Tag Archives: bulimia

Survey reveals referral rates need to improve

As part of Eating Disorders Awareness Week, Beat, the UK’s leading eating disorders charity, asked nearly 1700 people, (1420 of which had an eating disorder, the others knew someone close to them with an eating disorder) about their experience with GPs.

I took part in this survey to get my voice heard and it seems many people feel the same way I do…

The survey revealed that half of sufferers rated their experience as “poor” or “very poor”. Of people who would have benefitted from immediate psychological support 3 in 10 were not referred to specialised services.

More than half of the sufferers felt their GP didn’t understand them and only one third (34%) thought their doctor knew how to help them.

Only 20% of patients came away from their appointment with information about eating disorders and services that could help them.

It will have taken many of these people months if not years to have reached the point of asking for help, the courage to make the appointment, get through the door and start talking about their problem would have taken such courage, to be turned away with nothing is very worrying.



Why is early referral so important? Simple – recovery rates improve.

Anorexia has the highest mortality rate of all mental illnesses and currently, of those who live, many remain chronically ill. The sooner someone is referred for specialist support the higher their chances of full recovery.

It is important to work out why these vital referrals aren’t happening…

I do not want to come across as GP bashing, there is no way that some of the most caring people in our society are deliberately denying people the support and treatment they need. Andrew Radford, Beat’s Chief executive believes medical students, hoping to become GPs, need more training. I went to medical school, the shear volumes of information you need to absorb is vast. Maybe it’s not just about “recognising the signs and symptoms” as Mr Radford put it, maybe there’s more to it.

When I went to the GP as a 15 year old, I was not referred. I was not given any information. I did not receive the help I needed. It was hard enough just getting through the door but there is no way of turning back the clock to find out why. Maybe I didn’t explain myself well enough? Maybe there should be more eduction in schools so I was more equipped when I went to my GP?

My experience was 20 years ago but the Beat survey reveals this is still happening today. Is it the “old school” doctors who aren’t keeping up to date with training? Do newer GPs need more training? Are GPs/secondary services using out-dated/overly stringent criteria as referral criteria e.g. BMI? Is there an inaccurately held belief that if you refer someone there’ll develop an eating disorder where there wasn’t one? Are GPs so overworked, although they know the signs and symptoms to looks out for, they miss them? Do they think, “if it’s that serious they’ll come back”? Do patients go with too many problems and the GPs are distracted by other issues they consider more important? Do doctors not have enough times to refer people? Are doctors unaware of what secondary care is available? Do GPs think the secondary care is inappropriate/unhelpful? Is the mental health stigma still getting in the way?

We really need to get to the bottom of what is going wrong in the consultations where people are not getting what they need.

Perhaps some positive news is that once some of the sufferers swapped GPs (as nearly 1 in 6 did) they reported receiving the help they needed. When I approached a GP in my 20s I’m very glad to say I’ve had much better support. By this time I was a lot sicker, my GP had to persuade me to access the secondary and then tertiary services, she was excellent. Since then, I’ve moved a couple of times and each time, I’ve had a mixed experience with GPs. It’s been very difficult to find what I need but each time, with some perseverance I’ve found a GP with the right skills and experience to support me. Maybe I am a tricky/difficult patient but I’m definitely not alone with these feelings as the Beat research reveals.


Somehow we need to make sure that every single one of the 725,000 people in the U.K. affected by an eating disorder gets the support and treatment they need to recover.

Please share your thoughts in the comments section below.

For more information:

Independent.co.uk

Full results of Beat survey

9 truths #WeDoAct

WEDAD

2nd June 2016 is the first World Eating Disorders Action Day. “They” have put together “9 truths about eating disorders” so I thought I’d share my reflections on each of them:

  1. Many people with eating disorders look healthy, yet may be extremely ill – this prevents people getting the help they need for a variety of reasons. I looked “normal” so I didn’t think people would believe me if I said how much I struggled with food or how little I ate. I also struggled to be around people who did look ill as I didn’t think I belonged there or deserved help as I wasn’t “ill enough”. This misconception needs to be broken down in order for people to receive the help they need.
  2. Families are not to blame and can be the patients’ and providers’ best allies in treatment – I know my family have found it hard but they have stuck by me through all sorts of mess. Some people are not as fortunate as me. Sometimes guilt can be an unhelpful barrier to working through the difficulties.
  3. An eating disorder diagnosis is a health crisis that disrupts personal and family functioning – when I first asked for help as a teenager I did not receive a diagnosis, maybe it would have been helpful to have addressed it square on at that point. By the time I did receive a diagnosis my functioning was already disrupted but I was in denial as to how unwell I’d become and it didn’t seem real
  4. Eating disorders are not choices but serious biologically influenced illnesses  in truth, at times, I perpetuated my eating disorder by making the wrong choices but I was not being deliberately awkward or manipulative; my mind was sick. Some people get caught up in the “pro-ana/mia” influences but no-one chooses to be caught in the swirling hell that is a true eating disorder.
  5. Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations and socio-economic statuses – I was one of typical ones at onset a female teenager but I’ve met males and females of all ages from the UK and abroad. All affected differently, all requiring unique understanding but all struggling with the same basic issues – eating disorders do not discriminate.
  6. Eating disorders carry an increased risk of both suicide and medical complications – alongside a diagnosis of depression my life has been at serious risk of ending a number of times. Even in recovery I continue to have to come to terms with the long term medical complications.
  7. Genes and environment play important roles in the development of eating disorders – it has been shown that a genetic predisposition may be present but as with all illnesses, how the individual interacts with their environment will play an important role. Some people say stick thin models are a bad influence, others say constant “diet talk” is unhelpful. I think talking from a young age about how to look after our mental/emotional well-being and how to be compassionate to ourselves and others is vital – whether buzz words such as “body confidence” are used or not, just raising the issues so it can be talked about openly will break down the taboo and stigma.
  8. Genes alone do not predict who will develop eating disorders – there may be no hard and fast way of predicting eating disorders but this does not mean they cannot be prevented. Raising awareness and education will enable people of all ages to spot early signs and seek help before developing a full-blown eating disorder.
  9. Full recovery from an eating disorder is possible. Early detection and intervention are possibleI did not receive the early help required and only received the right help after years within mental health services but this does not need to be everyone’s story. I am proof that even over rocky road, recovery is possible.

