Understanding Eating Disorders

Taking place between February 28th and March 6th, Beat’s annual Eating Disorder Awareness Week (#EDAW) will once again bring attention to these diet-related mental illnesses, seeking not only to make more widely known the gravity of their impact but also as to how our current social and professional approaches to eating disorders remain deeply flawed. 

According to the charity’s research, eating disorders affect 1 in every 50. This means that, in the UK alone, over a million people are affected by a type of mental illness that not only poses significant psychological and physical risks but are also susceptible to the mental disorders with the highest mortality rate. Considering how widespread and severe eating disorders are, it then seems absurd that the average general practitioner (GP) receives less than two hours of training during their medical studies.

This figure becomes even more troublesome when we learn that it is our GPs that are the first port of call for many experiencing the early symptoms of an eating disorder. If they fail to accurately identify the signs of disordered eating, then ailments will develop, risking a misdiagnosis of worsened symptoms later in life, extensive struggle and illness, as well as, ultimately, a likelihood of death.

There is, however, hope.

If symptoms are recognised and remedied early on, recovery is possible. Options are available for those who might seek help. We spoke to Ed Emond, Deputy Director of Services at Beat, to discuss how eating disorders should be spoken about and how help should be sought.

“People worry about saying the wrong thing,” he notes, “but I always say it’s better to have a conversation and make mistakes than to avoid the conversation completely. Sometimes you might get a response that says nothing’s wrong, leave me alone but that’s okay, that’s started the process, and it’s been put in mind that someone is concerned.”

There are a number of challenges that make it difficult to recognise the initial signs and not only that mental illnesses tend toward preventing their detection. “The biggest barrier for somebody to seek support is actually recognising the problem themselves.” Stereotypes and misconceptions remain pervasive, making it difficult for individuals to clarify what might be an issue. Despite eating disorders affecting those from all walks of life, media depictions, for example, sustain this idea that only certain people will be affected and with physically distinct symptoms, such as emaciation. 

“There’s still,” Emond tells me, “quite a stigmatised picture of who can struggle.” Generally, it is easier to imagine a teenage girl with symptoms than a middle-aged male, or to characterise symptoms as extreme weight loss, which might not be as immediately relatable as, say, body image concerns.

When seeking to help others, it’s important to look for change, especially those occurring in a relationship with food-related decisions. “Identify what you’ve seen, what is the change you’ve noticed. It might be that you’ve noticed they’re a bit quieter at certain points in the day or that they’re not going out for a meal with their friends anymore. Some of those subtle things” 

“It’s not saying I’ve noticed a problem it’s saying, I’ve noticed this, can you tell me how you have been feeling about that? It’s about creating open conversations and not saying I think this is a problem. Instead, make your approach, this is what I’ve seen. It’s not the normal you. Let’s have a conversation about that.”

The response you receive might not always be immediately positive but, by establishing that bridge of topic and communication, there is a greater opportunity for recovery. Further conversations may take longer to manifest and have a similar outcome, even being cut short. However, even if months pass before a dialogue is fully engaged, it is worth persevering for the sake of your friends and family.

Once a person is able and willing to seek help, they should speak to their GP. Many symptoms manifest physically and pose risks to the body. Purging, for example, places significant stress upon the heart, leading to heart arrhythmia and failure. General practitioners should be able to spot these signs and take action accordingly. However, as per Beat’s campaign, without the necessary training, symptoms, especially those concealed internally, can be misdiagnosed or overlooked.

Body Mass Index (BMI) remains a hurdle for those struggling with an eating disorder, despite it being a standard form of measurement and classification within the healthcare system. A person’s relationship with food may change dramatically while their BMI remains less affected.

“It’s [BMI] not a diagnostic criterion that you necessarily need to meet,” Emond states, ”but in terms of being at the threshold for receiving treatment, particularly with anorexia, they’re looking at risk and when it comes to the risk of life, if someone is significantly underweight, then they will be a higher priority to access support.” With the challenges that healthcare services now face, especially in the wake of COVID, prioritisation leaves even more behind.

Thankfully, there are other options for support too. Beat has a dedicated helpline that allows for a safe space, enabling listening and discussion, as well as the ability to discern options for support. Therapeutic interventions can also be extremely useful, especially early on. These counselling sessions support an open and non-judgemental dialogue, one that can help to prevent disorders from developing and help those afflicted toward recovery.

The trigger for the development of an eating disorder can be variable, adding to the difficulty of identifying any issues early on. Eating disorders can and often do develop as a response to trauma, making counselling sessions an effective way to support those experiencing disordered eating and eating disorders. Emotional changes and stressful events can lead to food becoming a point of control, having lost this feeling elsewhere in life. Being able to process and work through such problems can be a liberating experience and, at Bristol Counselling and Psychotherapy, we are committed to offering high-quality counselling services, with support options for eating disorders available to help individuals along that journey.

As with many potentially terminal illnesses, early detection saves lives. Most eating disorders can be prevented if help is sought timeously, but often those suffering with one don’t realise they are ill until it’s too late; very few patients that have eating disorders make a conscious decision to develop one. If you find yourself in need of assistance, or know someone who does, seek support. Bristol Counselling and Psychotherapy has trained eating disorder counsellors ready to help. Get in touch today to discuss booking an initial assessment session. 

Many of the statistics around eating disorders are shocking, used not with the intention of scaring individuals but to demonstrate the severity. If you are concerned about your relationship with food, it is most important to know that there is hope. As Emond notes: 

“A full recovery is possible for those with eating disorders and people shouldn’t lose hope. It can be that, in the middle, there are times that you might think things will never get better but those people are able to turn those things around with proper support and care. Thousands of people are getting better and, not only that, but they’re living free.”

Thank you to Ed Emond and Beat for their guidance and support with this article.