December 17, 2024

1.1 million Australians are significantly impacted the deadliest mental illness, costing $67 billion annually—yet less than one-third receive the care they need. This election, commit to prevention, early intervention, and saving lives.

Dear Prime Minister We are writing as members and affiliate members of the Eating Disorder Alliance – a collaboration of eating disorder organisations concerned about increasing prevalence rates, significant barriers to seeking and accessing help, and lack of viable treatment options for people impacted by eating disorders. Eating disorders are claiming lives at the highest rate of any mental illness in Australia, and cost the Australian economy $67 billion every year in social and economic costs (Deloitte, Paying the Price, 2024). There are more than 1.1 million people in Australia living with a diagnosed eating disorder today, and yet less than a third receive the care they desperately need. While the government has increased funding for the treatment of eating disorders over the last decade, more needs to be done for the prevention, early intervention and treatment of these incredibly costly and heart-breaking illnesses. In the lead up to the Federal Election, we are therefore calling on you to demonstrate your commitment to improving the system of care for people with eating disorders and their loved ones. Summary In short, we are calling on government to:

1. Commit to the National Eating Disorders Strategy 2023-2033, including investment in its implementation, and an undertaking to action the government recommendations on public policy, health promotion, prevention programs, and prohibition of weight stigma.
2. Action recommendations from the recently released Evaluation Report on Eating Disorder Medicare Items, including increasing the rebate for ANZAED Eating Disorder Clinicians (Recommendation 23), and streamline eligibility criteria to include all diagnostic presentations of an eating disorder.
3. Embed support for eating disorders in government-funded mental health services, for example headspace, the Medicare Mental Health Centres and NGOs, ensuring they are equipped to provide evidence based early intervention and frontline treatment.
4. Invest in a mental health promotion community campaign to raise awareness, reduce stigma, educate about signs and symptoms, and increase early help-seeking
5. Deliver sustained funding into programs and initiatives aligned with the National Strategy Prevention Actions to prevent the onset of eating disorders including social media literacy and other protective factors.

Eating disorders are complex mental illnesses, and require a multi-faceted approach to prevention, care and treatment. Without significant investment now, we are facing catastrophic health outcomes for generations to come. Attached is a breakdown of these requests, along with their alignment to the National Strategy. We would welcome the opportunity to discuss these requests with you.

Yours sincerely,

EDA Members Dr Jim Hungerford, CEO, Butterfly Foundation

Jade Gooding, CEO, Australia and New Zealand Academy for Eating Disorders (ANZAED)

Jane Rowan, Executive Director, Eating Disorders Families Australia (EDFA)

Belinda Caldwell, CEO, Eating Disorders Victoria (EDV)

Belinda Chelius, CEO, Eating Disorders Queensland (EDQ)

EDA Affiliate Members Laurence Cobbaert, Chair and Research Lead, Eating Disorders Neurodiversity Australia (EDNA)

Eating Disorders Alliance is calling for urgent government commitment to the following:

1. Alignment with the National Eating Disorders Strategy 2023-2033

• Resourcing the implementation of the National Strategy with continued funding for the National Eating Disorders Collaboration (NEDC);
• Providing leadership in talking about and investing in the National Strategy;
• Extending relationships with states and territories to better support those with an eating disorder (e.g. bilateral agreements, co-funded services).
• Implementing the National Strategy Actions which are allocated to the Government, including;
  • Treatment Action 1.1: Government and health and mental health service leaders to endorse eating disorders treatment as a core public health service accountability and workforce planning priority.
  • Action 4.2: Treatment providers to have the required skills in line with national eating disorder clinical and training standards.
  • Action 5.1: Government to fund large-scale dissemination and evaluation of existing evidence-based prevention programs.
  • Action 8.1: Government and health services to ensure that all public mental health services provide eating disorder services consistent with the needs of their regions.
  • Action 8.2: Regional planners to ensure that there are low-cost treatment options in their region for those who require them.
  • Action 8.3: Training providers and relevant professional organisations to ensure that GPs and mental health professionals are equipped to utilise the Medicare Eating Disorder Treatment and Management Plan items.
  • Treatment (community based) Action 1.2: Government and health and mental health service leaders to endorse eating disorders as a core public health service accountability for public health services.
  • Treatment (community-based) Action 1.2: All community-based mental health services (including child and adolescent/youth mental health services, adult mental health services, headspace, Head to Health) to ensure sufficient staff are trained and supported to provide evidence-based treatment for binge-eating disorder, bulimia nervosa, OSFED (excluding atypical anorexia nervosa), UFED, and sub-threshold eating disorders, and to provide or refer to treatment for anorexia nervosa, atypical anorexia nervosa, ARFID, pica, and rumination disorder.
  • Treatment (community-based) Action 1.3: Mental health services to ensure that, at a minimum, staff providing treatment for eating disorders have completed introductory training, are trained in an evidence-based treatment model appropriate to the age group/s they are treating, and have access to ongoing supervision and organisational support.
  • Treatment (community-based) Action 2.3: Service commissioners and funders to fund early intervention pathways in treatment services.

