Eating Disorders Awareness Week 2021

1-7 March is Eating Disorders Awareness Week, which is an international awareness event, fighting the myths and misunderstandings around eating disorders.

Eating disorders are serious mental illnesses affecting people of all ages, genders, ethnicities and backgrounds. People with eating disorders use disordered eating behaviour as a way to cope with difficult situations or feelings. This behaviour can include limiting the amount of food eaten, eating very large quantities of food at once, getting rid of food eaten through unhealthy means (e.g. making themselves sick, misusing laxatives, fasting, or excessive exercise), or a combination of these behaviours.

As part of this important awareness week, we spoke to Sarah McDonald, Clinical Psychologist for the Trust’s Eating Disorder Service. She spoke about how lockdown has affected people struggling with eating disorders and how you can get help if this relates to you or someone you know.

“Lockdown has had a massive effect on us all for many reasons. We have been largely confined to our homes for almost a year, without regular typical interactions with other people, and it has sadly had a significant impact on the number of people experiencing eating disorders. We appear to be seeing an increase in local referrals in the CAMHS and adult services and nationally we know that there were 19,562 new referrals of under-18s with eating disorders to NHS-funded secondary mental health services in 2020, a rise of 46% from the 13,421 new referrals in 2019.

“Now you may be asking why has lockdown had such an impact? What has contributed to this? I think Eating Disorder Awareness Week, is an important opportunity to think about why this might be and for everyone to use this to consider if this could be relevant for you or someone you know.

“Firstly, eating disorders thrive on secrecy. People with eating disorders often try to keep their difficulties hidden from other people. Individuals who binge and purge by vomiting or taking laxatives tend to feel ashamed of their difficulties and will carry out their binges and purges in secret. Individuals who are restricting their food intake, in illnesses like anorexia nervosa and bulimia nervosa, can feel like they do not want people interfering with their food limitations, as they feel a strong need to stick to their restrictions. The lockdown has facilitated secrecy, particularly for people who live on their own, as it has made it more possible for people to do these things without being challenged.

“It is not necessarily physically apparent that someone has an eating disorder, but sometimes a change in weight can occur, and other signs (such as someone with anorexia having thinning hair, less energy and mobility, or blue fingers and lips in the cold) can be seen. When we cannot see each other, it’s impossible to know if someone who says that they are fine is actually fine. This means that people may have had eating disorder problems during the lockdown for much longer than usual, because no one has seen them to raise their concerns.

“Secondly, eating disorders can provide certainty and purpose in uncertain times. Eating disorders occur for many different reasons and are kept going in an equally diverse set of ways. One common factor is that eating disorders give people a sense of control and certainty. Even if everything else is uncertain and unreliable, knowing exactly what you are going to eat and how and when you are going to eat it can be very reassuring.

“Thirdly, eating disorders don’t like social meals. For individuals with anorexia who are closely monitoring their calorie intake and/or only permit themselves to eat certain food, the prospect of being invited out for a meal can be terrifying and days of anxious thinking can feel inescapable before a social event where food is involved. Individuals with bulimia or binge eating disorder may share these anxieties, or feel scared that their eating will get ‘out of control’; people with bulimia may worry about not being able to be sick after eating. These challenges are horrible to experience, yet they can sometimes help people with eating disorders to realise they need help or that they don’t want to have these feelings any more. During the lockdown, these challenges have disappeared, meaning eating disorders have had more opportunity to go unchallenged and become more entrenched.

“And finally, eating disorders do like social media. In a socially disconnected time, we have all been on our screens and searching for connection on social media. The rise of image-based apps consistently appears in research and clinical practice to have an influence on people’s body image, food choices and exercise behaviour; having more time on these apps can be highly detrimental for people with eating disorders.

“Talking about eating disorders can feel difficult. Those around a person with an eating disorder can feel unsure what to say and can feel worried about making things worse. Every situation is different, but letting someone know that you care about them and are there to listen without judgment can be a helpful starting point.”

“Early intervention is crucial with eating disorders so if you think this could be you or someone you know please do seek the help you need. With the right help and support it is entirely possible to recover from an eating disorder.”

Where to go for support:

BEAT: www.beateatingdisorders.org.uk – with plenty of information on eating disorders and options for online support.

FREED: www.freedfromed.co.uk – specifically tailored for 16-25 years olds.

Anorexia and Bulimia Care: www.anorexiabulimiacare.org.uk – with a telephone helpline and email support.

The Trust’s Eating Disorder Service is here to help and can be accessed through a referral from your GP. We offer services to any adult (18 years or over) who experiences difficulties with eating. https://www.nottinghamshirehealthcare.nhs.uk/eating-disorder-team 

We also have a CAMHS eating disorder service, which assesses and provides treatment for children and young people up to 18 years old with a significant eating disorder. You can be referred to this service by a healthcare or educational professional. Parents/carers and young people can also self-refer for CAMHS support using our online form or by calling 0115 854 2299. https://www.nottinghamshirehealthcare.nhs.uk/camhs-eating-disorder-team

This year we have also launched our FREED service, which is an early intervention service for young adults, aged 18-25 years-old with a first onset of an eating disorder. You can read more about it here: https://www.nottinghamshirehealthcare.nhs.uk/latest-news/trust-launches-new-early-intervention-eating-disorders-service-in-nottinghamshire-3907