Meeting of the Parliament

Meeting date: Thursday, March 2, 2023

Official Report 1161KB pdf

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Eating Disorders Awareness Week 2023

I ask members who are leaving the chamber to do so quickly and quietly. I also ask those who are in the public gallery to leave quietly.

The next item of business is a members’ business debate on motion S6M-07887, in the name of Kenneth Gibson, on eating disorders awareness week 2023. The debate will be concluded without any question being put. Members who wish to speak in the debate should press their request-to-speak buttons.

Motion debated,

That the Parliament notes that Eating Disorders Awareness Week 2023 will take place from 27 February to 5 March; recognises that the focus of this year’s Eating Disorders Awareness week is eating disorders in males; understands that around 1.25 million people in the UK of all ages, genders, and backgrounds have these illnesses, and that around one in four people with eating disorders are male; acknowledges the work of the organisation, Beat, which is the UK’s Eating Disorder charity whose mission is to end the pain and suffering caused by eating disorders; notes that the work of this organisation through its national helpline, which is supported by funding from the Scottish Government as per the recommendations of the National Review of Eating Disorder Services, exists to encourage and empower people to get help quickly; recognises the work that has been undertaken by the National Review of Eating Disorder Services Implementation Group to develop an approach for taking forward the recommendations of the review; understands that the review will pave the way to more equitable, accessible and supportive services in Scotland; encourages the Scottish Government to continue to work with NHS boards and Beat to ensure that people needing treatment in the Cunninghame North constituency, and elsewhere, have the support that they require, and wishes Beat and all those involved in this year’s awareness week every success in their efforts to heighten awareness of eating disorders and their impact on society.

12:55  

I am pleased to open this debate on eating disorders awareness week 2023, which takes place from 27 February to 5 March. I thank colleagues who supported my motion, allowing this important matter to be discussed in the chamber, and I thank those who will contribute, along with Beat, the United Kingdom’s leading eating disorder charity. I also apologise for being unable to stay beyond the next speech, having completely forgotten a long-standing engagement relating to the Finance and Public Administration Committee.

Today, I honour the continued campaigning of my former MSP colleague Dennis Robertson, who tragically lost his daughter Caroline to anorexia nervosa in 2011, when she was only 18. Dennis co-chairs the Scottish Government’s national review of eating disorder services implementation group with Dr Charlotte Oakley. I am delighted to say that Charlotte is in the gallery today. That group was established to ensure that those suffering from eating disorders receive equitable, accessible and supportive care. Lived experience is invaluable as the group reviews current service provision in Scotland and implements new strategies to ensure that fast and effective treatment is available to all who suffer from eating disorders.

Eating disorders are often endured in secret and do not discriminate by age, gender or background. Of the 100,000 people in Scotland who suffer from eating disorders, one in four is male. Their symptoms often go unnoticed. It can be easy to assume that changes in eating habits or weight, or a fixation with body shape, happen because, “He loves working out,” or, “He is just a picky eater.” However, it is important to recognise that eating disorders are complex mental illnesses.

Raising awareness about the number of men who suffer from eating disorders is a central theme of this year’s awareness week. Beat hopes to shine a light on the differing experiences that men face—breaking gendered stereotypes to encourage males to obtain the support that is needed in order to recover.

In conjunction with this week’s theme, Beat launched the United Kingdom’s biggest survey to date on men’s experiences with eating disorders. Of those who took part, one in three had never accessed treatment, one in five had never spoken about their struggles, and four in five felt that raising awareness would help more men to get treatment sooner. Those results highlight the importance of encouraging men to seek support and, equally, the importance of high-quality treatment so that, when people find the courage to take vital steps towards recovery, the right help is available.

A supporter of Beat, Andy, has shared his route to understanding and overcoming his eating disorder. In his conversation with the charity, Andy said:

“the eating disorder does not discriminate ... it doesn’t care for intellect, qualifications or logic.”

Despite having a psychology degree, counselling qualifications and a robust understanding of mental health, Andy silently suffered from an eating disorder for 25 years. The disorder stayed with him through marriage, career progression and becoming a father. He revealed that, at its peak, it had cost him his

“mental health, confidence, self-esteem, employment”

and

“friendships”.

Andy contacted Beat last year, after looking into the support that was available. He said:

“I was heard. I was understood. I felt accepted, and human, the shame left me and the edge was taken off this huge burden.”

Since reaching out, Andy has joined an online support group that is supervised by Beat. Understanding that other men face the same burdens has been a key revelation in his recovery process and has allowed him to begin rebuilding and enjoying his life.

