The NHS website provides an overview of how you can help someone with an eating disorder. The most important aspects to providing support are to be non-judgemental and open to listening. It is essential that professional help is sought as soon as possible to provide them with the best opportunity to achieve wellness in the future. Some of the tips the NHS recommends are to:

  • Keep trying to include them – they may not want to go out or join in with activities, but keep trying to talk to them and ask them along, just like before. Even if they do not join in, they will still like to be asked. It will make them feel valued as a person.
  • Try to build up their self-esteem – focus on positive personality traits and away from physical attributes
  • Give your time, listen to them, and try not to give advice or criticise – this can be tough when you do not agree with what they say or how they behave. Remember, you do not have to know all the answers. Being there is more important. They often feel very sensitive to rejection and criticism, which could drive further food restriction as an emotional coping mechanism.

(www.NHS.UK: 9/2/2022)

Eating Disorder Awareness Week

According to Beat, the UK’s eating disorder charity, around 1.25 million people in the UK are affected by eating disorders such as bulimia nervosa, binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa.

The theme of Beat’s Eating Disorders Awareness Week 2022 is to campaign that all UK medical schools and foundation programmes provide specific training on eating disorders. If they succeed it will mean that earlier intervention could be achieved, which would be life-changing for people affected by these conditions.

If you have not heard of the above eating disorders, here is a quick overview.

Bulimia Nervosa

Bulimia nervosa occurs when an individual consumes a large amount of food over a short period. They may use laxatives or induce vomiting to purge themselves and/or may also participate in excessive exercise to try to counteract weight gain.

The effects of bulimia are vast and can have long-term effects such as a reduction and damage to the tooth enamel caused from stomach acid and vomiting, as well as tears in the lining of the throat. Dry skin, hair, brittle fingernails and feeling weak and tired are commonly reported by those living with bulimia. There are also serious short-term risks to health caused by electrolyte disturbance, which can be fatal when they cause heart rhythm irregularities.

According to the Mental Health Foundation people living with bulimia may feel that elements of their life are out of control, and purging food quickly after intake restores a sense of power, diluting the extreme guilt and shame they experience. They also state that common traits of bulimia may include:

  • low self-esteem or feeling worthless
  • perfectionism
  • a fear of being inadequate
  • a fear of rejection
  • a strong desire to gain the approval of others

Avoidant Restrictive Food Intake Disorder (ARFID)

ARFID is a more common condition among children and young people. According to Beat, around 5% of eating disorders in the UK can be attributed to ARFID. A pattern may emerge whereby certain foods or food groups are avoided entirely or restricted in quantity. The ingestion of food is not deliberately reduced, and excessive exercise is not used to control weight gain. They do not purge. ARFID is generally not driven by body dysmorphia.

Some of the motivating factors with this condition may be:

  • Reduced drive to eat, lowered appetite, reduced reward from eating
  • The sensory sensitivities relating to food, such as smell, texture and appearance may trigger anxiety, arousal or overwhelm
  • They may have a fear of eating and choking, and avoid eating to try to reduce other distress

One of the most concerning aspects of ARFID is the nutritional deficiency that may occur as a result of the chronic reduced food intake which, in turn, may affect energy levels, development, sleep, concentration, mood or growth. In 2019, Cambridge University Press published an article to highlight the existence of ARFID due to the fact that it is under-recognised and underdiagnosed in the UK. It stated that:

“ARFID can present alongside neurodevelopmental disorders such as ASD, ADHD and intellectual disability, and it may be present in children with attachment difficulties”

It is clear that ARFID is a complex eating disorder and affects people differently. It requires expert support and guidance. ARFID Awareness UK has a vast resource of guidance and support materials, together with a Q&A section, should you require further information.

Binge Eating Disorder

Consuming a large amount of food in a short period of time without compensatory behaviours is what is known as binge eating disorder (BED). BED can be distressing, resulting in a feeling of embarrassment, disgust, shame, or guilt. It is common for binge eating to take place when there are feelings of sadness, anger, or anxiety, but also if someone is feeling happy or excited, which can make it difficult to spot. The Beat website lists the following warning signs:

  • Bulk purchasing and hoarding food
  • Eating very quickly
  • Social withdrawal and isolation
  • Secret eating

Binge eating can impact health, increasing the risk of diabetes, raised cholesterol leading to heart disease, and joint and back pain caused by weight gain. Early recognition and treatment improves health (including mental health) and outcomes and arranging an appointment with your GP or practice nurse is a good first step.

Anorexia Nervosa

Anorexia nervosa is one of the most publicised eating disorders, in part due to high-profile celebrities who have shared their experiences in a bid to help others. Anorexia sufferers restrict their intake of food, have a marked fear of gaining weight and a distorted body image. They drop their weight to seriously low levels.

Someone affected by anorexia has a very strong drive to restrict intake of food and may avoid scheduled mealtimes, withdraw from social situations that involve eating, or they may exercise excessively to burn more calories. Anorexia can occur at any age, but often firsts presents during the teenage years. The Royal College of Psychiatrists provides an extensive list of signs to look for if you are concerned about someone who may have anorexia, together with advice on seeking help.

Eating disorders can affect anyone and can begin at any time, irrespective of cultural background, ethnicity, sexuality, age, socioeconomic status, or gender. Encouraging awareness of the signs and symptoms is key to promoting intervention, which reduces the significant negative impacts on those with the eating disorders and their families and loved ones.

Eating Disorders Awareness Week

Eating Disorders Awareness Week attempts to break down the barriers to accessing help and reduce the stigma associated with these chronic distressing conditions. Raising awareness and improving the knowledge and understanding in our communities will hopefully make it easier to help those who may not be aware that they have a medical condition that can be treated. Help is out here.

The Eating Disorders International Conference takes place 23-24 March 2022. It is a virtual conference that will showcase clinical expertise alongside lived experience and aims to present cutting edge research from leaders in the field of eating disorders.

Tickets cost £150. This includes access to all conference sessions across both days and content is available for one month after the conference.

Anyone can attend the EDIC, but due to the programme content, design and nature of the research and debates being presented, the conference relies on delegates having an academic understanding in the field of eating disorders.

Reviewed by Dr Kirsten Ellis, Consultant Psychiatrist (MBChB, MRCPsych, MSc)