Download eating disorders presentation

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Eating disorders
Caroline Salter
Clinical Psychologist
Liz Walsh
Ward Manager
Vincent Square Eating Disorder Service
Aims of session
• Myths about eating disorders
• Symptoms of eating disorders
• Causes of eating disorders
• What treatment is available
• Help and resources
Myths about eating disorders
EDs are a modern illness
• FALSE
▫ Religious fasting
▫ ‘Wasting’ disease (Richard Morton, 1689)
▫ ‘Anorexia nervosa’ (Sir William Gull, 1873)
▫ ‘Bulimia nervosa’ (Gerald Russell, 1979)
Only young, affluent women get EDs
• FALSE
▫ Females aged 12-20 are most at risk
▫ However, eating disorders affect people of any age
and from any culture or background
▫ Approx 15-20% of ED cases are male (though
fewer present for treatment)
We can’t blame the media for EDs
• TRUE
▫ EDs have multiple causes
▫ The media does reflect and amplify societal norms
We can’t blame the media for EDs
• TRUE
▫ EDs have multiple causes
▫ The media does reflect and amplify societal norms
▫ There are more than 3 billion women who don’t
look like supermodels, and around 20 who do!
▫ Social media and pro-ana websites also easily fuel
ED beliefs
1 in 10 women are on a diet or
“watching their weight”
• FALSE
▫ It’s estimated that 1 in 3 women and 1 in 5 men
are on a diet at any given time
▫ The UK slimming industry is estimated to be
worth £2bn each year
▫ Approx. 95% of dieters regain weight lost
within 5 yrs
Young people feel they have no-one to
talk to about eating concerns
• TRUE
▫ A BEAT survey of 600 young women found that:
 Only 1% felt they could talk to their parents
 9% felt they could talk to someone at school
 17% felt they could talk to a doctor or nurse
 92% felt that they couldn’t talk to anyone
You can tell who has an ED by looking
• FALSE
▫ Eating disorders are a mental illness, so thoughts,
feelings, behaviours and emotions are all involved
▫ Individuals with eating disorders come in all
shapes and sizes
▫ People with bulimia nervosa are typically normal
weight or even above average weight
▫ Individuals with binge eating disorder are
typically overweight
EDs have the highest mortality rate of
any mental illness
• TRUE
▫ Mortality rates (particularly for AN) are higher
than for any other mental illness, including
depression and schizophrenia
▫ Premature death may be as a result of heart
failure, organ failure, malnutrition or suicide
Families are responsible for causing EDs
• FALSE
▫ Parents do not cause eating disorders
▫ EDs are associated with a range of factors
including genetics, brain structure, personality,
cultural environment and reaction to trauma
▫ Parents and other loved ones can be
important resources in an individual’s
recovery
It is possible to fully recover
• TRUE
▫ Eating disorders can be successfully treated and
full recovery is possible
▫ However, there can be long term physical
consequences associated with eating disorders
▫ Some people develop long term or recurring
disorders, but people can get better even after
long term illnesses
What are “eating disorders”
• Anorexia Nervosa (10% of EDs)
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Underweight (BMI <17.5kg/m2)
Fear of weight gain
Disturbance of body image experiences
Amenorrhea (in women)
• Bulimia Nervosa (40% of EDs)
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Recurrent episodes of binge eating
Compensatory behaviours
Both twice a week over 3 months
Self-worth unduly influenced by weight
Not a phase of AN
What are “eating disorders”
• Eating Disorders Unspecified (EDU)
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Atypical anorexia or bulimia nervosa
Binge eating disorder
Orthorexia (and clean eating?)
Chewing and spitting
Purging disorder
Food avoidance and faddiness (often in children)
• 40-50% of cases fall under EDU
Common co-morbidities
• Major depression and anxiety (50-75%)
• Alcohol and substance misuse (12-37%)
• Body dysmorphia
• Post traumatic stress and personality
disorder
• Medical risk
Who do eating disorders affect?
• More than 725,000 people in the UK are affected
by an eating disorder (The Costs of Eating Disorders Social, Health and Economic Impacts, 2015)
• Approx. 11% are male (NICE)
• Up to 6.4% of adults display signs of an ED (Adult
Psychiatric Morbidity Survey, 2007)
• Many EDs develop in adolescence, but can also
occur across the age range
Contributors to EDs
Consequences of semi-starvation
Physical
activity
Food-related
behaviours
Physical
changes
Binge
eating
Cognitive
changes
Emotional
changes
Social
changes
Sexual
changes
Significance of the study
• Many of the eating disorder symptoms are a direct
consequence of restriction
• EDs impact on virtually all areas of psychological
and social functioning
• Weight restoration important for health and return
of emotions/personality
• Consequences of starvation persist following weight
gain
Over-importance of weight and
shape/control/perfection
Strict control of
food/weight
Life events and
mood changes
Binge eating
Compensatory
behaviours
Significantly low
weight
Treatment at VSEDS
• Inpatient
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Mixed gender ward for people with high risk AN
Intensive treatment for weight restoration
Varied group therapy programme available
OT/nursing/medical/psychology input
• Daypatient
• Less intensive than inpatient
• Can be a step down for inpatients or
• A step up for outpatient who are struggling to
gain weight
Treatment at VSEDS
• Outpatient
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Cognitive Behavioural Therapy
Guided Self Help
Cognitive Analytic Therapy
Family Therapy
• Liaison
• Primary goal to stabilise health and keep patient safe
• Carers’ support
• Carers are a valuable resource in the patient’s recovery
• Carers’ skills workshops and drop-in support groups
Questions to ask
• Do you ever make yourself Sick because you feel
uncomfortably full?
• Do you worry you have lost Control over how much
you eat?
• Have you recently lost more than One stone in a
three month period?
• Do you believe yourself to be Fat when others say you
are too thin?
• Would you say that Food dominates your life?
Help and support
• Talk to those close to you
• Visit your GP
• Self-help material
• Charities
Resources and signposting
• Eating disorder charities
• Beat: https://www.b-eat.co.uk/
• Men get eating disorders too: http://mengetedstoo.co.uk/
• Self help books
• Getting Better Bit(e) by Bit(e): A Survival Kit for Sufferers of Bulimia Nervosa
and Binge Eating Disorders, by Janet Treasure
• Overcoming Binge Eating, by Christopher Fairburn
• Anorexia Nervosa: A Survival Guide for Families, Friends and Sufferers, by
Janet Treasure
• Skills-Based Learning for Caring for a Loved One with an Eating Disorder: The
New Maudsley Method, by Janet Treasure
• Clinic info
• http://www.cnwl.nhs.uk/vincent-square/further-informationresources/information-sheets/
• Minnesota study
• http://www.refinery29.uk/minnesota-starvation-experiment
Any questions?