Look in the mirror and what do you see? For most people, our reflection is just that, an image of our body at a certain time in our life.

For a person with an eating disorder however, that image can be more complicated. People with eating disorders can have a distorted self-image.

This can lead to a very complicated relationship with food – severely restricting, exercising excessively, and in the case of bulimia, binge eating and purging. What starts as a mental health condition, can over time have detrimental physiological impacts on the heart, digestive systems, bones and teeth.

It’s a very difficult condition for people to live with, and it must also be so hard for loved ones to witness, as detailed by Mairead*. The interview is part of our two-week series on eating disorders, written by Rosalind Skillen. Names were changed to protect the family’s privacy, but essentially, Mairead details that her daughter Sasha* started showing signs of an eating disorder at 15-years-old. At 17, she was in hospital, being NG fed, which is where a feeding tube is inserted in the nose or mouth to deliver nutrition. But everything changed when Sasha* turned 18.

What starts as a mental health condition, can over time have detrimental physiological impacts on the heart, digestive systems, bones and teeth.

Treatment for eating disorders in this country is segregated into child/adolescent care; and adult care. When Sasha became a legal adult, the services weren’t there for her, and so she was discharged. A vulnerable young woman with an eating disorder was left to fend for herself, and not surprisingly, it wasn’t long before she ended up in resuscitation in St James’s Hospital. For Sasha to get the treatment she needed, she had to go to the UK under the Treatment Abroad Scheme, where she has been for six years. Mairead says: “Sasha left her home in Co Limerick seven years ago to be treated in A&E and has not seen her bedroom since.” This is heartbreaking.

The Government has not delivered on its plans to provide adequate specialist eating disorder teams at community level, as set out in the 2018 Model of Care. The five-year plan ended in 2023. Two years later, we are still at 11 teams, rather than the planned 16. The result is people are being sent abroad for care and they are most likely from rural areas. While we do not have that confirmed, the reality is the allocation of hospital beds is a postcode lottery.

There are only three adult public beds in the entire country for people with eating disorders, and all are in St Vincent’s Hospital, Dublin and allocated to those in the catchment area. There are currently no eating disorder hubs in the midwest. So what are the options? Expensive private care? Getting care abroad? Families are being put in impossible situations.

This series details many figures, including the eye-watering money that is being spent sending people abroad for care, instead of being invested in services here. But we forget facts and figures. What we’ll remember is the heartbreak of Ciara Greene (profiled last week), who says that if she got the right help, she could have had a different life – kids, a full-time job. It is the despair of Mairead asking all the what-if questions – what if the adequate services were available in Limerick and her daughter didn’t have to go to the UK?

It is the stories behind the stats that show the true impact of the lack of services for those with eating disorders in this country.