John Prescott and bulimia
Sometimes I think Iain Dale is too nice for this world. He has just put up a sympathetic post about John Prescott and his "bulimia".
The revelation of John Prescott's bulimia is not to be laughed at. Bulimia is a serious condition and he is to be praised for his decision to be honest about it. Most people believe bulimia only afflicts young girls who don't want to put on weight. It doesn't. It can affect anyone, as John Prescott's case clearly confirms. (Iain Dale)Well, OK, Iain, we all have a soft spot for the old rogue. But I have patients with bulimia, and it ain't like this. John Prescott is a man of excess, and good luck to him. Michael Douglas was a man of excess too
Some people simply can't help being 'sex addicts', according to a new "discovery" by scientists. (Daily Mail)Maybe poor old Prezzy can't help that either. Ho! Hum! I am too old and cynical. I cannot buy into the idea that this kind of behaviour represents illness. I am more taken with the diagnostic skills of my learned colleague, Dr G. Fawkes, who presents a clinically persuasive picture in Pass the sick bag, Pauline.
The more fascinating question is what on earth prompted John Prescott to make this extraordinary public confession?
Labels: bulimia, John Prescott, sexual excess
16 Comments:
most people will find Guido's post nearer the mark.
Could it be because he's got a book coming out shortly?
Only asking.
jobbing doctor has it. I think it is entirely to boost sales of his new book, which otherwise might languish on the bookshelves before being remaindered.
Of course it's because he's got a book coming out shortly - and as it's called "Pulling No Punches" he could hardly gloss over something so important in his life. Is he asking for the sympathy vote? Probably, just as other has been politicians are? Does that mean that his revelations have done no good to anyone but him and his publisher? Absolutely not. At the very least they have provoked debate (some of it even sensible and educated) about bulimia and has helped to dispel the myth that the only people who suffer are teenage girls who want to look like models.
There is very little treatment out there for bulimics and much of it when you do get it is offered by Quacktitioners which is hard for GPs who have full responsibility for diagnosis and signposting under the NICE guidelines to get their heads round. Therefore when an overweight 70 year old male presents with the symptoms of an eating disorder there may not be that much in the way of specialist treatment on the NHS that his GP can offer, but at least I hope that all this publicity will help the GP consider the diagnosis in the first place and the patient feel less alone with the condition.
Book publicity, and conveniently distracting the press from government difficulties .... call me cynical if you like, but next to most of our politicians I am but an amateur.
"Does that mean that his revelations have done no good to anyone but him and his publisher? Absolutely not. At the very least they have provoked debate..."
Provoked debate..? That's the last thing they've provoked!
Disgust, amusement, ridicule, contempt. That's what they've provoked.
"...at least I hope that all this publicity will help the GP consider the diagnosis in the first place and the patient feel less alone with the condition."
No, it's more likely to make any prospective patient less likely to come forward, to avoid comparison to 'that fat, useless sack of lard Prescott'.
Publisher: how are we going to sell this dullard book by a fat old has-been politican?
junior: well there is always the possibility of the sick stuff.
Publisher: By jove! Yes! Old fat man has developed eating disorder because of his job. We get to sell books £££££! AND beat Tony Blair with a big stick too!
It's true there IS much cyncicism, prejudice, ignorance and plain old hate in much of the comment on the matter.
Of course much of this is because of who Prescott is and what he represents (pugnacious hasbeen politician from a disgraced regime who promised so much and delivered so little apart from chaos and constant change for change's sake).
On the other hand many ignorant, cruel and plain dangerous myths persist about eating disorders when the person suffering from one isn't John Prescott. One only has to look at the crude stupidity of some of the comments made on the Woman's Hour message board during eating disorders awareness week to see that.
As one commentator remarked elsewhere, are we going to poke fun at people with cancer next? No we're not because cancer is treated seriously as a "proper" disease whereas eating disorders are seen as a lifestyle choice - they are NOT. They are serious illnesses with often fatal consequences. Certainly they have a strong environmental component but so do cancers. If the next hasbeen politician "comes out" and tells the world he has pancreatic cancer we'll all be encouraged to feel sorry for him, even if alcohol has been a factor in the development of the illness. Personally I feel that this situation has much to do with the sense of hopelessness and fear that clinicians feel on being faced with mental health problems. Drug treatments have not provided a panacea for any mental health problems. In the case of eating disorders there is very little evidence that they help at all. One consequence of this is that the investment going in to the subject is miniscule compared to that given to cancer. Drug companies don't make money out of eating disorders. Medics don't make glittering careers out of treating them.
There HAS also been sensible debate, considered response and genunine learning. Eating Disorders do NOT only affect attracive young women who are interested in fashion. They are NOT all about body image and fashion. Males do suffer too. People do not automatically grow out of them when they grow up a bit and have babies (as one mother of a terribly ill 18 year old was told by her daughter's GP). Prescott and his publicisits have opened the debate. If they've exposed a great deal of biggotry and ignorance at the same time then perhaps this will be for the good too.