Dan, despite his love of football and boxing, developed anorexia nervosa in his late 20s. He has now shared his experience of overcoming societal stigmas to reach recovery. Due to stereotypes that are placed on eating disorders, he believes, he was undiagnosed for a long time, and he admitted that thoughts of having an eating disorder had never crossed his mind. While he was ill, Dan said, as far as he was concerned,

“men don’t get eating disorders, especially straight men and especially not anorexia”.

He did not know anyone else who had an eating disorder, so he knew of no reference point that might lead him to believe or accept that he needed help.

Due to family persistence, Dan visited his general practice, where he was listened to without judgment and given a referral to a specialist out-patient eating disorder service, which he reluctantly accepted. Throughout the years that he spent within that service, Dan met regularly with a therapist, a dietician and a doctor, who provided the highest level of support. Dan learned that he was not alone in battling anorexia. Speaking of the experience, he said:

“They genuinely celebrated my wins, picked me back up when I fell and even gave me that supportive kick up the backside when I needed it”.

Dan is now more than four years into recovery and, despite admitting that it was not an easy process, he has developed new hobbies and interests without the burden of his eating disorder overshadowing him.

Andy and Dan highlight how valuable our recovery services are. Denial and reluctance to seek help are feelings shared by both men and, no doubt, many other men whose health has been destroyed—like that of a far greater number of women—by an eating disorder. I hope that today’s debate and the campaigning that takes place throughout this week and the rest of the year will inspire others to seek assistance.

I am heartened by the Scottish Government’s commitment to delivering high-quality eating disorder recovery services, as is highlighted in its “Mental Health Strategy: 2017-2027”. Its ambition to

“prevent and treat mental health problems with the same commitment, passion and drive”

as we all have for

“physical ... problems”

is key to building public confidence in our services and encouraging more people to use the help that is available.

Mental health spending has almost doubled since 2007, with Scottish ministers investing £290.2 million this year to tackle mental health, deliver psychological therapies, reduce waiting times and improve community-based mental health and wellbeing support for children, young people and adults. That funding will help to ensure that people who have an eating disorder receive the treatment and support that they need, when they need it, regardless of who they are, where they live or what type of eating disorder they have. I encourage anyone in Scotland who suffers from an eating disorder, or who knows someone with an eating disorder, to reach out for help.

I will end by returning to Andy’s story. He poignantly said:

“Eating Disorders do not discriminate, but neither do Beat … and I know which one I’d rather have in my corner.”

Whether through opening up to a family member or friend, making an appointment with your GP or calling Beat’s helpline, support is available. Please reach out and grab it if you need it.

Members will be aware that business resumes at 2 pm. A number of members wish to speak in the debate—there is a lot of interest—therefore, I ask members to limit their speeches to the four minutes that they have been allocated. That would be really helpful.

13:00  

I welcome the debate, which allows us again to raise awareness of eating disorders. I congratulate Kenneth Gibson on securing it. He highlighted well the issues that surround eating disorders. Around 1.25 million people across the UK and about one in 50 people in Scotland live with an eating disorder, and the number increased during the Covid-19 pandemic. The pandemic exacerbated the situation, with a reported increase of 86 per cent in referrals to specialists between 2019 and 2020.

There is much discussion about what causes a person to have an eating disorder. Eating disorders affect people of any age, gender, ethnicity or background. Research has shown that there is a link between eating disorders and depression, low confidence and low self-esteem. It is important to remember that such disorders are not all about food but are about feelings as well. One of Beat’s key asks concerns social media. We know that social media can be the cause of eating disorders, and we need to ensure that people use it safely. I thank Beat for the work that it is doing on that, and I encourage everyone to look at its website, which is easy to navigate and comprehensive.

In March 2021, the Scottish Government completed a national eating disorder services review. The review’s report includes a total of 15 ambitious recommendations that are focused on ensuring that everyone affected by eating disorders receives timely and appropriate care and support. The recommendations include establishing a lived experience panel; better co-ordination of national activity and data collection; ensuring the national availability of self-help resources, which should be available to everyone at any stage in life; and a focus on early diagnosis with the aim of prevention. It is welcome that an implementation group was set up to review timescales and the cost of implementing the recommendations and that three sub-groups have been created within the implementation group. I would welcome an update from the minister on the implementation of those recommendations.

