EATING DISORDER CARE & TREATMENT
Eating disorders can be difficult to understand, many people wrongly believe this is a lifestyle choice or a fad, or a reason to be picky, or simply a stage in life driven by media..
An eating disorder is an extremely serious and life-threatening illness. Eating disorders are deceptive and can subtly creep upon us, and before a parent or child knows, have become a grave situation - one that is unmanageable with sole treatment at home.
Most eating disorders will develop during adolescence, although they affect people of any age they are particularly prevalent between the ages of 12 and 20, brought on by stressors, such as school pressures, personal and family relationships, and other factors that influence destructive eating habits.
To put into perspective the sheer enormity of the problem, eating disorders are responsible for more deaths than any other mental health condition and are becoming more widespread every day.
As with any illness, a child will need the full support of their parents during an eating disorder period. However, it's difficult to cope with, and most families struggle, leading to a high percentage of patients hospitalised because very specific care must be given to help their recovery.
If proper treatment isn't given, a sufferer may spend years going through recovery and relapse cycles and never quite get out of the pattern of an eating disorder.
What is an eating disorder?
An Eating Disorder causes a person to interact with food in an unhealthy way: limiting food intake or eating excessive quantities in an uncontrolled manner, and getting rid of food through purging, fasting, laxative intake or over-exercising. Sometimes a combination of these behaviours can occur.
It's important to mention that a person who has an eating disorder does not have a direct problem with food but in feelings that are provoked when eating. A sufferer may become fixated with their weight or body image, and use the intake of food to cope with their insecurity.
Anorexia Nervosa is a very serious illness which can lead to the starvation of our body and severe physical conditions. It’s diagnosed when a person's weight is extremely low due to their limited intake of food. The illness is often linked to depression, low self-esteem, self-harm and drug or alcohol abuse, and can place a huge strain on personal relationships.
A sufferer of Anorexia Nervosa has a distorted view of their body image. They see themselves as larger than they really are and fear to gain weight. They will often refuse to eat which makes the weight restoration phase of their recovery the most complicated. Professional treatment is highly recommended.
Bulimia Nervosa is a very serious illness which is characterised by eating large amounts of food (bingeing) and then offset this intake by vomiting, taking laxatives or fasting or exercise.
This severe eating habit causes huge amounts of stress on the body and can result in severe physical consequences, such as dehydration, gastrointestinal problems, heart difficulties and electrolyte imbalances. It can also lead to feelings of shame, guilt and low self-esteem. Many who suffer from bulimia fear weight gain and have a negative body image.
Avoidant / Restrictive Food Intake Disorder (ARFID)
An avoidant or restrictive food intake disorder is when a person’s eating issue involves avoidance of food or certain types of food or the general restriction of food intake.
ARFID can occur when a person has a specific fear of the consequences of ingesting a certain type of food, as they may be particularly susceptible to its smell, taste, or texture. Or may only be able to ingest foods served at a specific temperature.
This can occur after a bad experience, such as acute food poisoning or choking and can lead to fear or anxiety around a specific food type or eating in general.
Binge Eating Disorder (BED)
Often we use the term ‘binge eating’ lightly when we have eaten more than we should. However, the reality for those suffering from Binge Eating Disorder can be very distressing.
Binge Eating Disorder sufferers eat large amounts of food in a short period of time and often can’t remember doing so after the event. Often they are unable to stop themselves from binging, and it becomes almost like a ritual. Some BED sufferers will eat anything they can find, even resorting to stealing food or eating food that has been thrown away.
Other Specified Feeding or Eating Disorder (OSFED)
Unlike Anorexia, Bulimia and Binge Eating Disorder, which are diagnosed based on a set of psychological, behavioural and physical symptoms, Other Specified Feeding or Eating Disorder is diagnosed when the pattern of eating doesn’t fit but is nonetheless concerning to a person’s health.
Types of OSFED include Atypical Anorexia (weight stays within normal range), and Bulimia Nervosa and Binge Eating Disorder (both with lower intensity or duration).
As with many of the addictive and destructive behaviours we see in young people, it’s common to see co-occurring conditions of food/body issues and another addiction. We frequently see eating disorders come to the surface when other addictions are removed. For example, alcohol is removed from the equation, and an eating disorder comes to the surface.
In such a case, the two issues can enable each other, which is confusing for both the sufferer and their loved ones. Eating disorders don’t always coexist with faulty thinking around body image but they can.
In some cases, we can see something called body dysmorphic disorder, which is where the individual has unrealistic views of their self-image and their body. It can also co-occur alongside other conditions, such as addiction or mental health concerns. We often see it co-occur alongside a tendency to over-exercise, which might only become apparent only once we’ve started working through the eating disorder.
The UK charity BEAT Eating Disorders published the following statistics from NHS research studies.
- Around 1.250,000 are affected by an eating disorder.
- The condition is more common in females (75%), but males can also suffer.
- Binge Eating Disorder is the most common (specific) disorder (22%), Bulimia (19%), Anorexia (8%), Avoidant / Restrictive Food Intake Disorder (5%), and Other Specified Feeding or Eating Disorder (grouped together) (47%).
- Eating disorders are most common through adolescence but can develop earlier or later in life.
