:00:12. > :00:18.Tonight, will Olympic athletes soon have genetic engineering at their
:00:18. > :00:24.fingertips. This unexpected gold medal has won top one top swimming
:00:24. > :00:28.coach suggesting one -- this might be already a possibility. Can such
:00:28. > :00:32.engineering even been done. Better, stronger, faster, it is possible if
:00:32. > :00:36.you are a mouse, but humans? If we know what the key genes are, and
:00:37. > :00:40.many people in sports genetics believe they have a list of around
:00:40. > :00:44.100 genes they think are very important, theoretically, they
:00:44. > :00:47.could all be manipulated. scientist, an athlete, and bioet
:00:47. > :00:51.cyst, discuss what kind of modification is happening and
:00:51. > :00:55.whether we can test for it. Also tonight, we have been given
:00:55. > :01:00.new figures of the scale and causes of anorexia, does that change the
:01:00. > :01:07.way we see its victims. I would make myself run in the snow when I
:01:07. > :01:14.have chill blains, and I wouldn't touch food in case it went through
:01:14. > :01:18.my skin. A writer recovering joins the chair of the health Select
:01:18. > :01:22.Committee. Was there it all a Romney shambles, as his foreign
:01:22. > :01:32.tour jets home from Poland, what has it told us of the foreign
:01:32. > :01:35.
:01:35. > :01:40.policy of the man who could be US President in a few weeks time. Ye
:01:40. > :01:47.Shiwen has done it again, tonight she won gold in the 200ms medley,
:01:47. > :01:51.with the shockwaves still rerating from her gold in the 400 individual
:01:51. > :01:55.medley. In that race she took five seconds off her previous best time.
:01:55. > :01:58.Resulting in one of the US senior coaches labelling her performance
:01:58. > :02:02.immediately after heroin as "disturbing", there was no evidence
:02:02. > :02:06.of doping, and according to the chair of the Olympic Association in
:02:07. > :02:10.Britain, the swimmer deserves recognition for her talent. She
:02:10. > :02:17.also has particularly large hands and feet, which is not a crime.
:02:17. > :02:22.Imagine in the future if athletes could be genetically modified. We
:02:22. > :02:26.have news into research into this field? In the midst of this row,
:02:26. > :02:30.the idea of genetic manipulation, or gene doping in sport has sur
:02:30. > :02:34.Fayeed. We looked at this last -- if you are faced, we looked at this
:02:34. > :02:40.last week, some of the enhancing coming along in the future, the
:02:40. > :02:45.idea of epigenetics, a road athlete turning up or down useful genes. It
:02:45. > :02:49.turns out this very idea of how our genes and our environment interact
:02:49. > :02:53.will be the legacy of the Olympic testing lab. The Olympic testing
:02:53. > :02:58.lab, where they look at all the samples of athletes, we should hear
:02:58. > :03:02.from the Government tomorrow, will become a multimillion pound medical
:03:02. > :03:06.research centre, where we will look at the interaction between our
:03:07. > :03:10.genes and environment, to try to find new treatments. The way that
:03:10. > :03:14.our genes and environment interact determines how well we respond to
:03:14. > :03:24.certain treatments. So, for the time being, this lab is going to be
:03:24. > :03:37.
:03:37. > :03:41.focusing on keeping these Olympic It looks like it will be Ye Shiwen.
:03:41. > :03:50.Tonight Ye Shiwen was in the pool again, winning her second golgd in
:03:50. > :03:56.the final of the women's -- gold, in the final of the women's 200ms
:03:57. > :04:01.individual medly setting an Olympic record not a world record. The row
:04:01. > :04:05.was fuelled by outspoken reaction to that performance, byed leading
:04:05. > :04:11.American swimming coach, who described it as "unbelievable",
:04:11. > :04:17.today there has been huge support for the young young swimmer, by
:04:17. > :04:22.officials and athlete. These are athletes competing at the highest
:04:22. > :04:26.level, we have seen records broken all over the place. In terms of
:04:26. > :04:33.athletes themselves, as you know, in the final, the first five
:04:33. > :04:37.athletes are tested, compulsory, and two others. It is really well,
:04:37. > :04:40.we have a very, very strong drug testing programme, we are very
:04:40. > :04:45.confident if there are cheat we will catch them. As we already have
:04:45. > :04:50.done. This morning, the head of spwrin's Olympic Association backed
:04:50. > :04:58.up that position. -- Britain's Olympic Association backed up that
:04:58. > :05:01.position, saying Ye Shiwen had passed WADA tests. She has insisted
:05:01. > :05:05.there is no problem with her performance, because the Chinese
:05:05. > :05:09.sticks to the strict antdy doping policies. But there is another
:05:09. > :05:19.possibility, the idea that such outstanding performances might be
:05:19. > :05:31.
:05:31. > :05:37.the product of some form of genetic His is a lone voice, and US
:05:37. > :05:42.officials have today distances themselves from his views. But is
:05:42. > :05:46.genetic manipulation in sport possible, can we test for it? And
:05:46. > :05:50.is it happening. When people talk about gene doping in sport, they
:05:50. > :05:54.are not talking about designer babies, with genes hand-picked to
:05:54. > :05:58.create the superathlete of the future. What people mean by gene
:05:58. > :06:02.doping at the moment, is either adding genes to particular cells or
:06:02. > :06:07.organs of an athlete's body, say to increase oxygen uptake in their
:06:07. > :06:17.lungs, or the new science of epigenetics, turning up the power
:06:17. > :06:18.
:06:18. > :06:23.of any useful genes an athlete happens to have been born with.
:06:23. > :06:28.Tweaking genes can work in animals, Tweaking genes can work in animals,
:06:28. > :06:33.the mouse at the front has been manipulated from birth to carry
:06:33. > :06:38.extra genes to make it run faster, but also to want to run faster too.
