness have to endure, and they were, without question, the most miserable months of my life. Eating disorders are rife within the psychiatric system, often hiding behind other diagnoses and seldom receiving the treatment and attention they require. It's rare to find a toilet on the wards without a telltale film clinging to the surface of the water. The effects of medication, lack of opportunity to exercise and, above all, the boredom of in-patient life all exacerbate the problem.
Though repeated vomiting can cause electrolyte imbalances in the body, which can in turn lead to seizures, an irregular heartbeat and death, bulimia does not tend to scream for attention in the same way as severe anorexia, for example, or other forms of self-harm. Bulimia remains a private humiliation, and people can be too embarrassed to seek help. Where anorexia is about success, an appetite contained (albeit a success that will ultimately kill you), bulimics must, like unfortunate dogs, have their noses repeatedly rubbed in the shameful consequences of their failure.
Moreover, because bingeing does not generally present the immediate dangers of the self-harm it often accompanies, staff can be tempted to ignore the one in the hope of suppressing the other. My friend Sarah has suffered from severe bulimia for more than 20 years. She has also repeatedly self-harmed to an extent requiring life-saving intervention. More than once, she says, staff have encouraged her to binge in an attempt to prevent her cutting herself. While this may be understandable, I believe it is misguided.
Of course, effective treatment can be hard to come by. For a start, there's the challenge of finding a worker with a "normal" relationship with food. In an attempt to help her overcome her fear of certain foods, Sarah was encouraged to eat a Mars bar in the presence of a therapist, who would eat one at the same time. The therapist, however, substituted an apple, explaining that she was on a diet.
· Clare Allan is a writer and novelist
