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Dr Linda Craig: On Eating Disorders

eatingThe first week of March is Eating Disorders Awareness Week. Perhaps apt timing as mental health services across the United Kingdom are reporting a higher rate and severity of Eating Disorder referrals than ever before.

Eating Disorders provoke a great deal of anxiety. For sufferers. For loved ones. For services. If you are concerned that you or someone you care about might have an eating disorder, it can be hard to know what to do, what to say, how to ask for help, or even whether there is anything wrong.

Before talking to someone you are concerned about, it is helpful to be informed about Eating Disorders. While Anorexia and Bulimia are words you might have heard, there are in fact many different types of eating disorder. These include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder (ARFID), and Other Specified Feeding or Eating Disorder (OSFED).  All of these are serious mental illnesses requiring support, understanding, and treatment. They affect people of all genders, ethnicities, and cultural backgrounds.

It is common to assume that Eating Disorders are all about food. Often the first things that cause concern are significant weight loss or unusual behaviour around food. However, while it may look on the surface as though food is the problem, the reality is that people with eating disorders have come to use eating behaviour as a way to cope with difficult feelings or situations. It is helpful to keep this in mind as you approach a conversation with someone you think may be struggling with an eating disorder.

The types of eating behaviours that are common in individuals with eating disorders include limiting the amount of food eaten, eating a large amount of food all at once, getting rid of food after eating, or a combination. It is rare for these behaviours to start suddenly. More commonly they begin gradually and become more frequent and severe as the eating disorder develops.

This can be quite alarming for loved ones as the behaviour can appear chaotic or dangerous. Conversely, the individual may feel that they are in more control of their emotions and life. This can make it difficult for the sufferer to recognise that they are unwell and can lead to reluctance to talk about it with concerned friends and family.

Eating Disorders and secrecy go hand in hand. Sufferers fear judgement and loss of control. Often the person struggling with the eating disorder may not even recognise that they have a problem with food.  All of these issues can make it difficult to ask for help or to know how to bring up your concerns.  But be reassured, the majority of people who have recovered from an Eating Disorder look back and recognise that opening up about their eating problem was helpful, even if they did not feel that way at the time.

If you think you, or someone you care about, may have an eating disorder, it is important to encourage them to get support as soon as possible. The BEAT website has excellent resources for sufferers, friends, family, schools, and employers. Although it may feel difficult, starting the conversation about the eating problem is the first step to recovery.

If you think you might have an eating disorder, talk to someone you trust, ask for help, and share the feelings or experiences you are struggling with.

If you are concerned about someone else, take a deep breath and start the conversation. Choose a time when you are both calm and unlikely to be interrupted. Although you are likely to have noticed a number of things, avoid listing your concerns.  Remember that eating disorders are less about food than they are about feelings, so it might be better to start by asking the person about how they are doing more generally. Approach the conversation with empathy. If someone is struggling with an eating disorder, it is likely that their mental health is fragile. Encourage them to talk to someone that they do feel safe and comfortable with, even if that person is not you.

Remember that although eating disorders are serious, they can be treated and people can recover.

Dr. Linda Craig


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