:06:38. > :06:42.It might work in mice, but how might human athletes improve their
:06:42. > :06:46.performance by tweaking their genes. The two areas, strength and
:06:46. > :06:51.endurance. The strength we have genes like insulin growth factor 1,
:06:52. > :06:55.shown in animals, able to increase strength and power of animals
:06:55. > :06:59.models. That is a possibility. The second is the gene you get more of
:06:59. > :07:03.when you go to altitude, we have seen individuals who have mutant
:07:03. > :07:08.genes in that area, they have also enhanced performance in humans,
:07:08. > :07:16.that also would be a possibility. Tim Speckor carries out unique
:07:16. > :07:22.studies on twins, he's looking at how the outside world can help our
:07:22. > :07:26.how the outside world can help our genes being expressed in our body.
:07:26. > :07:30.We know what the key genes are, and sports people believe they have a
:07:30. > :07:36.list of 100 genes they think is important. Theoretically they could
:07:36. > :07:45.all be manipulated and tuned up or down, using these epigenetic
:07:45. > :07:49.methods. He thinks rogue athletes might one day be able to turn these
:07:49. > :07:56.up or down by taking a pill. Scientists at the Olympic testing
:07:56. > :07:59.lab say they have made it harder to cheat, and authorities have banned
:07:59. > :08:03.genetic manipulation. Whether it is being done I think is unlikely. I
:08:03. > :08:09.would show the evidence occurring from gene therapy, where we have
:08:09. > :08:13.tried for over 20 years to make it work and cure diseases like cystic
:08:13. > :08:16.fibrosis, and it is very hard. In practice we know how to do it,
:08:16. > :08:20.actually making it work is very hard.
:08:20. > :08:26.In the end, as other swimmers have said today, it is perfectly
:08:26. > :08:33.possible for a young swimmer to suddenly shine in this way.
:08:33. > :08:36.I'm joined now by Ruta Meilutyte, a bio ethicist in Scotland, and one
:08:37. > :08:44.of the first to write about gene doping.
:08:44. > :08:49.And a Professor of human geneology. And from Stratford, by the former
:08:49. > :08:55.world champion swimmer Karen Pickering, who has competed at four
:08:55. > :08:59.consecutive Olympic Games. First of all, that tremendous performance
:08:59. > :09:04.from Ye Shiwen, as we have said, she has been absolutely cleared. Is
:09:04. > :09:09.it inevitable that there will be talk of manipulation, when there
:09:09. > :09:12.has been such a stunning victory, taking five seconds off her record
:09:12. > :09:15.on Saturday. It is a bit of a shame, actually. I watched that
:09:15. > :09:18.performance, my first thought was what an incredible swim it was by a
:09:18. > :09:22.young girl that we have watched swim for a couple of years now, we
:09:22. > :09:26.have been waiting for her to do something quite impressive. It is a
:09:26. > :09:31.shame, and slightly cynical of some people, that they will look at that
:09:31. > :09:35.performance and think that it's not quite legitimate. That wasn't my
:09:35. > :09:40.first thought. We have seen a lot of amazing performances in the pool.
:09:40. > :09:44.Some much more spectacular than her's was. But I think part of the
:09:44. > :09:48.problem is that it was a little bit of sterotyping and a little bit to
:09:48. > :09:51.do with China's history of doping, the reason why she is being singled
:09:52. > :09:59.out. Do athletes expect it? We just heard in the film there, athletes
:09:59. > :10:05.are being tested all the time, so the whole atmosphere round
:10:05. > :10:09.enhancement is very live? I think that we know, unfortunately, there
:10:09. > :10:12.are always going to be some athletes who want to get an unfair
:10:12. > :10:17.advantage, whether that is through doping or through this new idea of
:10:17. > :10:21.gene doping, you know, there is always going to be some people who
:10:21. > :10:26.will try. You have been in the fifth Olympics,
:10:26. > :10:29.seventh, you are watching it very closely this idea that the very
:10:29. > :10:34.thing Karen said, there will always be athlete who is want to get ahead,
:10:34. > :10:40.for all sorts of reasons. That desire to get ahead is legitimate,
:10:40. > :10:43.can it be legitimately met through genetic engineering, or is it
:10:43. > :10:46.always something that will be banned? The challenge for athletes
:10:46. > :10:49.is we put them in a position where they are expected to go faster,
:10:50. > :10:54.higher and stronger, yet restrict the means by which they can do this.
:10:54. > :10:58.I think it is revealing that in 2006 the British Government
:10:58. > :11:04.launched an inquiry into human enhance. Technologies into sport,
:11:04. > :11:07.not anti-doping. It speaks to this broader culture of human
:11:07. > :11:10.enhancement that surrounds the world of sports. The give us an
:11:10. > :11:15.idea of something that would enhance an athlete's performance if
:11:15. > :11:20.it was genetic engineering? Not so much genetic engineering, but the
:11:20. > :11:24.kinds of enhancements are similar. Endurance and power are the two
:11:24. > :11:28.main things. Laser eye surgery is an example, it is one of those
:11:28. > :11:33.modifications that the world of sport can't really ban, but you and
:11:33. > :11:36.I can use them and athletes can use them, it could enhance its
:11:36. > :11:41.performance. That is the bigger challenge sport face, there will be
:11:41. > :11:46.an explosion of enhancements athletes can use. Test or not test,
:11:46. > :11:49.ban or not ban? Medically supervised enhancements is the way
:11:49. > :11:54.to go. I disagree with that, it is fundamentally against the nature of
:11:54. > :11:58.sport. That is why we have the Olympic here in London to sell rate
:11:58. > :12:03.that. The world anti-dope -- celebrate that, the World Anti-
:12:03. > :12:08.Doping Agency is clear about it, it has added gene doping to its list
:12:08. > :12:12.of banned substances for a good reason. Can you test for gene
:12:12. > :12:15.doping, there are 100 different genes said to possibly enhance or
:12:15. > :12:20.improve an athlete's performance, how do you test? The first question
:12:20. > :12:26.is, is anybody doing it, do we have any evidence that anybody is
:12:26. > :12:31.actually using, what effectively is, gene therapy techniques. Do you
:12:31. > :12:35.have the tests to know? The tests are being developed. There are
:12:35. > :12:38.developments in analytical chemistry, sell later and molecular
:12:38. > :12:43.biology, developing all the time. In eight years time, with a blood
:12:43. > :12:50.sample, there are likely to be genetic fragments, traces of the
:12:50. > :12:55.investigateors used to get genes into sis -- vectors that are used
:12:55. > :13:00.to get genes into systems. It might be possible. I look forward to the
:13:00. > :13:05.future in seven years when all the medals will be distributeded to the
:13:05. > :13:09.true winners. It seems to me that is the scenario athletes could face.
