DR MAX PEMBERTON: I have treated THOUSANDS of patients with bulimia and, like John Prescott, many suffered terrible shame. But there is another type of bulimia that YOU could have and not even know it…

When I heard of the death of former Deputy Prime Minister John Prescott last week, the news instantly reminded me of him.

However, unlike many others, he wasn’t thinking about his two Jaguars or the time he punched a protester.

Instead, I remembered how he had revealed to me that he had suffered from an eating disorder for many years. In her 2008 autobiography, Pulling No Punches, she admitted that in the 1980s she had succumbed to bulimia as a way of coping with the stress of serving in the then Labor Party shadow cabinet.

He wrote about the shame he felt as a man suffering from an eating disorder widely perceived as a “women’s disease.”

Fearing that he would be considered unstable and too risky to be a minister, he hid his problem.

Despite his bravery in going public with his battles, his revelation was met with confusion and even ridicule. How could a middle-aged man suffer from what was then perceived as a teenage illness? And why was he overweight? It showed how much misunderstanding there was around eating disorders. That was 16 years ago and I’m not sure much has changed.

I used to run an eating disorder clinic and supervised a treatment group for patients with bulimia and over the years I have seen thousands of patients with this condition. During this time, one of the most heartbreaking things I learned is that most bulimia patients wait more than ten years before seeking help. This is because, like Lord Prescott, they feel a mixture of shame, guilt and shame.

Many people with eating disorders have tremendously low self-esteem and self-worth, which makes them feel like they don’t deserve help and that they don’t deserve to receive help. It can also take a long time for some bulimics to recognize that they have the condition. Strangely enough, bulimia often stalks them and becomes a normal part of their life. Often, until someone mentions it, they don’t realize that their behavior is dangerous and an expression of mental illness.

Bulimia is a cycle of behavior that has three central components. The first is binge eating. This often develops as a way to cope with extreme stress or distress, or to regulate emotions. People can consume large amounts (several thousand calories) in one sitting. While bingeing, a person may momentarily feel better as they feel an emotional release.

A bulimic person will then typically be overwhelmed by feelings of shame and disgust that will lead to the second part: the purge.

They will usually make themselves vomit to get rid of the food they have eaten. Depending on the duration of the binge and the amount eaten, some of the food will be absorbed, which explains why some bulimics are overweight.

The final component is that they will then punish themselves by restricting their food intake, either eating very little or nothing at all. Food deprivation results in low blood sugar and often the next day they are so hungry that they binge and the whole horrible cycle begins again.

Bulimia has very serious physical health consequences, such as causing life-threatening changes in the body’s chemicals, such as low potassium levels and damage to the digestive tract, throat, and teeth. It is also very dangerous from a psychological perspective when sufferers fail to develop strategies to deal with the problems in their life that led to the binge eating.

Most people will be aware of the type of bulimia I just described. But there’s a second type that’s more insidious and harder to detect: Sufferers often don’t believe it’s an eating disorder, at least not at first. This is called the “non-purgative subtype” and involves not vomiting but rather doing something else to void the food they have eaten. They may exercise too much or obsessively count calories, for example, instead of purging.

With too much exercise, people convince themselves that they are healthy. They are often stunned when you explain that they have a type of bulimia. Problems often do not come to the doctor’s attention until, for some reason, the person is unable to perform the compensatory “punishment” behavior.

Over the years I saw quite a few patients who were in running or cycling clubs but, as they got older, they had suffered injuries that meant they could no longer exercise as much as they did to compensate for their binges. This caused them distress on a level that is difficult to describe. Beside themselves with anxiety, several attempted suicide.

I also saw quite a few younger men who, on the surface, looked healthy and muscular. However, when something triggered them, they would lose control and binge on what they considered “unhealthy” foods, such as chips, cakes, cookies and chocolate.

They would then make up for their guilt by committing to punishing exercises that would burn off all the extra calories they had consumed.

It was really horrible to hear some of the stories. A man only sought help after collapsing at the gym because he had been on the treadmill for six hours and worried staff had to ban him from using it.

The good news for people with bulimia, regardless of the type, is that specialized treatment has very good results.

Seeing how people who had been plagued by bulimia improved with psychotherapy was one of the reasons I loved working in the field of eating disorders.

It is important for those suffering from eating disorders to understand that they have nothing to be ashamed or ashamed of: they are sick and deserve our sympathy, support and help.

Zoe’s right to put family first

Zoe Ball has announced she is leaving her Radio 2 show so she can spend more time with her family. Many have been quick to point out that her son is 23 and her daughter is 14. Surely they don’t need mom around? I beg to differ.

His daughter, in particular, is at a crucial age. Yes, most 14 year olds don’t want their mother hanging around hindering their style. But anyone who knows teenagers will know that they exist in that strange intermediate age, which oscillates between being an adult and being a child.

There are times when they may seem very young and need mom or dad to support them or hug them. Teenagers, as they take their tentative steps out into the world, need to know that someone is still there, looking out for them. Even if they pretend they don’t.

The Cambridge Dictionary has named “manifesto” as its word of the year. This term refers to the idea that you can make something happen simply by wanting it badly, a Gen Z trend that’s huge on social media.

Of course, it is completely unscientific. An example of what psychologists call “magical thinking”: the belief that wishing for something or performing a ritual will make it happen.

The reason I hate the idea of ​​protesting is that it encourages people to be passive participants in their own lives. Deny any sense of agency and control over what happens to you, other than blowing out the candles and making a wish.

However, we have a lot of control over the direction of our lives and how to get what we want in life. Instead of hoping against hope that you will get what you want, go out and do something. Get a qualification, network, educate yourself, volunteer, get experience.

Yes, much harder than manifesting, but also much more likely to work.

Health Secretary Wes Streeting has announced a review of the deployment of 3,500 associate doctors (or assistants, as they should be called) currently working in the NHS. I hope it stipulates that PAs must warn patients that they are not doctors and therefore have professional limitations.