the media, that is what drove me to it. and it claims lives. this 20—year—old died after battling eating disorders for most of his teenage years. i think, with adequate care, steven would be alive today, and i think he would have been living quite a healthy life. it is time to break the silence on a growing problem for british men. i struggled with an eating disorder for over half my life. it is a very secretive illness. men, in particular, find it very difficult to talk about. but thankfully, more and more are coming forward. i have never really understood why this illness has blighted my life and the lives of so many others. it can hit at any time, and it doesn't discriminate. james is 25. he has anorexia nervosa, a serious mental illness where someone tries to keep their weight as low as possible by restricting the amount of food they eat. how is it going? are you all right? not bad, thanks. tommy, what is your anorexia like now? even my body is saying no, stop, my head is saying, go, keep on going. a lot of people say that the voice is not real, but it is. to you, it is. it is me. you cannot have even ten minutes without it, because it is constant, and you are battling yourself all day, and it is very self—destructive as well. is it there now? yeah. it wants to strip you of everything, and one of the main dark things i am going to say is the actual goal of it is to take everything from you and eventually kill you. if skin goes over the top of my trousers, i feel that is fat that shouldn't be there. james lives in merthyr tydfil. at home, he checks himself in the mirror constantly. if your face looks sunk in and bony, looking at mine at the moment, it doesn't look sunk in, bony, but if it is, that is the look that i would rather be looking for. as a teenager, james wade almost 19 stone. at university, he went on a diet. he ended up in the local paper. student slimmer sheds seven stone in a year without any help from the diet industry. but his weight—loss got out of control, he had to suspend his studies and return home. it kind of makes me sick, because it makes me feel that what has happened is i have restricted my eating, but the restriction has become an obsession and leading to anorexia. anorexia has serious consequences. it can lead to depression, brittle bones, and even heart failure. i could not walk up the stairs, i felt weaker. ifelt more frail, and i could feel some of my bones sticking out. james's weight kept plummeting. it reached dangerously low levels. at first, he got psychiatric treatment, but now he only sees a dietician. he is struggling to manage the condition on his own. calorie amount... what is it like to try to deal with anorexia, with this voice in your head every day? james is going to keep a video diary to show us and the reality of life with an eating disorder. i think this morning i am in the mood for food restriction, my mind is telling me this, and i feel i have to cut back on my food, and probably that is what i will end up doing. it is estimated around 1.6 million people in the uk have under eating disorder, and 400,000 of those are thought to be men. i am one of those statistics. i grew up in rural carmarthenshire. here i am aged 19. what no—one knew at that time as i was struggling with my own sexuality. i was also struggling with depression. i started realising that the type of person that i was finding attractive was not finding me attractive, or would not find me attractive because i was fat, obese in my eyes. i started making myself ill, i wanted to lose weight, so i would go to the toilet and make myself sick — not far off every meal nearly, you know. i had bulimia, where someone tries to control the weight by purging after eating, usually by making themselves sick. for nearly 20 years, it became a way of life for me. when i was 36, everything changed. my mum was diagnosed with terminal cancer. i cried all day thinking about things, and i went to the toilet to make myself sick, and i couldn't. you know, i stuck my fingers down my throat, and nothing would come up. i think seeing what my mother went through made me stop. after years of bulimia, it seems like i had finally got control. we do also have good information on the website... the uk's largest eating disorder charity is beat. it's advice centre in warrington receives 20,000 calls a year, around a fifth from men and boys. i have never asked for help for my eating disorder, but more men and boys are now coming forward — albeit slowly. it is definitely the case that men and boys are not seeking help as readily, many of them don't want to be seen as suffering from what is perceived as a girl‘ problem. their parents are not looking for a eating disorder, if they get to the gp, the gp may not be looking for an eating disorder, so it may be diagnosed as something else. that allows the eating disorder to get ever more in control, and that makes it much harder for the treatments to work when they finally get into treatment. i encourage you to try that different therapy and see how it goes and let us know if you need further support. some of the things coming in there, written down, i was thinking, that is exactly how i was, you know, that is what i needed 25 years ago, something like this. we wanted to find out the scale of the problem across the uk, so we asked every mental health trust and board how many men were referred to eating