John,
I very rarely disagree with you, but here I must.
All doctors are familiar with stereotypes in medicine, particularly in exams.
The IVDU with HBV; the male hairdresser mysteriously befallen with PCP; the high-achieving white female with a low BMI and no periods..
Except that it doesn't happen like that, does it?
Illness - and particularly stigmatising mental illness - does not discriminate thus.
Whilst I can see some logic to the argument that this might all be a publicity stunt to sell a book - and would advocate the right of anyone to express this view - it leaves a nasty taste in the mouth that you, a registered doctor, should go on record to compound a crass stereotype based on nothing more than crass tabloid conjecture. And as for quoting the Daily Fail to illustrate your point. . .
It was indeed a strange notion that JP should be a bulimia sufferer when the news broke. But if his public confession leads to a few "atypical" presentations for help, then he has surely done something worthwhile.
Chris BSc MD MRCP(UK)
You mentioned Iain Dale's blog... but didn't mention his line:
"In some ways, his bulimia partly explains his affair with Tracey Temple, and no doubt others."
I think this is unfair on all bulimia sufferers! Book deal or no book deal.
Michelle
Chris
Well, I'm not sure I agree. This story shows that the saying "Any publicity is good publicity" is not true. This will not help the cause of bulimia. It will drive sufferers further underground.
Prezzer has come out with this to try to flog his book. Even if he had genuine bulimia, and I don't buy it, tell me why he has released the story now? We all know the answer to that.
Do you think this story is going to liberate young bulimic girls and make them go to their doctor? Sadly not. I think it will have the opposite effect.
And dear old Iain's suggestion that bulimia explains or excuses shagging the secretary is risible. I wonder if Bill Clinton was bulimic?
John
I don't know whether JP does or does not suffer from bulimia, I do find it incredibly odd that he has decided to go public with this fact, why doesn't anyone want to live their lives in private anymore?
The people it will drive underground are the people who do suffer from bulimia and yet don't look like they are skinny or suffering from an eating disorder and will be afraid of the ridicule that Prescott is having thrown at him. It is possible to be bulimic and overweight Dr Crippen.
As far as shagging the secretary goes sleeping around is linked to low self-esteem as is bulimia.
And dear old Iain's suggestion that bulimia explains or excuses shagging the secretary is risible. I wonder if Bill Clinton was bulimic?
I hope your medical logic's better than this.
drchris, hear hear! My mother's hypothyroidism presented atypically; it was finally diagnosed when a GP who thought he'd found a heart abnormality decided to run a battery of tests. I now think she was also anorexic but again atypical (boring reasons for thinking this deleted).
I don't actually blame the other GPs for failing to diagnose the thyroid condition, rather, I see cases like that as supporting the MOTs some doctors scorn.
Bulemia, aclcoholism, sexual incontinence, drug abuse, thieving and lying etc do all correlate. That does not mean that all bulemics are sexually incontinent, or that all alcoholics are bulemic.
It just means that these behaviours are different manifestations of Multiple Impulse personality disorders, sometime classed as borderline personality disorders. Like most personality disorders it is hard and rather arbitrary where exactly the line to "normal" behavior lies.
To quote from a sample paper in this area:
Self-damaging and addictive behaviour in bulimia nervosa. A catchment area study
JH Lacey
Department of Mental Health Sciences, St. George's Hospital Medical School, London. The British Journal of Psychiatry 163: 190-194 (1993)
This study examines the prevalence of self-damaging and addictive behaviour in a consecutive series of 112 normal-weight bulimic women all stemming from the same urban catchment area. A quarter reported consuming over 36 units of alcohol a week, and nine drank over 50 units. Twenty-eight per cent abused drugs, 21% repeatedly stole, 18% repeatedly overdosed, and 8% regularly cut themselves. In all, 40% reported self-damaging and addictive behaviour, 80% of whom gave a history of three or more behaviours together. Alcohol abuse was significantly associated with drug abuse and repeated overdosing; repeated cutting was significantly associated with drug abuse. Repeated stealing and overdosing were markers of severity and did not occur in isolation. A core group, termed and defined by the author as 'multi- impulsive bulimics', were older, less likely to be employed, married, or in a stable union, but were more likely to have an alcohol-abusing partner or to come from a family with a history of alcohol abuse. They were also more likely to give a history of sexual abuse.
"As one commentator remarked elsewhere, are we going to poke fun at people with cancer next?"
Only if they're a wanker...
Have you considered the issue of prevention. I don't know if you read the article like http://articles.mercola.com/sites/articles/archive/2002/04/17/cattle1.aspx It talks about how the beef that we eat is raised...I believe it to be horifiying that the people are being fed this crap and the government wont stop it. Many Europian countries have put a ban on such meat but we still eat it without many of us realizing what we eat. I appologize for such a long winded comment, but maybe John Prescott and so many others wouldn't have this problem if he/us avoided foods that are genetically modified?
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