I contacted the dietetic team from NHS Dumfries and Galloway. The team has a dietician who works specifically with patients who are living with, or at risk of developing, an eating disorder. I heard that, because of the rurality of Dumfries and Galloway, some people who are at risk of developing an eating disorder might not be picked up as early or as easily as they could be and might be reluctant to access support because of the travel involved in attending appointments. Although that situation has improved with virtual appointments, there still exists an issue for people in rural areas with accessing eating disorder support services, so I ask the Minister for Mental Wellbeing and Social Care to ensure that rural areas are included in the approach moving forward.

I welcome the Scottish Government’s investment of £120 million in the mental health recovery and renewal fund with a focus on improved support for mental health in primary care settings and enhanced community support. I also welcome its increased investment in Beat, which has received more than £400,000 from the Scottish Government to support carers, adults and young people across Scotland who are coping with eating disorders. The funding follows the national review of eating disorder services in Scotland, which generated recommendations for treatment across the country. Those recommendations will be taken forward by the eating disorder services implementation group, which is responsible for planning and delivering improvements to eating disorder services.

I am conscious of the time, and I know that there are other speakers. I welcome the debate and thank the minister for the work that has been done so far and Kenneth Gibson for bringing the debate to the chamber.

13:04  

I am grateful for the opportunity to take part in the debate and congratulate Kenneth Gibson on securing it.

I apologise to you, Deputy Presiding Officer, the members and the minister, as I will not be able to stay for the full debate because I have a pressing engagement to attend to.

As we have heard, 2023’s eating disorders awareness week goes from 27 February to 5 March. Eating disorders in males, on which this year’s week focuses, are underreported. As the motion rightly highlights, although there are approximately 1.25 million people living with an eating disorder in the United Kingdom, around 25 per cent of them are male, which equates to around 300,000 individuals. Indeed, the National Centre for Eating Disorders confirms that it is hard to know just how many men are suffering from the condition at any one time. It is also hard to know what proportion of newly reported cases are male related. There could be many reasons for that. Perhaps, over the years, we have been overly sensitised by the media in relation to weight loss in individuals. Indeed, there are many who are likely to talk about the complexities of age. When it comes to dealing with the complexities and anxieties about shape, size and weight, those issues come into the equation.

Women often talk about food and dieting much more in relation to weight loss than men do, whereas men with eating problems often hide their difficulties by exercising—or over-exercising—when they visit the gym. Men are more likely to avoid seeking help, because of peer pressure. It is also widely known that, historically and across many cultures, men have been celebrated for how active they are and what they can conquer, while women have been valued for their appearance. That has changed as the culture has changed, and it is no longer the case, but there is still a complexity around media involvement and the shift that relates to all ages and genders.

Taking health orientation as a benchmark, it would seem that men are becoming increasingly involved in this area. The number of men with gym memberships has greatly increased, and cosmetic surgery has even become more apparent in males, along with dieting. There are changes that are taking place, and we all acknowledge that.

I have spoken about eating disorders previously in the chamber, and I have talked about Beat’s campaign, sock it to eating disorders. I also spoke in a similar debate last year, which was secured by Emma Harper, as I have an awareness of what is taking place and how it is managed. We have to understand and acknowledge conditions such as anorexia, bulimia, binge eating and other disorders.

In recent years, the support of MSPs has helped to increase the political profile of eating disorders. However, there is still much work to do to ensure that we encapsulate what is going on. I pay tribute to organisations such as the Scottish Eating Disorders Interest Group, Diabetes Scotland, Beat and our national health service, all of which provide vital support and ensure that vulnerable individuals are supported and looked after.

We must encourage and empower people to take action, no matter how long their symptoms have been present or what they have dealt with.

In conclusion, eating disorders are a terrible affliction for many individuals, male and female, and I encourage everyone to get the message out about them, whether or not a campaign is taking place, to ensure that as many people as possible, as often as possible and wherever possible, get that message.

13:08  

I start by thanking the member for Cunninghame North for bringing this important issue to the chamber.

There is often a tendency to focus on anorexia or bulimia in discussions about eating disorders, but it is important to stress that there is a broad spectrum of these illnesses, which can impact on anyone, of any background. That is why I welcome that, this year, the focus of eating disorder awareness week is on eating disorders among men. Issues around eating disorders are often discussed in relation to women, but the reality is that approximately one in four people with eating disorders are men—increasingly, young men.