:13:09. > :13:14.Tell me, if there was something like the laser eye surgery, which
:13:14. > :13:18.actually makes an Archer see better, and it is open to everybody else on
:13:18. > :13:23.the planet. Do you mean to say athletes can't take it because it
:13:23. > :13:27.will give them an unfair advantage? There is a clear distinction
:13:27. > :13:29.between medal exemption for different conditions. What about
:13:29. > :13:33.actively trying to make your performance better? It is a grey
:13:33. > :13:39.area. We could have the same debate about someone, for example, who has
:13:39. > :13:42.a mutation in their mystaten gene, for example, which we know,
:13:42. > :13:46.enhances muscle mass. Do you ban these individuals, who, through no
:13:46. > :13:50.fault of their own, have a genetic mutation. I think you don't. I
:13:50. > :13:54.think actually the future of sport will wrestle with this problem, and
:13:54. > :13:57.find it very difficult to restrict people from participating. On that
:13:57. > :14:02.point, you were saying that there will always be some athletes who
:14:02. > :14:09.want to get ahead. What if the advances in genetic engineering are
:14:10. > :14:13.such that athletes can get a -- ahead in a legitimate way. Using it
:14:13. > :14:18.to repair muscles and make them stronger. Do you think that should
:14:18. > :14:22.be outlawed? I think it is up to WADA, the IOC, for governing bodies
:14:23. > :14:26.to look at what those roles r it is our duty as athletes to abide by
:14:26. > :14:32.those rules. We have to hope and know that our governing bodies will
:14:32. > :14:36.do what is ried right, will make the right decisions and -- right,
:14:36. > :14:40.will make the right decisions and clear up that grey area and we
:14:40. > :14:44.stick to the rules. It is unfair to athletes if there is a grey area.
:14:44. > :14:48.If things are changing all the time. Athletes, through no fault of their
:14:48. > :14:51.own, could fall foul of the rules there must be a fear about that?
:14:51. > :14:55.Absolutely. But never going to be black and white. There will always
:14:55. > :15:00.be situations. You have had now in terms of medications as well. If
:15:00. > :15:03.you just have to take, for instance, athletes who are asmathic, and
:15:03. > :15:06.legitimately need some medication, that may be banned in being taken
:15:06. > :15:09.in other ways. I think that there iss always going to be areas that
:15:09. > :15:14.need to be looked at, and unfortunately it is never going to
:15:14. > :15:18.be black and white. But we just have to hope that, with the
:15:18. > :15:21.advancements in technology, and the science behind, and as well, using
:15:21. > :15:25.intelligence testing, as much as possible, to understand what is
:15:25. > :15:30.going on out there, because athletes do hear about things,
:15:30. > :15:34.people do talk, and the knowledge is spread, we just have to hope
:15:34. > :15:38.that using all those techniques we can catch those people and stop
:15:38. > :15:42.them. You are talking about the knowledge being spread, one of the
:15:42. > :15:46.many legacies of the Olympics, is this testing lab for dopg, and
:15:46. > :15:56.presumably for gene testing, is going to be something that will be
:15:56. > :15:59.used, not only for athletes, but for the general population. The
:15:59. > :16:09.point is, science is moving so fast and coaches know, athletes are
:16:09. > :16:15.always on the look out for these things, is it policable? The bigger
:16:15. > :16:19.challenge is five years from now it could cost less than �1,000 to map
:16:19. > :16:27.a genome. There will be such a strong public argument by then from
:16:27. > :16:31.everybody, to have their genome map, that conceivably we will all have a
:16:31. > :16:36.24-hour look at it. And presumably for parents if your kids are going
:16:36. > :16:40.to be good at eightly thes. If there is genome therapy, you can't
:16:40. > :16:45.ban that? Athletic performances are such a beautifully integrated
:16:45. > :16:50.performance, so many factors are involved, it will be incredibly
:16:50. > :16:54.complex to tease out the genetic factors, we don't have gene that is
:16:54. > :16:57.can accurately predict performance, they are only loosely associated
:16:57. > :17:01.with performance. A long way to go. We will see what happens over the
:17:01. > :17:05.next seven years and look at those testings.
:17:05. > :17:12.Anorexia is a killer and dreadful death. It is not too harsh to say
:17:12. > :17:20.it has been dismissed in the past that it is a disease that affects
:17:20. > :17:24.self-obsessed teenage girls. We have news that eating discords are
:17:24. > :17:30.costing billions. And anorexia sufferers are presenting younger,
:17:30. > :17:36.even below ten. And brain scans intricates a strong predisposition
:17:36. > :17:40.to the disease. Doctors are warning that budget constraints are
:17:40. > :17:45.preventing people being referred early enough to get to the root of
:17:45. > :17:49.the problem. This report contains some explicit images.
