Overview – Eating Disorders

Eating disorders are mental health conditions, which can develop in people of any age, gender or ethnicity. Eating disorder behaviours often develop in the context of difficulties with body image and as a means of coping with difficult feelings and situations. The behaviours may involve eating too little, eating in a way which feels out of control and/or trying to get rid of food or preventing weight gain in an unhealthy way. The person who is suffering from the eating disorder is never to blame, and with the appropriate treatment and support, most people can recover.

Most Common Eating Disorders:

  • Anorexia Nervosa (AN) may be characterised by: Someone trying to control their weight by restricting their energy intake. They may experience an intense fear of weight gain and/or distorted body image. They are likely to have lost significant weight or be maintaining their weight at a level below what is appropriate for their height and age.
  • Bulimia Nervosa (BN) may be characterised by: Someone having frequent episodes of bingeing where they experience a loss of control over how much they eat. Attempts are made to prevent weight gain, such as vomiting, abusing laxatives or diuretics, or excessive exercising. It is likely that someone’s view of themselves will be disproportionately influenced by their shape and weight.
  • Binge Eating Disorder (BED) may be characterised by: Again someone having frequent binge eating episodes, where they experience a loss of control over how much they eat. In binge eating disorder, this would not be associated with frequent attempts to compensate for these episodes

OSFED (Other specified feeding or eating disorder):

A person may have OSFED if their symptoms do not exactly fit the criteria of any specific eating disorder, but they still have significant difficulties around eating. This can include atypical anorexia nervosa and atypical bulimia nervosa.

What treatment is available?

Eating disorders can be serious psychological and medical problems and it is important to access professional help. Your GP can refer you to one of the all age specialist eating disorder teams covering Lancashire and South Cumbria. Clinicians in these services include psychologists, psychological therapists, specialist nurses, dietitians, medics and support workers. The majority of people are treated in an outpatient setting.

In some circumstances the all age eating disorder service will also need to work with other agencies to ensure you have additional support, which they will discuss with you before a referral is made.

What forms of treatments are available?

A variety of therapies are offered within the specialist eating disorder services and are based on the National Institute of Clinical Excellence (NICE) guidelines. The service offers both group and individual sessions with an eating disorder specialist. Young people will often be offered family based approaches such as Family Therapy for Anorexia Nervosa (FT-AN) or Family Therapy for Bulimia Nervosa (FT-BN). Cognitive Behavioural Therapy for Eating Disorders (CBT-ED) is the most likely treatment option for adults, either in individual or group settings.

Other cognitive interpersonal therapies such as the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) or Schema Therapy may be offered. Family Therapy and Systemic Therapy may be considered if they are deemed to be more appropriate.

Alongside psychological interventions, people may also be offered dietetic interventions, case management and physical health monitoring.

How long will treatment take?

Length of treatment is dependent on individual requirements. During assessment, we plan for recovery and discharge – the details of which will be agreed between the individual and professional and reviewed at appropriate intervals.

What are the benefits of treatment?

Clinicians will work collaboratively with service users and their families to develop shared goals around recovery. These goals will often involve developing a healthier relationship to food and eating and reducing or ceasing inappropriate behaviours such as vomiting and laxative abuse. It will often be a goal of therapy to work on identifying and improving other underlying issues which serve to maintain the eating disorder.

These issues might be related to areas such as body image, self esteem, managing emotions and relationships.

What are the expectations of me?

In order for the service to support you with your recovery and to keep you safe, it is important that we work together. Whilst under the care of the all age eating disorder service you will be expected to:

  • Have your physical health monitored, including your weight

  • Attend your scheduled appointments

  • Your family may also be expected to attend some appointments

What difficulties may I experience in treatment?

It is completely understandable to find treatment difficult at times.

We understand that people may have a range of worries and would encourage someone to contact us to discuss any anxieties which might act as a barrier to you accessing support. It can be extremely challenging and anxiety provoking to try and make changes to eating patterns and face fears around weight restoration. Difficulties with motivation to change can be addressed as part of the treatment process. It may also be difficult to open up about your difficulties and emotions. The clinicians who are working with you are here to support you with the process. The more open you can be about the struggles you are experiencing, the more they can support you.

How do I get referred to a specialist eating disorder service?

The first step is to speak to your GP about your concerns and difficulties around eating. Your GP or any other health professional can refer you to your local eating disorder service. As part of the referral process, we ask for your GP to conduct blood tests and a physical health assessment, including weight and height. This information is very important for us to understand your current situation and the associated risks at the point of referral. We accept referrals for people across the full weight range.

What happens next?

Once a referral is received, if it appears likely that you are suffering from an eating disorder and we have the relevant information, you will be offered an assessment. The assessment will consist of a meeting with one of our team, which will last approximately 90minutes. In the assessment, information will be gathered about your current difficulties around eating and the history of your difficulties. You will also be asked about any other mental health difficulties and information will be gathered about other aspects of your life. Following this assessment, a decision will be made about whether our service is appropriate for you and a plan will be made with you about the most appropriate treatment.

Some thoughts from one of our service users:

"There’s no magic wand but the staff are incredible at helping provide you with the tools and guidance to recover. I’ve learned and relearned things about myself that I will never take for granted. I’ve accepted that I couldn’t change what happened or what I did but I could change my future. A year changes a lot, I’ve grown up, given up and put myself back together. You didn’t choose to have an eating disorder but you can choose to fight back and recover. Recovery is not a linear process.

There may be setbacks and difficult days, but never forget that every stumble will make you more determined to get back up and keep moving forward. Dreams do come true when paired with hard work, commitment, and a dash of courage. If I can do it you can too."

Other Sources of Information:

Beat

Beat are an eating disorder charity who provide lots of resources and support for sufferers of eating disorders and those that provide care and support for them.

Helpline: 0808 801 0677

More information available on the Beat website.

Young Minds

Young minds are a mental health charity who provide support and resources for young people struggling with mental health issues and their parents.

More information available on Young Minds website.

Patient Advice and Liaison Service (PALS)

If you have some concerns, questions or need advice on our services, you can contact the Patient Advice and Liaison Service (PALS) on 0800 234 6088 

Feeling low and need someone to talk to?

Call 0800 915 4640

Monday to Friday 7pm to 11pm Saturday to Sunday 12pm to Midnight

Need urgent help?

Call 0800 953 0110 24 hours a day, 7 days a week

This leaflet is available in alternative languages and formats upon request. Please speak to a member of our staff to arrange this.