A post-code lottery for residential eating disorder care is leaving some patients feeling stuck and without the help they say they need.

Diante Peihopa-Harris says when she finally worked up the courage to seek support for her eating disorder, she was told there was nothing available in Northland, where she previously lived.

People whose eating disorders result in significant medical complications can receive care in a medical ward, but specialist residential treatment can be out of reach for some people who live where it is not available, or who can not afford to shell out for private care.

'Trapped in my eating disorder'

Thirteen years after she first noticed her relationship with food was not as it should be, Peihopa-Harris finally feels ready to break free of the day-to-day battle and look to the future.

The 24-year-old has just finished five months at residential facility Recovered Living in Canterbury, a charity-run organisation that takes privately paying or ACC clients, and was about to have a job interview when she spoke with RNZ.

That seemed unthinkable just a couple of years ago.

"I did go to my GP about my struggles and they said that they would look into referring me to eating disorder services," she said.

"However, they got back to me and said that there are actually no public eating disorder services in Northland."

This left her feeling even more on her own.

"I asked my doctor, 'What can we do now?' and she then went to speak to public eating disorder services in Auckland, as they were the nearest region to Northland.

"They, unfortunately, said that I would be out of their scope as I don't live in that region."

Health New Zealand general manager for mental health and addiction services Deborah Barrow said there were specialist mental health and addiction outpatient services in Te Tai Tokerau, for people with moderate or severe eating disorders.

"People whose eating disorder has resulted in significant medical complications requiring hospital admission receive inpatient care in a medical ward within the district.

"Specialist residential treatment for eating disorders is provided through services in Auckland."

But with these out of reach, Peihopa-Harris' doctor recommended a couple of private services. Peihopa-Harris could not afford these and, like the public options, they were in Auckland.

She said at that point she felt stuck.

"It was really hard. I felt so desperate for help, and that would have been at least two years ago.

"I just felt really really hopeless and really trapped in my eating disorder."

Binge eating 'not understood'

Peihopa-Harris said her binge eating was caused by trauma, and would result in her isolating herself, attempting to hide her behaviour.

The New Zealand Eating Issues and Eating Disorders Strategy estimates about 400,000 New Zealanders will experience an eating disorder during their lifetimes.

But Peihopa-Harris said binge eating could either not be taken seriously, or was seen to have a simple cure.

"For example, with binge eating disorder, [people say] 'just don't over eat, then,' or 'just control yourself'.

"Eating disorders are far more complex then a lot of people know and so I think there's a general lack of understanding."

Last year she moved to Hamilton, partly to access treatment, which was available there.

However, she still was not able to function as she wanted while her illness took hold.

Then, through an ACC claim, she was accepted to the Recovered Living programme, which has proved a life-altering experience.

Recovered Living clinical director Rachael Haldane said from her experience binge eating might be even more prevalent than anorexia.

"Because it's not anorexia and can be associated with what appears to be normal body weight or higher body weight, it's often not probably diagnosed or recognised when, in fact, it actually needs consideration, support and people to work out what the underlying cause of the binge eating is," she said.

The residential programme - which operates in a home-like environment rather than a clinical setting - teaches people to change the way they view food, such as getting them to learn about nutrition.

"It's not just about re-feeding, it's not just about putting weight on somebody," Haldane said of the programme at Recovered Living.

"It's about getting to the bottom of what actually is causing the food or the weight issues, or the trauma that makes people feel that they're not good enough or that they need to control their food or their body weight."

Recovered Living had hoped to get a contract to provide services through Health NZ, but despite meeting officials that had not happened.

Paying privately was expensive, while the ACC funding did not always cover the full amount of time someone would need to complete the programme, Haldane said.

Call for more funding

Eating Disorders Carer Support chairperson Sarah Rowland said New Zealand needed more residential support beds, but there was no one-size-fits-all solution.

"Some people can do really well in the community with the right support, whereas others might need that higher level of support and 24-hour care, which families and careers often aren't at capacity to be able to do."

Binge eating disorders could provide challenges for families and carers, she said.

"The more classic types of eating disorders, like anorexia nervosa and ARFID [avoidant-restrictive food intake disorder], tend to present at younger age groups, so parents and families can have a lot more inclusion and interaction with specialist services, if the referral is accepted."

Peihopa-Harris said now, for the first time in her adult life, she could live without her days being dominated by her eating disorder.

"I have so much more space in my brain and in my life for other things. Me and my life are not consumed by my eating disorder.

"I can see that a future is possible and I feel like I have the energy and the capacity to do things, to dream, and to put those dreams into action."

She is calling for more funding to support people with eating disorders and hopes that by sharing her story she will help others.