:17:49. > :17:54.One of the saddest things that my brother, who is 16 now, doesn't
:17:54. > :17:58.remember me without this illness. I feel I have lost my innocence, it
:17:58. > :18:04.has taken everything. Ffion Jones last had a birthday cake when she
:18:04. > :18:08.was 11, that is when she developed anorexia. Now 22, it stole her
:18:08. > :18:12.childhood. At first I felt like I was in control, I felt like it was
:18:12. > :18:15.something that I could have as my own. That I was good at, because
:18:15. > :18:20.nobody else could not eat. I felt quite invincible and powerful at
:18:20. > :18:24.that point. That changed really quickly. I just felt like
:18:25. > :18:30.completely consumed, I got taken over. Not only did she stop eating,
:18:30. > :18:35.to the alarm of her family, she refused to drink. I developed all
:18:35. > :18:41.these obsessive tendencies, I was a compulsive exerciser, I would make
:18:41. > :18:45.myself run in the snow when I had chillblanes, I wouldn't eat or
:18:45. > :18:51.drink, I became phobic of food, I wouldn't touch food in case it got
:18:51. > :18:55.be a surbed through my skin. She is being treated at one of the
:18:55. > :19:01.specialist centres at Cotswold House, intensive support is helping
:19:01. > :19:05.her eat regularly. The latest research suggests a strong genetic
:19:05. > :19:11.predisposition of anorexia, she will always have to live with its
:19:11. > :19:14.consequences. I have a lot of long- term implications which I was quite
:19:14. > :19:18.ignorant of and didn't want to acknowledge as part of the illness.
:19:18. > :19:28.They are a lot of serious side- effects, it is not a case I will
:19:28. > :19:28.
:19:28. > :19:36.not eat for a while and put on weight. I got diagnosed with
:19:36. > :19:39.osteoporosis at 18. I went for an X-ray on my spine, my back is
:19:40. > :19:44.crumbling because of calcium depletion, and my spine is
:19:44. > :19:48.crumbling. I'm not sure if I can have children or note. By the time
:19:48. > :19:51.people are diagnosed with anorexia, their weight is so low, their
:19:51. > :19:55.general health is severely compromised. They are at risk of
:19:55. > :19:59.organ and heart failure. This is especially true in younger patients.
:19:59. > :20:05.Newsnight has seen new figures from the charity, Beat, which reveal the
:20:05. > :20:09.true costs. In the UK more than 1.5 million people suffer an eating
:20:09. > :20:18.disorder. Most cases start in adolescence, affecting seven out of
:20:18. > :20:22.1,000 girls, and one in a thousand boys. In England their ill-health
:20:22. > :20:28.costs �1.26 billion, a figure expected to double over the next 20
:20:28. > :20:31.years. Of all the psychiatric illnesses, anorexia is the most
:20:31. > :20:35.deadly. It kills more people than depression, and alcohol and drug
:20:35. > :20:42.addiction. Half the people who get it doesn't recover, while a fifth
:20:42. > :20:48.will die from it. This is a few years later.
:20:48. > :20:52.This is rosary Marston, during her 30 -- Rosemary Marston, during her
:20:52. > :20:57.30-year struggle with the illness. I thought I was living a lifestyle
:20:57. > :21:02.that suited me. Today she says she's finally recovered. In one
:21:02. > :21:08.crisis, when her funding support specialist treatment was withdrawn,
:21:08. > :21:14.she expected to die. I saw my reflection in the mirror, and took
:21:14. > :21:19.photographs of my reflection in the mirror. I thought this is what I
:21:19. > :21:24.want to leave behind, that people know that this illness isn't just
:21:24. > :21:33.about vanity, it is not about looking good on the beach. This is
:21:33. > :21:38.serious. I then went into a coma. I was taken into hospital that day.
:21:38. > :21:41.Stopping the symptoms themselves, damaging the brain more, is very
:21:41. > :21:45.important.... Her consultant, a world renowned
:21:45. > :21:50.expert in eating disorders, explains why people with anorexia
:21:50. > :21:53.are simply unable to think straight. The symptoms themselves, because
:21:54. > :21:58.they interfere with nutrition, that means the body and brain are
:21:58. > :22:05.damaged, because the brain is one of the hungryist organs in the body.
:22:05. > :22:14.It uses more calories per gram than muscles even. If you are depriving
:22:14. > :22:20.the brain of calories, it doesn't function as well. The brain is the
:22:20. > :22:26.focus of ground-breaking research into possible genetic causes for
:22:26. > :22:32.the illness. Professor Bryan Lask says photo imaging technology, has
:22:32. > :22:34.allowed his team to study part of the brain, the insula, which in
:22:34. > :22:37.anorexic patients is not working properly, changing our
:22:37. > :22:42.understanding of the disease. so long people thought this was
:22:42. > :22:46.just people choosing to go on a diet and rather manipulating people
:22:46. > :22:50.around them, by saying they are footoo fat. It was seen as this --
:22:50. > :22:54.they are too fat. It was seen as spoilt middle-class girls getting
:22:54. > :22:59.it. It is not like that at all. It is not a choice. You inherit a
:23:00. > :23:04.particular profile of genes, not one gene, there isn't an anorexic
:23:04. > :23:09.gene, but a combination of genes, that render you vulnerable to the
:23:09. > :23:13.development of anorexia, when exposed to other factors.