disorders services for a first assessment. from those that responded, we discovered that, in 2016, there were 871 referrals, an increase from 2014 of 43%. our research also revealed that, from those that responded, more than 2500 youngsters, both boys and girls, received help — a rise of 42% over the last two years. this 14—year—old lives with his parents and younger sister in south wales. he has just come out of hospital, where he was being treated for anorexia. nice to meet you. would you like to come in? eating disorders can develop at any age. the risk is highest for young people between 13 and i7. i always had this idea of the body that i wanted, probably because of stuff i saw on social media. when you say the body you wanted, you were looking at sports people? yeah. you wanted to look like that? i started exercising, even more than i previously had, so i was doing stuff in the house as well as... obsessed with exercise as well? yeah. i noticed the back of the neck was getting very scrawny. was he hiding it from you? i think he was, and then his behaviour just got more and more weird. he started doing starjumps, he wouldn't sit down, he was standing up all the time. i probably didn't realise he was just concentrating all day on food, that was all he was thinking about day and night, i think. she took her son to the doctor's. 11 days later, he was in hospital. the night he went into hospital, i can remember a horrible, wet february night, and he was kick jumping into the hospital, he couldn't walk normally, he was kick jumping. as he was being monitored, his heart rate dropped so low he was at risk of cardiac arrest. he was discharged in february after nearly three weeks in hospital. you get the onions, i'll get the peppers out of the fridge, yeah? his family thought he was improving, but a few days later they found chocolate and yoghurt in the bathroom bin. what i was doing was hiding them, and then they found some of the food that i had been hiding, yeah. we thought we were keeping a close eye on him, watching him, after he had eaten his food, but obviously they get very deceptive, and he managed to hide some food. didn't you? yeah. but i felt like people were intruding into my life, and it was not of their business. i didn't understand why they were sort of... i was being forced to put on weight. he had to go back to hospital before being admitted to a children and young people's mental health ward, where he stayed for nine weeks. he finally came home in may. he is now receiving weekly therapy through a support worker. but his family say he has yet to see a dietician. according to nice guidelines, children with anorexia should be offered supplementary dietary advice. he is brave. 14 years of age, to be able to speak about what he has been through, that is very, very brave. i don't think i could have done that at 14 years of age. so how long do people have to wait for treatment? we asked every mental health trust and board in the uk. we discovered that average waits for treatment for both males and females vary from one week to 28 weeks, with some patients waiting almost a year. all of that time, the clock is ticking, the illness is getting its claws into the sufferer. the treatments are mostly talking therapies, and in those early days, they are much more likely to work, to be successful, than they are if you leave it a very long time. back in south wales, james says he has been asking for talking therapy for more than two years. in the meantime, his anorexia has taken control again. it is telling him to over—exercise. i havejust been on my run, i did a lot more than what i was supposed to do, i was thinking of my next meal, what i am planning, and my mind was telling me to restrict, to hold back. but i know what i should be having, a substantial meal. the health board in charge of both james's and the ia—year—old's pair, cwm taf, says that while it cannot comment on individuals, its priority is to provide the best possible care for children and adults with eating disorders. many of the young lads i have spoken to with anorexia seem to have been obsessed with exercise, but for me it is myjob. being a rugby ref means i have to keep up on the pitch with athletes have my age. so i am under huge pressure to maintain my fitness. my eating disorder has been a big part of that. today i am in dublin to referee the pro12 final. thanks, nigel. i've always spoken about bulimia like it is in my past. actually, that is not quite true. it returned as i approached the pinnacle of my career, refereeing the world cup final. it started sneaking back probably a little bit before the world cup. i was under huge pressure to reach certain fitness levels, and the fitness levels are very high. so, i sort of made myself sick a couple of times as well, leading up to the fitness testing and stuff like that. after the world cup final, the next year, you are just in cloud cuckoo land, really. so i started seeing myself putting some weight on, i was looking in the mirror and i thought, you know, i'll get rid of this quite quickly. and then the bulimia came back. it would be twice a week one week, and then nothing for months and months. i know it's not the right way to lose weight. i know it makes you more harm than good. but why i still do it from time to time? i don't know. it's a question i've avoided for most of my life. but i know now i need