Eating Disorders

• Anorexia Nervosa (AN): Anorexia Nervosa is characterised by an intense fear of gaining weight, leading to restrictive patterns of eating and a distorted body image. Individuals with anorexia often have an excessively low body weight and exhibit obsessive behaviours related to food and weight control e.g. mostly restriction of intake, body checking behaviours, and compulsive exercise. However, it is important to note that ‘Atypical Anorexia’ is another eating disorder whereby all of the diagnostic features of Anorexia Nervosa are met, though they do not have a clinically low body weight.

• Bulimia Nervosa (BN): Bulimia Nervosa involves recurrent episodes of binge eating, followed by compensatory behaviours. These compensatory behaviours can include one or more of purging/vomiting, excessive exercise and the use of laxatives/diuretics. Individuals with bulimia often experience significant feelings shame and can feel a lack of control over their eating habits. A common pattern with Bulimia Nervosa is that post a binge/purge episode, individuals restrict in order to further compensate for their intake. Though the restriction itself places the individual at an ever higher risk of a further binge episode. This creates a very challenging and distressing pattern to break.

• Binge Eating Disorder (BED): Binge Eating Disorder is characterised by recurrent episodes of binging. A binge is characterised by consuming a large amounts of food in a short period, and is accompanied by feeling out of control and unable to stop. Unlike bulimia, individuals with Binge Eating Disorder do not engage in compensatory behaviours. This often leads to significant feelings of distress, shame, and weight-related and body image concerns.

• Avoidant/Restrictive Food Intake Disorder (ARFID): ARFID is characterised by a limited range of foods and a strong preference for certain textures, colours, or smells. Individuals with ARFID may experience significant anxiety or fear around eating, leading to inadequate nutrition and impaired growth. Psychological interventions aim to address underlying anxieties and promote healthy eating behaviours.

• It is also important to note that there are other types of eating disorders not outlined above and that eating disorders do not always fit neatly into an eating disorder category. There can be overlap between symptoms and symptoms of eating disorder’s can change over time and throughout treatment.

• All eating disorders have very serious and varied effects on physical health, this is not limited to Anorexia Nervosa. Eating disorders have one of the highest mortality rates out of all of the mental health conditions. Some of the physical health issues with eating disorders include an impaired immune system, cardiovascular issues, gastrointestinal issues, kidney issues, deterioration of the skin, musculoskeletal issues, reproductive issues, damaged eyes, teeth, oesophagus and more.

• No matter the eating disorder, you will require a comprehensive treatment plan involving medical, nutritional, and psychological support. A General Practitioner (GP) will be closely involved in the monitoring of physical health (e.g. weight, vital signs, blood tests, heart monitoring etc.). While a dietitian may work with you to develop a nutritionally appropriate meal plan, facilitate safe re-feeding in some instances, as well as help you to understand and challenge the unhelpful patterns driving your eating disorder e.g. like challenging ‘food rules’ such as having safe foods.

Psychological treatment plays a crucial role in the recovery journey of individuals with eating disorders. Here are some of the common approaches used:

• Cognitive Behavioural Therapy (CBT): CBT helps individuals identify and challenge dysfunctional thoughts and beliefs related to food, body image, exercise and self-worth. It focuses on developing healthier coping strategies and building self-esteem, emphasising the importance of challenging distorted thinking patterns.

• Dialectical Behavioural Therapy (DBT): DBT combines elements of cognitive behavioural therapy with mindfulness techniques. It helps people to better manage intense emotions, through developing healthy coping mechanisms, and improving self-regulation skills.

• Family-Based Treatment (FBT): FBT is the leading treatment approach for young people suffering from an eating disorders. This involves the active participation of family members in the treatment process. It aims to restore healthy eating habits with the direct support from the family and empowers the family to become a support throughout their loved one's recovery.

• Interpersonal Therapy (IPT): IPT focuses on addressing interpersonal issues and relationship difficulties that may be contributing to or result from the eating disorder. It helps individuals improve their communication skills, establish healthy boundaries, and enhance their social support networks.

• Psychodynamic Therapy or Schema Therapy (ST): Both of these treatment approaches allow for a deeper level of processing to help identify underlying causes of your eating disorder, seeing the eating disorder as having developed in the context of as less than desirable early life experiences. This helps people to build insight into the role that their eating disorder has played in their life to cope with distressing feelings and/or experiences.