:23:13. > :23:19.Figures for those with anorexia are stable, but clinicians report they
:23:19. > :23:25.are seeing younger patients, some below the age of ten, making
:23:25. > :23:29.earlier intervention and treatment vital. It is definitely not taken
:23:29. > :23:32.seriously enough. You could talk to any number of parents who have a
:23:32. > :23:35.daughter with anorexia, and they will tell you about the struggle
:23:35. > :23:39.they have, not only with trying to help their daughter themselves,
:23:39. > :23:44.which is another story, it is so difficult for parents, but getting
:23:44. > :23:48.informed help. They so often get palmed off with it is just a phase,
:23:48. > :23:52.or they will send her to a dietician, they are wonderful if
:23:52. > :23:55.you need one, but this isn't about what you eat, it is about what you
:23:55. > :23:59.can't eat. We are really depriving our children of an essential
:23:59. > :24:04.treatment. This specialist centre is run by
:24:04. > :24:08.the private sector for younger patients. Traditional treatment of
:24:08. > :24:13.anorexia involves restoring a sufferer's weight. But it is
:24:13. > :24:18.recognised it takes far more to restore a healthy attitude to
:24:18. > :24:23.eating. To avoid the disruption anorexia brings to a young person's
:24:23. > :24:28.life. Eating will have left them with a lot of high emotions, high
:24:28. > :24:32.levels of anxiety, feeling very angry, post-meal support is about
:24:32. > :24:39.sitting with a young person after a meal, for a period of time, so they
:24:39. > :24:44.can go past the most dangerous part of that anxiety. But the most
:24:44. > :24:48.complex cases require long-term treatment. This centre include an
:24:48. > :24:51.Ofsted-approved school toe try to replace the education that is -- to
:24:51. > :24:56.try to replace the education that is sometimes otherwise lost. The
:24:56. > :25:01.average stay at this home is about 20 months. Such specialist centres
:25:01. > :25:07.are, of course, expensive, it is worth it, say staff, if repeated
:25:07. > :25:10.hospital admissions can be avoided. But the pressures on health budgets
:25:10. > :25:15.means people are much more ill, their weight much less, before they
:25:15. > :25:21.can be referred to places like this. Clinicians warn of a revolving door,
:25:21. > :25:26.where patients are pushed into and out of treatment, to save money.
:25:26. > :25:30.will see more revolving door cases because we're not getting to the
:25:31. > :25:36.root of the problem, we are addressing the symptoms quite
:25:36. > :25:41.effectively, but we're doing so over and over again. In turn, as I
:25:41. > :25:48.said, that will mean that a certain percentage of those cases will keep
:25:48. > :25:55.coming back, and I think that actually a well intended strategy
:25:55. > :25:58.to keep people out of hospital, will actually lead to more chronic
:25:58. > :26:04.and severe and enduring cases. People say you are not thin enough
:26:04. > :26:08.to need specialist services, and that's awful, that, you know,
:26:08. > :26:15.people have to get more ill before they warrant specialised services.
:26:15. > :26:19.So I think that needs to be changed, the fact that early signs and
:26:19. > :26:24.intervening before people need intensive care, such as in-patient
:26:24. > :26:28.care, is very important. Last year, Bryan Lask noted a
:26:28. > :26:34.dramatic fall in referrals for in- patient treatment, caused by cuts
:26:34. > :26:39.in spending. He was alarmed by the effect on patients. So the cutbacks
:26:39. > :26:42.are leading to really deteriorating patients? Absolutely. The cutbacks
:26:42. > :26:47.have not only deprived the children of treatment, but they have
:26:47. > :26:53.actually made them worse. As a young woman, Rosemary Marston
:26:53. > :26:59.didn't recognise she had an illness. This is her at 37. By then,
:26:59. > :27:03.anorexia had her in its grip. would go into hospital, my weight
:27:04. > :27:07.would be restored, but I left not feeling too much better about
:27:07. > :27:12.myself or my prospect. And so, it was only a matter of time before I
:27:12. > :27:18.would be back in hospital again. As I got older, the periods of time
:27:18. > :27:28.between admissions were shorter and shorter. I think I worked out that
:27:28. > :27:30.
:27:30. > :27:36.in the last 20 years of the illness, I spent 18 years as an in-patient.
:27:36. > :27:42.Tests like this one, used by Bryan Lask's team, are used to identify
:27:42. > :27:45.some of the characteristics associated with anorexia, like a
:27:45. > :27:49.tendency to obsessiveness, and attention to tail. They hope it
:27:49. > :27:52.will lead to new treatment -- detail. They hope it will lead to
:27:53. > :27:58.new treatment, and prevent the illness becoming chronic,
:27:58. > :28:02.interrupting people's lives. Even now, those of us who work in the
:28:02. > :28:05.area of eating disorder, with this younger population, we are
:28:05. > :28:10.struggling with the idea that once their weight is restored they are
:28:10. > :28:15.cured, it is nonsense, they are not at all. I realised how rich an
:28:15. > :28:20.illness it had been. Rosemary describes the process of recovery
:28:20. > :28:25.as being harder than the illness, she works as a mentor with others
:28:25. > :28:29.with eating disorders. I know there are God knows how many other people
:28:29. > :28:35.out there going through exactly the same thing that I did. I'm no
:28:35. > :28:42.different to them. If all I can do is offer them the hope that
:28:42. > :28:50.whatever they see in me, as being recovered, and something that they
:28:50. > :28:54.would like, then it is doable. It is possible.
:28:54. > :29:00.Ffion is planning to go to university next year, to train as a
:29:00. > :29:05.psychiatric nurse. I want to be able to order a take-away, or have
:29:05. > :29:08.a meal, without a panic attack in the toilet. I want to be able to
:29:08. > :29:13.eat a box of popcorn without having to count out how many of them are
:29:13. > :29:19.in my hand. I don't want to be a rocket scientist, or rich, I just
:29:19. > :29:25.want to be "normal", I suppose really, if there is such a thing.
:29:25. > :29:30.Joining me now are Stephen dor reel, the chairman of the Select
:29:30. > :29:36.Committee, and the Times columnist who suffered from anorexia, author
:29:36. > :29:42.of An Apple A Day. First of all, recovering from
:29:42. > :29:45.anorexia, do you recognise that you genetically had a predisposition?