A recent UK survey on men with eating disorders, which was undertaken by the excellent charity Beat, found that half of those who responded did not realise that someone like them could develop a disorder of that kind, with 76 per cent of respondents indicating that access to specialist services must be improved. That has only been exacerbated by the tendency of social media to be curated in such a way that men and boys are increasingly feeling peer pressure with regard to their body image. Perhaps the minister could respond to that specifically in his reply, particularly with regard to how we encourage positive role models and the use of social media in a positive way to reinforce messages that will provide greater reassurance to young men about how they can manage their diet and their body. We should be pursuing that as a public health policy.

In 2021, the Scottish Government published its national eating disorder services review, which included recommendations that could go some way to improving access to those services in Scotland. However, I understand that, regrettably, those recommendations remain to be fully implemented, despite increasing demand for specialist help. Indeed, the number of people in Scotland with an eating disorder who were reaching a stage of their diagnosis at which they required admission for in-patient treatment rose to 233 in 2020, compared with 125 in 2019. That was a stark increase.

However, it is likely that the reality of eating disorders in Scotland is, sadly, even more bleak than the picture that is painted by that statistic on hospital admissions alone. The data that we collect on the prevalence of eating disorders in Scotland is poor. Only data on people with eating disorders who have been admitted as in-patients to hospitals is collected centrally. That is another symptom of our hospital-centric national health system. We need to push more of that activity out into communities and focus much more on prevention.

If we had central data on every person in Scotland who has received an eating disorder diagnosis, we could have an even clearer understanding of how many people are impacted by disordered eating, which could inform the structure, capacity and design of NHS services so that they could be scaled and adjusted accordingly.

Eating disorders are deadly illnesses. Indeed, eating disorders such as anorexia claim the most lives of any mental illnesses, so we must ensure that the health service is adequately resourced to treat them as such. It is estimated that, at present, people can wait as long as three and a half years to start treatment after their illness begins. That delay is potentially fatal for many, as recovery is much more likely for patients who receive medical intervention early, when behaviour can be adapted before it becomes too ingrained.

The pandemic has, of course, had an undeniable impact on the efficiency of our national health service. However, as is often said, politics is about choices. I urge the Government to reconsider its freeze on mental health service funding so that eating disorder services can meet the growing demand for specialist support.

This is the third year running in which we have rightly debated in the Parliament eating disorder awareness week. We must ensure that we do not just talk about why people with eating disorders deserve better; we must deliver clear and measurable solutions to that major public health concern.

13:12  

I, too, thank Kenneth Gibson for bringing this important debate to the chamber.

As the motion highlights—and as other members have highlighted—approximately 1.25 million people in the UK suffer from some form of eating disorder. However, despite the widespread nature of the issue, there is still a lack of understanding among the public of how prevalent those illnesses are, how to spot signs that someone is suffering and how to help.

The prevalence of eating disorders among males is even less understood. It comes as a surprise to many that males account for one in four of all those who suffer from an eating disorder. Therefore, it is positive that the focus of this year’s eating disorder awareness week is on breaking the taboo of male eating disorders.

The importance of breaking that taboo is clear. George, who is a young man with an eating disorder, described that importance. He said:

“Finding out I had an eating disorder was actually a relief. I’d spent five years being incredibly unwell. Because I was a man, no one even considered it.”

Across Scotland, the impact of eating disorders is only growing, and the problem has been exacerbated by the mental and emotional impact of the pandemic. That is borne out by the alarming increase in the number of children suffering with the condition who are admitted to Scottish hospitals. Between 2019 and 2021, that number increased by a staggering 86 per cent. It is clear that cases of eating disorders are on the rise, and the impact on children and young people in particular must be recognised and addressed.

A key part of tackling the rise of eating disorders and supporting those who suffer from them is ensuring that we do not do anything to inadvertently make things more difficult for those who are already affected. The Scottish Liberal Democrats have concerns about the impact of the Scottish Government’s plans to make calorie labelling on menus mandatory in food outlets, such as businesses, takeaways, restaurants and hospitals, as part of Scotland’s obesity strategy. A survey by Beat, which is the UK’s eating disorder charity, found that 95 per cent of people affected by eating disorders feel that calories on menus will negatively impact them. Many expressed concerns that calorie labelling would increase feelings of fear and guilt for those who are currently unwell, encourage behaviours such as restrictive eating, and make recovery more difficult.

My understanding is that some restaurants are making non-caloried menus available for people if they book a table, for instance. That might help to counter the issue of calories on menus.

