What is an eating disorder?

Image courtesy of Tiverylucky at FreeDigitalPhotos.net

Image courtesy of Tiverylucky at FreeDigitalPhotos.net

It’s EDAW – Eating Disorder Awareness Week 2017

So, in honour of EDAW, I’ll tell you what an eating disorder is not. An eating disorder is not a choice, and neither is it anything to do with wanting attention. It is not necessarily about being skinny – you don’t have to be very underweight to have an active eating disorder and need help.

Eating disorders are complex brain based illnesses with a genetic link, which means that if you are predisposed to getting an eating disorder, even losing weight through illness can trigger one.

Below are some facts taken from the FEAST – Families Empowered and Supporting Treatment of Eating Disorders – website. Do check out their website as there is a host of information that may help you if you or a loved one is showing signs of an eating disorder (ED).

Other resources for family and friends of loved ones with an ED include two Facebook groups that I’m a member of – Mothers Against Eating Disorders (MAED) and Eating Disorder Parent Support (EDPS). They are fantastically knowledgeable and supportive places that are ‘closed’ groups, meaning that your other Facebook friends cannot see what you post. These warm, friendly groups have people from all over the world in them, and strong bonds and friendships are formed. Groups like these are especially necessary if you are in the UK, as I am, as our Mental Health services are stretched to the limit. Which means that we need to take control of our ill loved ones and help them to eat! That’s fine (to a point) when you have a child, but once they turn 18 things start to get even more difficult with the legalities over what health professionals can share with the parents – particularly concerning as they are still children and need our continued help and support to recover from this debilitating illness. The ED stunts the rate of maturity, so most 18 year olds are usually still at the mental age of the onset of the ED.

Food is medicine – and yet, to someone with an ED, it is also the most scary thing on earth. The thought of putting that delicious burger or cake into your mouth is terrifying, and the fear of what it will do to your body is equally scary. But these fears and thoughts can go once the individual is weight restored. And it’s really important to remember that there are no bad foods when you have an ED – all foods are good!

Here’s a fantastic blog post on extreme hunger and eating as much as you want when you have a restrictive eating disorder like Anorexia Nervosa. That sounds like a complete contradiction to what I said above, about food being scary. The important thing to note here is that you have to face your fears – just as an arachnophobe needs to gradually learn to look at a spider for the fear to lessen – in order to get through to the other side and into recovery. Do check out Tabitha’s other blogs and her website, which are all aimed at helping adults with EDs.

The UK’s treatment of eating disorders is still way behind best practice in many areas. CAMHS (Children and Adolescent Mental Health Services) are slowly improving, but adult services are completely under resourced and frequently fail adults with eating disorders. Many adult mental health services, in our experience, include some so called ‘professionals’ who have a dangerous lack of up to date knowledge on both what EDs are and how to treat them. Compound that with the fact that our specialist hospitals have long waiting lists for beds in their ED wards and you have a recipe for disaster. Often our loved ones have to wait until they’re so ill, so dangerously underweight, before they can get treatment. This situation is so WRONG – fast, rapid re-feeding is the ONLY way to catch this illness and get our loved ones back to a healthy weight (even then it takes a long time – years – especially if there are other mental health issues too). And when I say ‘healthy weight’, I mean of a BMI of well over 22. Too many people are discharged from care at a BMI of 18 – far too low. Most people quickly relapse, creating a revolving door situation.

Too ill to ask for help

In my opinion, the Government has a duty of care to our many vulnerable adults whose bodies and minds are consumed with this debilitating illness. When you are so utterly under nourished, you cannot easily advocate for yourself. You feel ‘bad’ or guilty when you ask for help, because your eating disorder is making you think that you don’t deserve help. It is so hard to fight those thoughts when you are ill with an ED. So many people don’t, falling through the cracks of the NHS mental health services. And, let me tell you, there are many cracks.

When will the Government do the right thing and inject a huge amount of funding and specialist, evidence based resources into our adult mental health eating disorder treatment? Things are getting worse, not better.

So creating better awareness of what eating disorders are (and what they’re not), are crucial in our body image obsessed society. Yes, we have an obesity problem. But I would say we actually have a disordered eating problem in the UK. We should not be making things harder for those with life threatening EDs, or those vulnerable to having one triggered, by harping on about ‘unhealthy’ food!

All Food in Moderation is my mantra. No demonising of food groups, no body shaming. Let’s all get into the Health At Every Size mindset, and then maybe society will be a happier, healthier place!

FACT: Weight is only one measure of health.

When we dismiss the possibility of an eating disorder because of appearances, we: fuel the illness, reinforce stigma, dis-empower the patient and their family, and create a huge barrier to identification and early intervention. To learn more, read: “Facts and Concerns About School-Based BMI Screening, Surveillance and Reporting”

FACT: We do not fully understand the causes of eating disorders. 

What Do We Know About Causality?

FACT: Families play a key role in treatment and in relapse prevention.

See what families CAN do…

FACT: Parenting a child with an eating disorder is not normal parenting, or even normal care-giving.

An eating disorder diagnosis affects every member of the family and the lifestyle of the family, just as it would with any grave illness. Creating a safe and supportive home environment for all family members during recovery is critical, but families often lack the crisis management skills and face stigma in the community when asking for help. Learn more about Parenting During Recovery…

FACT: “Knowing that the brain is operating differently in eating disorder patients can help families respond with less frustration: it can help to understand that this is not a set of choices or lack of motivation to change. No one, including the patient, is at fault.”

Read more from “PUZZLING SYMPTOMS: Eating Disorders and the Brain, a F.E.A.S.T. Family Guide to the Neurobiology of Eating Disorders.”

FACT: By knowing the warning signs of an eating disorder, families and health providers can set aside false stereotypes, leading to earlier diagnosis and intervention, when treatments are most effective.

Learn more about the Warning Signs of eating disorders…

FACT: “Malnutrition, which is found in all EDs, is a serious medical condition, and nutritional rehabilitation is a fundamental component of treatment.…

While the physical symptoms of starvation are fairly obvious, many people do not realize that when the brain becomes malnourished, it negatively affects mood, behavior, appetite regulation, relationships, and can even distort a patient’s perception about their own body weight and shape.”  To learn about the connection between malnutrition and mental illness, read more from “UP TO THE PLATE, a F.E.A.S.T. Family Guide to the Importance of Nutrition for Understanding and Treating Eating Disorders.”

FACT: Eating Disorders are biologically-based brain disorders.

As science has more clearly illuminated the biological nature of the illness, the question of “nature versus nurture” has evolved to a “nature AND nurture” and also expanded the discussion of environment to include genetics, prenatal influences, nutrition, developmental changes, personality traits, hormones, over-exercise, illness, and stress. Learn more about Environmental Factors and Eating Disorders…

FACT: Some environmental influences can increase the chances of a person developing an eating disorder, but probably only if that person has a genetic/biological predisposition.

A person with a predisposition for an eating disorder may never develop one if certain environmental influences never appear, or do not appear at certain developmental stages of growth and brain maturation. Learn more about Genetic Risk Factors for Eating Disorders…

FACT: “With appropriate expert and family assistance, there is always hope for successful recovery.

Treating eating disorders is not easy, and the earlier the intervention, the higher the chance of success. Effective care usually requires a multi-disciplinary approach, specialized caregiving skills, and long-term vigilance. Although an eating disorder diagnosis may feel like a devastating blow to a patient and their family, it is an opportunity to begin a treatment process that can allow your loved one to restore their mental and physical health and live a full, successful life.” Read more from “Port in a Storm: A F.E.A.S.T. Family Guide to Eating Disorder Treatment…

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