:29:45. > :29:49.didn't develop anorexia until I was about 19. I certainly wasn't born
:29:49. > :29:54.with it. But I think that the genetic predisposition must come
:29:54. > :29:58.into it, having seen obviously the research from Professor Lask. It is
:29:58. > :30:04.absolutely fascinating for someone like me. I think that there is a
:30:04. > :30:08.variety of things that come together, the stresses and the live
:30:08. > :30:13.expeerences and then going on a diet, and starting to lose weight,
:30:13. > :30:18.and then I think the genetic thing is part of that. I don't think it
:30:18. > :30:25.is you are born with anorexia, but when we see the brain imaging,
:30:25. > :30:30.there are cognative differences in people's brains with anorexia. That
:30:30. > :30:36.does not change after you have restored your healthy weight. That
:30:36. > :30:41.insula, there is still abnormal blood flow to the insula after the
:30:41. > :30:45.weight has been restored. It proves it is not a lifestyle choice.
:30:45. > :30:51.fundamental difference with this research is it shows, often
:30:51. > :30:55.anorexia has been dismissed as a teenage girls obsessed with their
:30:55. > :31:01.looks, narcissism and so forth. This shows it is a mental disorder?
:31:01. > :31:04.Yes, and indeed to a degree, a physical disorder, an identifiable
:31:04. > :31:08.one, according to Professor Lask's research. This is relatively new
:31:08. > :31:11.research, we have to work through the implications from a policy
:31:11. > :31:18.perspective. The thing that strikes me about this from a health policy
:31:18. > :31:22.point of view, is how similar it is to other conditions, where the
:31:22. > :31:25.opportunity is there to identify a condition early, to intervene early,
:31:25. > :31:31.and to deliver care that is not only better from the point of view
:31:31. > :31:34.of the patient, because it avoids the acute incidence of the
:31:34. > :31:40.condition, but it is better value for the taxpayer, because it
:31:40. > :31:44.doesn't cost as much in pounds. It is a win-win. Actually, the policy
:31:44. > :31:47.is wrong at the moment, because Bryan Lask is saying the cutbacks
:31:47. > :31:52.are not only depriving children of treatment, they are making them
:31:53. > :31:56.much worse, and that Professor Janet Treasure, saying people are
:31:56. > :31:59.not referred to specialists because of the cuts because they are not
:31:59. > :32:03.thin enough. You are stoking up far more problems financially, because
:32:03. > :32:08.you haven't the right policy to intervene early, and have, as it
:32:08. > :32:13.were, a holistic approach, to dealing with anorexia. It is a
:32:13. > :32:17.familiar problem in the health service, that you put it off.
:32:17. > :32:22.just to press you on this, as a result of this fairly new research,
:32:22. > :32:25.very new research, you do think there should be a change in policy
:32:25. > :32:30.towards anorexia? I absolutely think that in anorexia and other
:32:30. > :32:33.conditions as well, there ought to be ach greater emphasis on
:32:33. > :32:38.identifying the tell tale signs that show where a condition is
:32:38. > :32:42.going to rise, interintervening early, that is where you deliver
:32:42. > :32:46.better care and better value care. Later you deliver savings later,
:32:46. > :32:49.but tell me about the importance of early intervention? I always say to
:32:49. > :32:55.people, you know if you have a problem. And deal with it as soon
:32:55. > :33:00.as you can, because if you wait ten, fifteen years down the line, it
:33:00. > :33:04.becomes part of you. It becomes part of your identity. Did you, you
:33:04. > :33:10.were quite, in a sense you were quite old at 19, did you know, were
:33:10. > :33:14.you able to go for help quite early, I imagine if you are 10, 11, 12 it
:33:14. > :33:17.is a really difficult thing for parents? That is the problem with
:33:17. > :33:22.early intervention. Teenage girls go on diet, young girls
:33:22. > :33:27.increasingly are worried about their weight. The majority of them
:33:27. > :33:33.won't develop anorexia. The 10% or less than that will develop
:33:33. > :33:36.anorexia. There is a problem with early intervention. You need people
:33:36. > :33:40.trained to know the real signs. didn't know, I didn't really talk
:33:40. > :33:44.about it at all until I was, I started writing my column in my
:33:44. > :33:49.early 30s, for the Times. That was coming out about it. I didn't get
:33:49. > :33:53.help for the first couple of years. It is a terribly shameful illness,
:33:53. > :33:58.there is something terribly hidden about it. Is there a way that
:33:58. > :34:03.actually, you know, that anorexia, we know from the statistics, that
:34:03. > :34:06.1.5 million, are suffering from it just now. Many more. It is
:34:06. > :34:10.essentially hidden, and really not fully diagnosed. That actually
:34:10. > :34:13.because it is such a dreadful thing, by and large that it hits younger
:34:13. > :34:18.people, it should be a priority for this Government? I think it should
:34:18. > :34:20.be a priority for any Government, and for the people who decide the
:34:20. > :34:24.priorities within health expenditure, which is the
:34:25. > :34:30.Government at a global level, but it is actually decisions taken at
:34:30. > :34:35.the local level. The provision of service. The other key thing here,
:34:35. > :34:40.is public health information. So that families and individuals can
:34:40. > :34:46.identify with it. The revolving door is costing more. Can I tell
:34:46. > :34:51.but the waiting lists, the waiting lists to get cognitive behaval
:34:51. > :34:53.therapy for anorexia is absolutely horrendous. I have gone out of the
:34:53. > :34:59.health service. The waiting lists would be different in different
:34:59. > :35:05.parts of the country? I stopped having psychotherapy four years ago,
:35:06. > :35:09.and started begin two years ago, I was able to get on a trial, and my
:35:09. > :35:14.waiting list was only six months. It can be much longer than that,
:35:14. > :35:18.six months to a year for people who are seriously ill. I agree with
:35:18. > :35:24.that. The point is that if you wait and delay the intervention, it is
:35:24. > :35:28.back to the resolving door. -- the revolving door is bad and expensive
:35:28. > :35:32.care, it is unaffordably bad. You are on recess, but you will go
:35:32. > :35:35.straight back to the health select in the new research? It is
:35:35. > :35:39.something that will come up with the health Select Committee, it
:35:39. > :35:43.doesn't meet when parliament is in recess. If you want details of
:35:43. > :35:53.organisations which offer advice and support on eating disorders, go
:35:53. > :36:08.