to face up to it. could it be the pressure of being a professional sportsman? research shows that male elite athletes are 16 times more likely to develop an eating disorder in comparison to nonathletes. boxer bradley pryce is a case in point. like me, he has made himself sick to lose weight. is it safe to come in? how is it going? you're hitting that hard, aren't you? bradley, from cwmcarn in south wales, won the commonwealth light middleweight title in 2006. a decade later, he can still pack quite a punch. eight years ago, he was training to defend his title. i had to get down to the 11 stone mark. i got lazy, i didn't train the way i was supposed to. my weight was kind of not coming down. so i decided to start making myself sick, just to make the weight. everything i was eating, i was bringing it up. everybody assumed i was training hard in the gym. you are hiding it? yes. when i made the weight, on the weigh—in, i got on the scales and my legs were buckling underneath me. i had a job to stand straight. i knew the fight was lost then, pretty much. i thought, i've got nothing in me. bradley was knocked out in round three and lost his commonwealth title, which he blames on his eating disorder. it kind of ruined my career, losing a fight. if i had won, i would have kept doing it. bradley is still competing and has to lose three pounds before a fight at the weekend. and you haven't done it since? i have done it since, yes. you have, have you? not as extreme as i had done it for that fight. but leading up to a fight, when you can't have any fluid or anything, i have had a bottle of pop and drank it, and then brought it back up. people now still find it hard to believe that i had to put my finger in my throat and make myself sick. i know how he feels. that temptation is always there for me, as well. i have had a bulimia for most of my adult life, and in the back of my mind, i am constantly aware that it could come back at any time. but i never thought about the damage it might be doing to my body. cambridge university student james downs survived anorexia as a teenager, but then developed severe bulimia, which has left its scars. i caught up with 27—year—old james at his parents‘ home in cardiff. i would bring all the food up here in the night. i would feel very stressed a lot of the time. it was only when i was eating that i didn't feel that. it was a relief. so i used to eat all of the food, and be sick here, in large buckets, and put them in the wardrobes. you would hide in there? yes, and then the next day, when somebody was out, i would clean it up. they would be overflowing with sick. my room with smell. james looks healthy to me, and that is the problem with an illness like bulimia. the damage can remain hidden. like, i have to take medication for my stomach, because i still get a lot of acid. still now? yeah. but it has definitely had an impact. my front teeth aren't my own, they have to be replaced. because you make yourself sick? i was sick so much that the nerves were hanging out of my teeth. that is because of the acid in your stomach, it eats away at your teeth? it does, yeah. james is back at university, and is focusing on his recovery. he has had help in the past, but despite the severe physical symptoms, he is struggling to get more treatment from his local health trust. i went to the gp and asked if there was any support available. and they referred me to the adult eating disorder service. unfortunately, they didn't even offer me an assessment. the referral was not accepted because james was within a normal weight range. i was very disappointed. because, as well as the bulimia, ifind it hard to manage how much i exercise. and those kind of anxieties play a big role in my life. it's unbelievable, really. you know, ithought i'd had it pretty bad with bulimia, but nothing compared to what he's been through. i didn't realise people could have it that bad, you know? cambridgeshire and peterborough nhs foundation trust eating disorder service told us that they cannot comment on individuals, but they are experiencing severe staff shortages, and are only able to accept those with the most urgent need. time and again, when meeting these young men who have battled with eating disorders, i have heard stories about the struggle to get treatment. our research has revealed that health trusts and boards across the uk have turned down more than a70 referrals for eating disorders for men and women, for a variety of reasons. steven brazier, from minster, in kent, was a funloving teenager before his eating disorder took hold. i started to sort of notice that he wasn't eating. he wouldn't eat with us. and then, when he did eat with us, afterwards, he would disappear into the bathroom for ages afterwards. he just wouldn't eat for days, and then he would binge, where he'd eat all the deserts, or he'd eat a whole loaf of bread. afterwards he was full of remorse. saying, i've got to be sick, i've got to be sick. in the end, he would be pleading with you to let him go and be sick. he had no control over it. it was upsetting, because he vanished in front of my eyes, basically. and he just got thinner and thinner, and the sparkjust went out of him. his gp referred him to the local eating disorders team, but steven continued to deteriorate. his potassium levels became very low, which meant repeated stays in hospital. he was sectioned for