I thank the member for that helpful information. However, more than half of the survey respondents said that they would go out to eat less frequently if such legislation was introduced in Scotland. Elsie, who suffers from an eating disorder, said:

“It took me years to unlearn calorie counting and to find joy in food again—to have it displayed so openly, to potentially hear friends discuss it right in front of me, would be very triggering and harmful.”

Dr Stephen Anderson, a consultant psychiatrist in eating disorders, has said:

“There is no good evidence that this kind of calorie labelling is effective in reducing obesity.”

The Liberal Democrats are therefore calling on the Government to scrap those plans.

Good work is being done to support those struggling with eating disorders. Just yesterday, I read about a young woman, Molly Smith, who has started her own podcast exploring disordered eating, in the hope that it can break down stigmas and misconceptions. Molly says that she wishes that she had had access to something similar when she was younger. Work such as hers is vital in helping those who are struggling and helping others to realise when they need help.

I take this opportunity to acknowledge the excellent work of Beat in raising awareness and providing much needed advice and support to those suffering from an eating disorder and those close to them. I also echo the calls for the Scottish Government to work closely with NHS boards around the country to ensure that no one is left without the help and support that they need.

13:16  

I, too, thank Kenny Gibson for bringing this important annual debate to the chamber.

Eating disorders are serious mental health issues that affect an estimated 1.25 million people in the UK. Eating disorders can affect anyone, of any age, gender, ethnicity or background. They have severe impacts on individuals and their families. Types of eating disorders include binge eating disorder, bulimia, anorexia, other specified feeding or eating disorder and avoidant-restrictive food intake disorder. Eating disorders have high mortality rates, with anorexia having the highest, and with one in six people with binge eating disorder attempting to end their life.

The theme of this year’s eating disorder awareness week is eating disorders among men. Unfortunately, there has not been a lot of research on that. However, an estimate based on the existing research suggests that about one in four of those with an eating disorder are men.

Men face increased stigma when it comes to eating disorders, and the current research is not representative enough, as it focuses mainly on white, cisgender men, so the true number might be much higher. Stigma is undoubtedly a factor in the low representation of men in such studies. For many, the perception that eating disorders affect only women and girls will undoubtedly prevent people from recognising their symptoms in the first instance.

Many of the signs and symptoms that we have spoken about in recent years or those that are reported do not align with the symptoms that many men might suffer. Not knowing that their symptoms are a problem, let alone that they might be a sign of an eating disorder, will prevent people from seeking help. Those who know that they might have an issue might not seek help for fear of perceptions of their problems and the associated stigma.

Beat’s website has this quote from a man sharing his experience:

“I feel like eating disorders are often spoken about in relation to women. I didn’t expect that this would happen to me. When I initially developed an eating disorder, I didn’t know I had one. I didn’t exactly fit the common stereotype, and even if I did, I was in complete denial”.

As Emma Harper and others have said, social media is one of Beat’s areas of focus. Social media has a huge part to play in this and, as someone who loves a good TikTok scroll before bed, I know that the sheer number of videos—often sponsored videos or adverts—that promote different diets, weight loss and fitness regimes is enormous. That is not to say that such videos in and of themselves are harmful, but what strikes me is the number of them and the often conflicting information.

The member makes an important point about the pervasiveness of social media among young people in particular, including boys. Does she agree that the Government could consider a measure such as accreditation for certain social media content creators that reassure young people and provide them with good-quality advice, so that young people can be assured that they are getting good-quality, evidenced information?

That could certainly be looked at.

As members on all sides of the chamber have acknowledged, eating disorders are a societal problem. I would like us to look at all the different places where we could provide young people with nutritional information. We could certainly look at including such information as part of personal and social education, so that young people develop those habits early in life and cannot be influenced by the misinformation that we see on social media.

However, there is no easy solution to the issue. I remember growing up in the late 1990s and early 2000s, when diet culture was at its height. To a certain extent, even though attitudes move on and there is now more of a mainstream focus on being body positive, we have not got rid of that toxic diet culture. In a way, it rolls around every new year, when the goal—I have done this myself—is to lose weight rather than eat better and look after yourself. I cannot imagine how triggering that must be for people who have an eating disorder.

I realise that I am rapidly running out of time. Once again, I thank Kenny Gibson for bringing this important debate to the chamber, and I thank Beat for its continuing work.

13:21  

I congratulate my colleague Kenny Gibson on his motion and on securing time today for us to debate eating disorders. This afternoon’s discussion of how eating disorders can affect men and boys has already been valuable.

