05 March 2021 | by Guest
A timely piece for National Eating Disorders Week from Dr Stephen Linacre, Clinical Psychologist at Derbyshire Eating Disorder CAMH’s Service, with lived experience of eating disorders.
I’m a clinical psychologist, but I also have personal experience of having anorexia and bulimia when I was a lot younger.
Coming into this work is something I mulled over for a long time, wondering whether it would be re-triggering, or cause me to relapse.
But what I’ve realised is that I’m now a lot better placed to be able to support others because of my own experiences.
These days I work with young people with eating disorders and their families, but in the past I’ve also worked with adults with eating disorders and people with learning disabilities, and there’s a lot of cross-over between the psychological approaches across these different services.
The estimate is 1.6 million people have a diagnosable eating disorder, but we also know that there’s a lot of people out there that as yet have not sought support or feel ashamed about seeking support.
Unfortunately whilst we’re on lockdown, many coping strategies have been eliminated, so the number of referrals that we’re seeing has increased.
It’s very addictive and can affect your neurological pathways, which mean you can become very fixated, and you can’t be flexible.
People should consume something every four hours to keep the body going, otherwise it goes into starvation mode, and that doesn’t matter what weight you are, the body starts to process energy differently if it’s got no food in the system.
It’s both a biological and a psychological thing.
We know that when people start to lose weight they get a sense of achievement from it.
That can also play into why it’s reinforced, why they think they need to lose more weight even if they’re very underweight already.
Comfort eating provides people with endorphins and can help them to feel better immediately but, in the long term, if you’re overeating it can affect your weight and your body image, which consequently affects your self-esteem.
And, with lockdown, people are not doing the things that they used to use as coping strategies.
Whether you’re eating just for comfort, or if you’re restricting to get a sense of achievement, these kinds of things become very problematic when that’s the only thing you’re focused on.
Seeking support, whether by talking to your doctor, a friend, or visiting one of the many positive websites, is important, so if you feel you can reach out to somebody, that’s the first step.
Parents and carers are a very big part of how people get better.
So, if you notice someone is starting to comment a lot on their weight, things like body checking, looking in the mirror, squeezing parts of their body, that’s an issue that’s on the person’s mind.
If they are doing more exercise, and also restricting what they’re taking in nutritionally, that can be a problem as well.
If people are becoming withdrawn, or refusing to socialise, such as on zoom or face chat, because sometimes people will dislike even seeing their picture on the screen, that also suggests that there’s low self-esteem which is a clear marker for people to develop eating problems.
If you feel you’re struggling, whether that’s overeating, or not eating enough, focusing on your body, your shape, or calorie intake, it’s important that you seek somebody to talk to, whether that’s a professional, your GP, or services locally that have self-referrals (which a lot do now).
BEAT offers a helpline, web-based forums, and carers workshops for friends, parents, and family members to attend to help them to learn how to say the right things.
Because what can tend to happen is they start to say things that inadvertently reinforce the eating disorder.
Everybody can fall into a trap with how we talk about food, and carers and parents need the education to understand how to communicate with a loved one rather than just going along with it.
The best way for someone to be supported is if they can say they’ve got a lot of thoughts about this whilst they’re still a healthy weight.
It gets much more difficult to shift once people are extremely under- or overweight.
There is a lot of evidence-based psychological treatments, such as CBTE, and family-based therapy, that can be very helpful too, as well as new evidence coming out around cognitive remediation therapy, which looks at helping people to be more flexible in their thinking patterns.
There’s a lot of different treatments out there and what we do in an eating disorder service is take a holistic approach, involving the parents and the carers as part of the recovery.
Most people do recover and often get to the point where they can function, make a full recovery, and go on to do what they want in life.
I’m an example that, having been able to recover after eight years of having anorexia (including several hospital admissions), you can come out and find a new identity.
An eating disorder does become your identity, so that everything revolves around the eating disorder, but that can change with support from loved ones, and through the right therapies.
Eating Disorders Awareness Week tries to help people to realise that having mental health difficulties is a common thing, not something that people should feel negative, or ashamed about.
There are a lot of treatments, such as talking therapies, as well as some medications that can help with anxiety and sleep, to help people get back their purpose and identity in life.
An eating disorder doesn’t have to control you.