- A study in Australia suggests that anorexia lasts for an average duration of eight years and Bulimia, five years. Severely affecting the growth and development during the important adolescent years.
Causes of Eating Disorders
Eating disorders are complex.
The origin behind Eating Disorders is unknown, and there is no specific cause that can be singled out, but a variety of factors, often the result of biological, psychological or environmental issues.
Examples of factors that a person afflicted with an ED might suffer include dysfunctional family relationships, bullying, the stress of exams, childhood trauma, sexual abuse and peer pressure.
Children or young adults who practice a sport in which it’s essential to maintain a lithe body may also end up with an ED: gymnastics, ballet and diving, are examples of sports which require high body maintenance.
How to detect an Eating Disorder
Unless a person loses a lot of weight in a short period of time or becomes emaciated, it’s difficult to detect an Eating Disorder by appearance alone, as many sufferers will stay within the normal weight range or may even be overweight, depending on the disorder affliction.
If your child or someone close to you has two or more of the following symptoms, they may be suffering from an Eating Disorder.
- Has an uncontrolled pattern of eating - may eat very little or large amounts of food in an average period of time.
- Intentionally makes themselves ill after a meal or undertakes excessive exercise
- Has lost more than one stone in less than a three-month period
- Appears overly preoccupied with their body image or weight
- Suffers from mood swings
- Prefers to eat alone
- Has a strict eating regime which dominates their life
As a parent, it can be tricky to know when to seek professional help for an eating disorder. If your child is showing two or more of the above symptoms you should be seeking professional help and advice.
Treatment for Eating Disorders
Because of the complexity surrounding eating disorders, a comprehensive, personalised and professional treatment approach is essential to achieve success.
Two of the most important reasons for seeking professional help is the high relapse rate and maintaining the motivation to recover at home. Professional treatment gives someone the best chance possible of overcoming their eating disorder for good.
There are a variety of ways to conduct treatment, and at The Wave Clinic, we take a holistic approach, helping to treat the whole ‘self’ rather than focusing solely on the concern at hand.
Often, treatment for eating disorders comprises a number of factors, including specialised therapies, nutritionists, exercise coaches and clinicians.
Mindfulness and acceptance practices
Only after you accept the issue can you begin to overcome it. We help patients face and accept the difficult internal states they may be facing to help them focus solely on the transcendent self, and not their conceptualised self.
In some cases, we use medication to help with mental health concerns that may arise and to help stabilise moods. The introduction of medication into a treatment process is important for both psychodynamic and physiological reasons.
Family is a powerful thing, and family interventions are an effective way to help a person through their eating disorder. But they must be done in the right way and at the right time – a deep understanding of the patient is essential to their success. For younger patients, family intervention is one of the more critical factors to treatment success.
Expressive therapies like gestalt therapy, psychodrama and dance and movement therapies can be therapeutic and diagnostic, and they often help a patient express their inner selves, providing a sense of catharsis in the process. But they must be conducted carefully and at the key points during treatment.
Art therapy is another expressive therapy that can help reveal to a clinician some of the deeper problems a person with an eating disorder might be facing. This is also a great way to relax, switch off and actively rest while undergoing treatment.
The Wave Approach
At The Wave, treatment involves a high level of care, which in the early days can mean 24-hour observation, particularly around purge and restricting cycles, and the rituals that often go alongside eating disorders, such as fluid input and output. We operate a 3:3:3 meal plan: three meals, three snacks, 3 hours apart with individual observations for each young person. Our Meal Plans include addressing fear foods and food challenges in a gentle and supportive community.
Our mindful eating table is monitored by a member of the clinical team. We sit with our clients to eat, and we also sit with them after eating to make sure they remain safe. We practice intuitive eating, which means relearning the clues the body gives us when it’s hungry and when it’s full. These clues can often be lost in very pronounced eating disorders. Our kitchen facilities are locked, meaning we don’t have food and snacks on show all the time, which can be troublesome for people with overeating, binge eating or purging cycles.
Healing from food and body issues is a very gentle path, which must be taken with great respect for the individual. Eating disorders are very different from other addictions in that we can’t abstain from food or body-related matters. Residential treatment has been proven as the most effective way of working through these issues. Not only is the client supported through counselling and complementary and holistic therapies, but being removed from habitual triggers, destructive patterns and well-meaning loved ones can be incredibly healing.
Excellence in Young Minds
Clients each work with a nurse, a case manager who’s responsible for liaising with all carers, a primary therapist, and a primary recovery coach who are all responsible for different aspects of your care. They’ll also have a personal trainer who’s responsible for the physical aspects of their care, and who will oversee their nutrition with the help of Chef San, our fantastic onsite chef. This, in turn, is all overseen by our treatment director and clinical director, who will liaise with family and any outside providers or medical practitioners who need to be kept abreast of the client’s recovery.
We don’t encourage any breaks within the first 10-12 weeks of our clients’ treatment. Around month 3, if the client is in a safe space and has a good support network, we may be able to facilitate a small break in treatment before returning. We might also involve them in a small break in treatment if they’re moving onto our secondary care programme.
For more FAQs, please refer to our FAQs page.
There's Always Hope
Recovery is not a journey that should be taken alone.
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