When I was listening to Beatrice Wishart, I was thinking that 25 per cent of 1.2 million is significant enough, but if there are men and boys who are not being diagnosed or who do not consider that they might have an eating disorder, the true number could, as Gillian Mackay said, be even higher. The expectations that are placed on young women and girls, of which I have experience, will also have a negative impact on men and boys, as they may think that body image is a female issue.

I am grateful to Beat for providing a briefing ahead of the debate. I am aware that Beat recently actively supported a steering group in Shetland, in my region of the Highlands and Islands, that was aimed at supporting sufferers in the isles, following the recommendations from the Scottish Government’s national review of eating disorder services. Eating disorders can affect people of any gender at any age, wherever they live. However, Beat’s research into men and eating disorders showed that half of the respondents to its survey did not think that someone like them could develop an eating disorder.

It is quite hard—as I know, because I tried in preparation for the debate—to find support groups and specific information for people living in many of the communities, especially island communities, that I represent. I hope that the minister will be able to provide an update on the timescale for implementing the review recommendations, in particular on the creation of the national network.

As with so many things, it all comes back to understanding and acceptance. I have heard so many stories from friends and constituents about the specific incident that they call to mind when they talk about a time when their disorder developed or resurfaced. They talk about a family member calling them fat, or praising them for being skinny, sometimes when they were really young bairns. They talk about being bullied at school or even as an adult, and dismissed or mocked for their size—not understood or accepted, just othered.

We know that malicious actors online can target people who have mental health issues with posts and adverts that are aimed at creating eating disorders or making them worse. Although dealing with much of that is not in the gift of the Scottish Government, I question whether it is ever appropriate for people to be able to pay to target folk with online advertising based on protected characteristics. I am aware that those who run gambling adverts, adverts that take advantage of impulsive spending and adverts that aim to trigger suicidal feelings, harmful eating or other feelings relating to mental health issues can pay to target people whom algorithms have identified as possibly having a mental health issue.

However, it is not just anonymous accounts online that can cause people such distress and harm. We could all do with being more aware of how commenting on someone’s weight, even if we mean it in a nice way, can trigger dangerous feelings and habits. There is no need to tell people that you think they are too fat or that they look a lot better now that they have lost weight. They might not have lost it in a healthy way, or they might be really struggling with the weight loss. They might have lost it because of illness, stress or bereavement, or something else that they could do without a reminder of.

The fact that many people developed eating disorders over lockdown, or their eating disorders became more of a problem for them, demonstrates the link between eating disorders and anxiety, trauma and co-morbidities with other mental health issues. Those are all situations that any of us could find ourselves in, and we never know when that might be, so being considerate of how our words and actions may affect people with eating disorders benefits everyone.

In the meantime, if anyone has been listening to the debate and has found it difficult, I encourage them to contact Beat, which can be contacted on a live web chat. Beat’s phone number is 0808 801 0432, and it also has an email address.

13:25  

I thank Kenneth Gibson for securing this important debate on eating disorders awareness week. I take this opportunity to thank Beat, which has representatives in the public gallery, for its exceptional work raising awareness around eating disorders and offering vital services to those who are suffering.

I will also take this opportunity to thank those who take the courageous steps to speak about their experiences, raising awareness and informing decision makers across the chamber of this cruel, devastating and complex mental illness, so that we can work together on improving services and lives for those who are suffering.

When it comes to supporting those with eating disorders, I believe that we are largely on the same page across the chamber. Today, given the time, I will focus my remarks on calorie labelling on menus, given the Scottish Government’s ambition to incorporate calorie content into menus in restaurants, cafes and takeaways across Scotland.

Having formerly worked with the healthy living award, I am aware that the benefits of a balanced diet cannot be overestimated. From our fruit and vegetable intake to high-fibre foods and protein, nutritional value is paramount. Take the humble avocado. About 60 per cent of its fat is monosaturated fats, which research suggests help to protect against heart disease and lower blood pressure. Avocados provide an excellent source of potassium, folate and fibre, all of which benefit the heart and the cardiovascular system. However, having calories on menus ignores all of that vital nutritional information, instead focusing on that one metric—calories. As the minister is aware, there is very little evidence that having calories on menus manages obesity in the long term.

There is much that we agree on in this area. I welcome the views from the Scottish National Party benches at Westminster earlier this week. Carol Monaghan, the SNP MP for Glasgow North West, stated:

“We also need the removal of calories from menus; their inclusion was aimed at tackling obesity, but unfortunately the message is hitting the wrong people.”—[Official Report, House of Commons, 28 February 2023; Vol 728, c 235WH.]