2. Action all recommendations from the recently released Evaluation of the Eating Disorders Medicare Benefit Schedule Items 2024. Including:

• Legislating for a higher rebate for ANZAED Eating Disorder Clinicians to provide the Eating Disorders Management Plan MBS items
• Creating MBS items for carers
• Streamlining eligibility criteria to make it more accessible and easier for people with a non-low weight presentation to access an EDMP
• Bulk billing for disadvantaged communities (as defined in the report)

3. Embed support for eating disorders in government-funded mental health services

Leverage existing and planned mental health supports to ensure they include support for eating disorders.

• Build on existing upskilling of headspace and Head2Health services to ensure soon-to-be launched Medicare Mental Health Centres and Early Intervention services can respond to eating disorders.
• Mandate the employment of ANZAED Eating Disorder Clinicians in every Medicare Mental Health Centre
• Include eating disorders in existing and planned service navigation programs and tools
• Include eating disorders in existing mental health policy and infrastructure, e. g. the lived experience workforce initiatives

4. Invest in a mental health promotion community campaign As aligned with National Strategy:

Identification Action 1.1: The eating disorder sector and government to work together to galvanise public awareness of eating disorder signs and symptoms and increase understanding of the need to respond as early as possible, such as through a national public health campaign.

Identification Action 1.2: Eating disorder and mental health organisations to continue to provide evidence-based information about eating disorder signs and symptoms and pathways to care, tailored to a range of audiences.

The risk of developing eating disorders has now increased to more than half of the general community, with 57% having experienced at least one of the symptoms of an eating disorder compared to 50% in 2020, with young people aged 18-24 years at greatest risk Verian 2024 Community Insights Report). We are therefore calling on government to:

• Invest in an integrated health promotion campaign to reduce body image dissatisfaction and appearance-related discrimination, co-designed with lived experience including carers and family members, with an independent evaluation to assess reach and impact
• Increase general community awareness of the signs and symptoms of an eating disorder and when to access help
• Break down stigma to further encourage help-seeking
• Identify where and how to access help, providing service navigation support
• Identify and understand risk factors, e.g. food insecurity, cost of living, to better support at risk communities.

5. Sustained funding into programs and initiatives aligned with the National Strategy Prevention Actions to prevent the onset of eating disorders

As aligned with National Strategy:

Prevention Action 1.2: All levels of government to ensure that public policy and initiatives related to education, health promotion, food and nutrition, physical activity, weight management, advertising and media do not contribute to eating disorder risk, drawing on eating disorder-safe principles and expert input.

Prevention Action 5.1: Government to fund large-scale dissemination and evaluation of existing evidence-based prevention programs.

Prevention Action 5.2: Government to fund research for the development and evaluation of prevention programs where gaps exist for specific age groups or for underserved and higher risk population groups.

Prevention Action 6.1: Government to enact prohibition of weight and size discrimination in anti-discrimination legislation at national and state/territory levels, where none currently exists.

Deloitte’s Paying the Price (2024) research found the incidence of eating disorders among children and young adults aged 10-19 has almost doubled in the last decade – an 86% increase. Online environments are particularly challenging for young people, with a proliferation of harmful content and social media trends (Social Media, Body Image and Eating Disorders Working Group, 2024); supporting young people to navigate these spaces safety is critical for preventing and reducing the development of body image-related harms including eating disorders. We are therefore requesting that the government:

• Commit to ongoing investment into the prevention of body image concerns, disordered eating and eating disorders;
• Fund large-scale dissemination and evaluation of existing evidence-informed preventative school programs, including Butterfly Body Bright, Butterfly BodyKind and Butterfly Online Education Program, to build protective factors and decrease risk factors of developing an eating disorder;
• Require social media platform providers and media organisations to include inclusive and diverse language and imagery and enforce bans on appearance-related abuse, harassment and discrimination.

References

Deloitte Access Economics. (2024). The social and economic costs of eating disorders in Australia 2022- 23. Report commissioned for Butterfly Foundation. Sydney: Butterfly Foundation.

National Eating Disorders Collaboration (NEDC). National Eating Disorders Strategy 2023-2033 [Internet]. 2023. Available from: https://nedc.com.au/downloads/nedc-national-eating-disorders-strategy-20233-2033.pdf

Social Media, Body Image and Eating Disorders Working Group. (2024). Recommendations from a roundtable working group Convened by Zoe Daniel MP and Butterfly Foundation. September 2023 – May 2024, Butterfly Foundation.

Verian. (formerly Kantar Public). (2024). Community Insights Research. Report commissioned for Butterfly Foundation. Sydney: Butterfly Foundation. Brand information is not publicly available but can be provided in-confidence on request.