:36:08. > :36:13.He could be the leader of the free world in matter of weeks. But after
:36:13. > :36:18.a mini-three-country tour, gaffes and all, are we getting a flavour
:36:18. > :36:22.of what Mitt Romney's foreign policy will look like. He upset
:36:22. > :36:28.Palestinians by comparing their weak economic performances to that
:36:28. > :36:32.of their Israeli hopes. On a visit to London he warned our Olympic
:36:32. > :36:42.Games running the risk of becoming a flop. Beyond the insults, what of
:36:42. > :36:43.
:36:43. > :36:47.his grand vision, and how might he contain countries like Iran.
:36:47. > :36:51.The Republican challenger has been racking up air miles, with a
:36:51. > :36:54.foreign tour intended to bolster his credentials as a statesman. His
:36:55. > :36:59.first stop was Britain, where a remark about preparations for the
:36:59. > :37:04.Olympics was deemed insulting by his critics. It is hard to know
:37:04. > :37:07.just how well it will turn out, there are a few things that were
:37:07. > :37:11.disconcerting, the stories about the private security firm not
:37:11. > :37:14.having enough people, the supposed strike of the immigration and
:37:14. > :37:19.customs officials, that obviously is not something which is
:37:19. > :37:23.encouraging. But that was a relatively minor
:37:23. > :37:27.faux pas, the striking thing about the Romney campaign, is it's focus
:37:27. > :37:31.on the US economy, and other domestic issues, has so far
:37:32. > :37:38.prevented the world from getting much of an idea about how far a
:37:38. > :37:41.Romney foreign policy might differ from President Obama's. Mitt Romney,
:37:41. > :37:45.until last week, had had only delivered one foreign policy speech
:37:45. > :37:49.of the campaign, that was nine months ago. He doesn't have a
:37:49. > :37:53.senior staffer whose portfolio is solely foreign policy. He had had a
:37:53. > :37:57.foreign policy spokesman who lasted just two week, this is not a
:37:57. > :38:01.priority for Romney. It conveys a lack of seriousness, both on his
:38:01. > :38:05.part, but also in tune with his party, when it comes to America and
:38:05. > :38:08.the re- of the world. That, is quite a substantive difference with
:38:08. > :38:15.Barack Obama. It was on the way to his second
:38:15. > :38:19.stop, Israel, that things started hotting up. On board the flight,
:38:19. > :38:23.Romney's spokesman told reporters that they would back an Israeli
:38:23. > :38:28.strike against Iranian nuclear facilities. Once there, he
:38:28. > :38:32.delighted the Israeli right with a pledge to relocate the US embassy
:38:32. > :38:36.to Jerusalem. I think it is long been the policy of our country to
:38:36. > :38:39.ultimately have the embassy in the nation's capital, Jerusalem. The
:38:39. > :38:44.decision to actually make the move is one, if I were President I would
:38:44. > :38:48.want it take. Perhaps the most revealing statement on his trip was
:38:48. > :38:58.the candidate's observation that the disparities in wealth between
:38:58. > :39:03.
:39:03. > :39:06.Israelis and Palestinians could be One American politician said a
:39:06. > :39:09.gaffe is when the politician tells a truth, a gaffe is when a
:39:09. > :39:16.politician reveals what he really thinks. I think there was something
:39:16. > :39:23.revealing in that remark of Mitt Romney, it did suggest a kind of
:39:23. > :39:27.colonialist mentality that some how seemed to think that the oriental
:39:27. > :39:30.people, Palestinians, were some how culturally inferior, to the
:39:30. > :39:35.Israelis, who are more western and more like the Americans.
:39:35. > :39:37.headlines from the Palestinian comment followed the candidate to
:39:37. > :39:42.Poland. REPORTER: Governor Romney do you have a statement for the
:39:42. > :39:48.Palestinians. The press vented their annoyance at
:39:48. > :39:52.getting so little access to him. And quickly put down by Romney's
:39:52. > :39:56.staff. This is a holy site for the Polish people, show some respect.
:39:56. > :39:58.That was unfortunate, and has left even those on the right questioning
:39:58. > :40:05.the achievements of Mr Romney's trip.
:40:05. > :40:07.In terms of sending out very clear messages about what kind of foreign
:40:08. > :40:13.policy president he would be, strong support of Israel, very
:40:13. > :40:19.concerned about the Iranian issue, strong supporter of their allies in
:40:19. > :40:21.Eastern Europe, strengthening that relationship. Strong believer in
:40:21. > :40:25.the special relationship between Great Britain and the United States.
:40:25. > :40:31.In terms it of the public relations and the press managment, it has
:40:31. > :40:34.been utter and complete amateur hour. There are aspects of the
:40:34. > :40:39.President's foreign policy over Russia and Iran, that provide
:40:39. > :40:44.plenty of ammunition to the Conservative who say the incumbent
:40:44. > :40:48.has made America look weak. But President Obama's stepping back
:40:48. > :40:53.from foreign entanglements is part of a response to the American
:40:53. > :40:56.crisis. It will be hard for a Republican challenger to campaign
:40:56. > :41:01.on a world's policeman ticket, or concede the country can no longer
:41:01. > :41:04.afford to do that. Mitt Romney has flown home to concentrate on
:41:04. > :41:08.economic issues. But looking presidential requires a confident
:41:08. > :41:14.grasp of world affairs too. If the Romney campaign doesn't raise its
:41:14. > :41:23.game, it will simply give the President a key advantage.