That view was echoed by her colleague, Patricia Gibson, SNP MP for North Ayrshire and Arran.

Calories on menus are a blunt instrument. I am aware that, in December, representatives of Beat met the Minister for Public Health, Women’s Health and Sport, Maree Todd, to hand over an open letter with 3,500 signatures. I would like to hear clarity from the Minister for Mental Wellbeing and Social Care in his response, explaining why the Scottish Government is so resistant to taking an evidence-based approach to the policy. It feels like the Scottish Government is sidelining the views of those with lived experience of an eating disorder. The minister knows that, for individuals suffering or recovering from eating disorders, the policy could cause immense harm.

A 2017 study found that, when calorie labelling was on menus, participants with anorexia nervosa ordered significantly fewer calories for hypothetical meal choices, while participants with bulimia nervosa ordered significantly more calories. We also know that calorie labelling on menus is very likely to be ineffective in improving public health.

I urge the Scottish Government to halt the policy, or at the very least pause the legislation, until further research is released. For all those who suffer with eating disorders, I urge the minister to listen to the 3,500 signatories and put a stop to calories on menus.

13:29  

In the interests of time, I will try not to repeat points that other members have made. As my colleague Paul Sweeney stated, Scottish Labour supports the aims and objectives of eating disorders awareness week 2023, with this year’s focus on eating disorders in men.

To better understand these complex mental illnesses and put gender stereotypes to bed, it is right that we applaud Beat for launching the UK’s biggest survey to date on men’s experiences with eating disorders. I acknowledge the work that has been undertaken on raising awareness and bringing people with lived experience together, and on advancing the care of people with eating disorders.

As we heard, the statistics are stark. I will not go over them again, but we know that, tragically, one in four people who experience an eating disorder are men, and one in five of those men report never having discussed those struggles, which is shocking. That acts as a reminder to us all that eating disorders are prominent and serious. Eating disorders still have a taboo around them that means that men in particular feel that they cannot speak out.

As Beat has indicated, it is essential that we take seriously our role as members in raising awareness, fighting for funding for research and scrutinising the Government in delivering the full implementation of the 2021 national review of eating disorder services, which includes 15 ambitious recommendations. Like other members, I would be interested to hear the minister’s response to the review. I hope that the minister will answer some of those points in his closing remarks, particularly the group’s conclusions from September 2022, which recommended a national eating disorder network. When will he oversee the implementation of those recommendations?

Furthermore, the 2021 national review of eating disorder services highlighted a lack of training and education on eating disorders for healthcare workers in Scotland. I spent many years working in the NHS as a dietician as part of the allied health professions team, so I know only too well the importance of raising awareness of those conditions and disorders and of training future healthcare professionals.

It is clear from members’ speeches that we all take the issue very seriously. The research work and contributions made by charities, experts and others are important, but there is more to do. With cross-party support, which we seem to have in the chamber today, we can work together and address the concerns of individuals, charities and others across the country. I look forward to hearing the minister’s remarks on the issue.

13:33  

I welcome the annual debate to mark eating disorders awareness week. We have been having the debate for many more than three years now, Mr Sweeney, and I pay tribute to Dennis Robertson, who kicked off these debates. It allows us to raise awareness about eating disorders and the terrible impact that they can have on those who are diagnosed and on their family and friends.

I thank Kenny Gibson for lodging the motion this year, and Emma Harper, who lodged the motion a couple of years in a row before that. The debate focuses our minds on how significant the subject is. We know that the past few years have been incredibly difficult for everyone, including for people with disordered eating and those diagnosed with an eating disorder.

I assure all members in the chamber this afternoon that the Scottish Government continues to work closely with NHS boards, local authorities and third sector organisations such as Beat to ensure that people who require support for an eating disorder have access to the right care and treatment. I extend my thanks and appreciation to everyone across the country who works day in and day out to support the recovery of people with an eating disorder and their families.

As we have heard, the theme of this year’s awareness week is eating disorders in men. Beat believes that around one in four people who develop an eating disorder are men. It is clear from its recent survey that more needs to be done in that regard. Mr Gibson mentioned Andy and Dan. The reality is that we probably all know an Andy or a Dan, but we do not know that they are suffering from an eating disorder. We need to get awareness right, we need to change attitudes and we need to reduce stigma further, so that no one is afraid to come forward for help.