a year. when he was discharged, they said the referral would be taken by the mental health team. they would look after him, help him. none of that materialised, and it was just constantly a battle all the time. nobody wanted to do anything. steven died ied at home shortly afterwards, in february 2014, aged 20. a postmortem recorded his cause of death as anorexia with bulimia. i think so many opportunities were missed. with adequate care, steven would be alive today, and i think he would be living quite a healthy life. melanie took legal action against kent and medway nhs and social care partnership and settled out of court earlier this year. they admit that their care was not adequate, and say they have improved it as a result of learning from the failings in steven's case. we wanted to talk to secretary of state for health jeremy hunt about waiting times for eating disorder treatments. he declined. the department of health told us a pathway for adults is being developed, and it is investing £150 million in children and young people's services, and will expect them to be seen within four weeks, or one week if it is urgent. for adults and children in wales, that waiting time standard is four weeks, in northern ireland nine weeks, and in scotland 18 weeks. this is the maudsley hospital in london. its eating disorders unit for children and young people is renowned for its research and treatment. eating disorders are probably the only condition in mental health where, actually, if you get a diagnosis early, it can lead to a better prognosis, provided you get the right treatment. delaying treatment can make treatment more difficult. there is also good evidence to show that, the longer an eating disorder goes on, the harder it can be to treat. eating disorders are renowned for actually having the highest mortality out of any psychiatric condition. are they? so more people will die of eating disorders than any other mental health problem. over the years, i have spoken openly about my sexuality and depression. but this is the first time i have ever confronted my eating disorder. i've just come back from argentina two weeks ago, where i was making myself sick three or four times in argentina, because i was eating more food than i needed. and i knew, if i eat all of this food, i will make myself ill afterwards. so i have never sought help about it, because, until speaking to you now, i guess that i have always felt that i was in control of it. but i'm not, am i? i would say that it is clear that you still have some symptoms, and it's still affecting your life. if you haven't really received treatment for an eating disorder, it is that much more likely to re—emerge. so i think it would be really good if, at some point, you could think about maybe getting some help. that was a bit of a reality check, really. you know, speaking to dr darren there today, it was sort of an acknowledgement that i need to do something about it, really. i need to sit down and speak to somebody to try and get it out of my life forever, i guess. from what i've heard from the people i've met, it's hard to say you've ever fully beaten an eating disorder. but, if you are given the tools to stay one step ahead, you do have a chance of recovery. this young man is certainly not out of the woods yet, but he is making a phased return to school, where his friends will be keeping a close eye on him. maybe be slightly intrusive, sort ofjust check that at lunch i'm eating a bit. that i'm not skipping it. i guess that is what you guys can do for me. yes, if we see you getting skinny again in your face. let you know before it gets to that stage. make sure you say something. james also hopes that, with the help of the people around him, he can get back on track with his recovery. but he knows it's not going to be easy. yeah, it's going to take time, and some battling and fighting. but then the anorexia is not going to be there forever. there is light at the end of the tunnel, i suppose. i know i can get somewhere where i know i can be happy. well, it has been an incredible journey. a strange, but an incredible experience, as well. and realising how many different types of people, from all walks of life, men and boys, that an eating disorder affects. to actually accept that you have an eating disorder, or a mental health issue, is actually a sign of great, great strength. it is not a sign of weakness at all. but, as i've discovered, is not always easy to get the help you need, when you need it. so, the sooner you start talking to people, the better. don't be in my situation, 27 years on, still suffering from it. welcome to bbc news, broadcasting to viewers in north america and around the globe. my name is mike embley. our top stories: international condemnation of venezuela after the arrest of two opposition leaders. the un says the escalating crisis makes a peaceful solution more difficult. 50 times stronger than heroin: growing fears fenta nyl after dozens of deaths in the uk. a message to north korea from the us secretary of state — america is not seeking regime change but dialogue with pyongyang. we are not your enemy, we are not your threat, but you are presenting an unacceptable threat to us and we have to respond. and turkey puts almost 500 people on trial — they're accused of taking part in last year's failed coup.

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