:41:23. > :41:28.Joining me now from Washington are my guests.
:41:28. > :41:36.Good evening to both of you. What can we tell from the countries that
:41:36. > :41:40.Mitt Romney chose to visit? I think when he planned the trip he chose a
:41:40. > :41:48.deliberate theme. Going to one of our most important allies in Europe,
:41:48. > :41:51.to the UK, go -- going to one of our most important allise in the
:41:51. > :41:58.Middle East, and the focus of attention -- allies in the Middle
:41:58. > :42:06.East, and the focus of attention for Iran, Israel, and Eastern
:42:06. > :42:10.Europe allies, Poland. Is is it the danger that the gaffes overshadows
:42:10. > :42:17.any coherent foreign policy direction? Absolutely. They
:42:17. > :42:21.certainly do not help this trip, that was very finely crafted to be
:42:21. > :42:25.a possibility and opportunity for Mitt Romney to show off his foreign
:42:25. > :42:29.policy experience, and for him to appear presidential. He had plenty
:42:30. > :42:33.of successes on the trips, he had great meetings and great photo
:42:33. > :42:36.opportunities, he specially at the western wall in Jerusalem. But on
:42:36. > :42:41.the way home here we are talking about some of the missteps over the
:42:41. > :42:44.past few days, and the way he snubbed the Palestinian and some
:42:44. > :42:51.British people. Tell me, do you think there has been something
:42:51. > :42:55.emerging of the man that Mitt Romney might be in the White House.
:42:55. > :43:00.Barack Obama was all about diplomacy, is Mitt Romney more
:43:00. > :43:04.directional, there is more clarity in what he's saying in the
:43:04. > :43:08.direction he will take America? has said there is. We don't know a
:43:08. > :43:12.lot about Mitt Romney on the front of foreign policy. We know what he
:43:12. > :43:15.has said and what he would do, which is calling out China on
:43:15. > :43:19.currency manipulation, he has talked about bombing Iran, or
:43:19. > :43:26.stopping that country from acquiring a nuclear weapon. He has
:43:26. > :43:28.talked about Russia and it being our top geopolitical foe. He has
:43:28. > :43:33.talked about all these issues and dealing with them within the first
:43:33. > :43:37.days of office. We don't know exact low what he would do. What would he
:43:37. > :43:40.do? We very well know at that America cannot be the world's
:43:40. > :43:44.policeman, he has been slamming Barack Obama for not doing enough
:43:44. > :43:49.about Iran, but, for example, if he's in the White House, and there
:43:49. > :43:56.is still an issue in Syria, what exactly would a Mitt Romney foreign
:43:56. > :44:00.policy in Syria look like, do you think? First of all, let me go back
:44:00. > :44:07.to the question you just asked Dan. We are talking about this because
:44:07. > :44:11.you, at the BBC, are asking another reporter for another news magazine,
:44:11. > :44:14.Newsweek, what you think about the supposed gaffes that Mitt Romney
:44:14. > :44:18.made on this trip. I think the media of not brilliantly managed on
:44:18. > :44:22.this trip, but the notion that the American people are quite as
:44:22. > :44:26.interested and obsessed on this as you are is simply ridiculous.
:44:26. > :44:29.Unfortunately for me, and you know foreign policy is my business,
:44:29. > :44:35.foreign policy doesn't enter into the top ten issues for the American
:44:35. > :44:38.people in this election. The notion that this is some how doing to be a
:44:38. > :44:42.dispositive question for him, as the American people look at him and
:44:42. > :44:47.see how he questioned the Olympics and whether there was enough
:44:47. > :44:52.security is a little bit ridiculous. Let's set that one aside. Doesn't
:44:53. > :44:57.he have to appear presidential abroad? I think that he needs to
:44:57. > :45:02.have a good trip, and I think in the large part he did. The notion
:45:02. > :45:06.that he can't repeat things that the British press itself has
:45:06. > :45:10.aggressively been putting forward about the Olympics is a little bit
:45:10. > :45:14.silly. The reaction from both Mr Cameron and Boris Johnson were both
:45:14. > :45:21.a little bit sensitive, let as say that. That being said, you never
:45:21. > :45:25.want to get bad press, you want perfect press. On the other hand,
:45:25. > :45:28.the only thing that leads to perpect press is glibness and lying
:45:28. > :45:36.among politician, we have rather had enough of that. Let's talk
:45:36. > :45:40.about Syria? Hang on, the man put out a foo plus, well, let's talk
:45:40. > :45:47.about the foreign policy question, I'm happy to talk about Syria. The
:45:47. > :45:52.plan put out a fifty-plus page White Paper, I don't go back and
:45:52. > :45:55.refer to that eagerly, it is single-spaced and quite long, the
:45:55. > :45:58.view that he hasn't put out his views on a variety of issues is
:45:58. > :46:02.really not quite fair. The American people aren't interested in talking
:46:02. > :46:06.about the Olympic, the Palestinians or Poland at the moment, what they
:46:06. > :46:09.are interested in talking about is unemployment. Let me deal with the
:46:09. > :46:14.fact that he has stated his direction, just briefly? He has put
:46:14. > :46:19.some of these positions on the record. The problem is, none of
:46:19. > :46:23.these have real beef behind them, he hasn't answered the question of
:46:23. > :46:26.logistic, would you really bomb Iran if you could, or confront
:46:26. > :46:29.China on currency manipulation. These are big promises to make,
:46:29. > :46:33.once you become President, and get in the Oval Office, and get
:46:33. > :46:41.classified security briefings, a lot of this is receiptor that he
:46:41. > :46:45.said. We don't have a clear picture -- rhetoric, that what he said. We
:46:46. > :46:49.don't have a clear picture. Foreign policy is not a major issue, with