Over the past three years, we have taken significant actions to ensure that those who require support for an eating disorder can receive timely access to appropriate treatment. That has included providing further funding to NHS services and the third sector, working with those at the heart of our services to deliver the recommendations from the national review of eating disorder services.

Since the publication of the report of the national review in 2021, we have made positive progress in delivering the review’s short-term recommendations and in the planning to deliver the remaining recommendations.

In 2021, in response to the national review, I established an implementation group to support us in delivering the recommendations. That group of dedicated individuals has worked hard to identify priority areas on which we should focus our resources. That has included developing quality standards for eating disorders and mapping out the delivery of longer-term improvements to services through a national eating disorder network.

The group will be publishing its final report in the coming weeks, providing an update on the progress that we have made so far in delivering the national review’s 15 recommendations. The report will also outline our next steps and the actions that we are taking this year.

Over the next year, key progress will be made to support improvements to eating disorder services. The quality standards will be consulted on this spring, with the intention to publish those by the end of 2023. Recruitment for a national eating disorder lived experience panel has already started, with panel meetings commencing in mid-April.

To improve data around eating disorders, we will be undertaking an NHS benchmarking deep dive on eating disorder services, which will provide us with an up-to-date baseline position on services across NHS boards to inform future policy development and resourcing.

An absolute priority over the next six months is the establishment of a national eating disorders network, which will support the delivery of the work that I have outlined and the remaining recommendations from the national review.

Additionally, we will continue to provide funding to NHS boards to ensure that those accessing specialist support for an eating disorder can access the support that they require. This year, we allocated £46 million via the mental health outcomes framework to continue delivering improvements in child and adolescent mental health services—CAMHS—psychological therapies, eating disorders and neurodevelopmental services for children and young people.

I turn now to some of the most important issues that members have brought up in the debate. I start with calorie counting, which was mentioned by Beatrice Wishart, Maurice Golden and Emma Harper. The Scottish Government takes eating disorders extremely seriously, and we will take the views that have been expressed fully into account. We have been engaging with Beat and other organisations, and we will continue to do so. We have been engaging with a wider range of key stakeholders on this work so that we get it absolutely right. I want to ensure that we do our best here. We will soon publish an independent analysis of responses to the consultation on the issue. We need to take that evidence-based approach that Mr Golden mentioned.

Social media was a feature of most speeches, including those of Ms Mackay, Mr Sweeney and Ms Harper. There is a great opportunity in the UK Government’s Online Safety Bill but, unfortunately, it keeps clawing back on all of that. That is, quite frankly, not good enough. As a Government, we have been investing, particularly in young people’s organisations, to highlight the difficulties with using social media and talk about avoiding them. However, we need the UK Government to move further on the Online Safety Bill in relation to not just eating disorders but suicide prevention and self-harm prevention.

Will the minister take an intervention?

I will take Mr Sweeney’s intervention if I am allowed to, Presiding Officer.

Please be brief, Mr Sweeney.

I remember the iconic Health Education Board for Scotland adverts in the 1990s and 2000s, when I was young. They were very effective in pushing public health messages, but that approach has, sadly, fallen away in recent years. Will the minister consider using targeted social media advertising by the Government to reinforce positive messages?

We have been doing that but not necessarily through the Government. For example, we have provided resources to the Scottish Youth Parliament and the Scottish Children’s Parliament for the Mind Yer Time web resource, which goes into the subject of social media in depth, highlighting the issues and giving young folk advice on screen time and sleep, and the impacts on body image and mental wellbeing. I think that having young people speaking to young people is probably better than having Government speaking to young people, but I am willing to consider all of that as we move forward.

Emma Harper made a very important point about rural services, and Beatrice Wishart and Emma Roddick mentioned rural and island communities. We have commissioned directors of e-health to work with others, including Public Health Scotland, to improve data from all over Scotland, but we are also looking at how we can deliver better in our rural and island communities. We have to make sure that the services that we provide are for all of Scotland.

Presiding Officer, I know that I have gone over my time, so I will finish. I again thank Kenneth Gibson for lodging his motion and I reiterate my support for and thanks to the staff across Scotland who have been working tirelessly to care for those with an eating disorder. I pay tribute to Dennis Robertson for the work that he has done and to Charlotte Oakley for her work in jointly chairing the implementation group with him.

We all still have work to do to deliver on recommendations from the national review. I assure all members in the chamber that ensuring that we improve support for those with an eating disorder is a top priority for me and for the Government.

13:42 Meeting suspended.  

14:00 On resuming—