Resources:

World Eating Disorders Day

B-eat

Anorexia and Bulimia Care

Eating Disorders

EDAW_2016_logo

Eating Disorders Awareness Week this year is 22nd– 28th February. A recent survey showed that as many as 6.4% of adults in the UK show symptoms of an eating disorder (a similar prevalence to diabetes). Most eating disorders start in adolescence although children as young as 6 have been diagnosed with anorexia and older adults can also develop symptoms. It is unfortunate that outside adolescence eating disorders are more likely to be misdiagnosed.

There is a belief that eating disorders are all about a desire to be thin, and while this can be a central issue there is a lot more to understand. The typical picture may be an emaciated girl looking at herself for hours in the mirror seeing an obese girl looking back. But what about the woman who dreads the office party because she’ll have to calculate the calories in every hors d’oeuvre that’s passed around? How about the man who dreads colleagues’ birthdays because doughnuts will be brought in, if he has one, the overwhelming guilt will lead him to purge it? Or the lorry driver getting behind with his deliveries because the urge to eat cannot be resisted and he has to stop more frequently than the schedule allows? People with eating disorders often lead hidden and secretive lives where even close friends and family are unaware of the depths of the despair felt by the suffering individual. Most of the disease is in the mind but even the symptoms that are difficult to hide e.g. extremely low body weight or excessive exercise can often be brushed off as an extension of the norm or extreme healthiness! For me, I wanted to lose weight because I wanted to disappear. I was under the misconception that I could control my emotions if I controlled my food. I thought if I could restrict my food, I could avoid painful emotions. Unfortunately, the more I restricted, I was achieving what I wanted, to  be smaller but my emotions just seemed to get more unbearable.

Figures now say that 45% people who suffer with anorexia and bulimia will fully recover; this figure will only improve with greater awareness, earlier diagnosis and better treatment option. This is not a promotional blog for better funding but I fear the recent mental health funding cuts are going to have a negative impact on outcomes for people with eating disorders.

Anorexia is the number one killer within the mental health world, from medical complications and from suicide. The low mood associated with eating disorders cannot be underestimated, it perpetuates the downwards spiral of physical and mental health that prevents the sufferer taking advantage of the support on offer. Someone with anorexia will restrict their food intake and may also exercise excessively in order to lose weight. Someone will suffer with anorexia for an average of 8 years and with bulimia for an average of 5 years. This is too long and often, permanent damage will have been done. Hormonal imbalances are often long standing. The initially menstrual irregularities can lead to difficulties conceiving and problems in pregnancy and childbirth. Even though I’m in recovery, my fear is that I’ve done myself long term damage.

Awareness of the medical complication of binge eating disorder is increasing. Eating too much of the wrong foods can lead to obesity which is the leading risk factor for heart disease, diabetes, stokes, joint disorders and many cancers. This is not just laziness or greediness, it is a compulsion, an uncontrollable urge to consume large quantities of food, often followed by feelings of guilt and shame. Once the cycle has been kicked off, by a traumatic life event, low self-esteem, loneliness, etc., the disorder is perpetuated by blood sugar levels rising rapidly, followed by insulin, cortisol and adrenaline fighting to control the effects on the body. Blood sugar levels crash and false messages are then sent to the brain, the cravings for more unnecessary foods continue. The strain put on organs can be catastrophic. People struggling with binge eating disorder can hide their secret for many years, blaming themselves, fearing consequences and judgements if they share their experiences.

Some with bulimia is caught in cycles of binging (rapidly ingesting large quantities of food in a short space of time) and purging (vomiting or using laxative and diuretics). The purging associated with bulimia perhaps causes some of the most alarming medical complications. Suffers may damage their oesophagus or bowel. Chronic dehydration from vomiting and laxative and diuretic abuse and mineral imbalances can lead to kidney damage/failure and irregularities in how the heart functions.

Instead, we are more likely to see someone who uses food, or the control of food to manage their emotions or to fill a void in their life. It may not seem that serious but no-one can know what’s really going on and things can quickly spiral out of control. So, how can we help?

  1. Be a friend – just ask them how they are, and mean it. Someone doesn’t need to talk about what they did or didn’t eat last night but saying they’re feeling a little lonely or a bit low at the moment might be the first step towards accepting help. Listen to what they say.
  2. Don’t comment in public – commenting on someone’s weight or what they’re eating/not eating in public is really insensitive. If you’re concerned about a change in weight or eating habit, talk to them in private, say you’re concerned and offer them an opportunity to talk and listen to them but don’t force the issue.
  3. Offer alternatives – socialising in our culture often revolves around food – if you suspect someone’s struggling, consider alternatives…bowling, watching a film/TV, playing games/board games or getting crafty (making cards, jewellery, knitting etc) together. If food is necessary, make it part of the event rather than the main focus.

Think about this…if you have 300 friends on Facebook,

  • 20 of them will have an eating disorder,
    • 10 will have symptoms serious enough to warrant a diagnosis of anorexia or bulimia.
      • One of them will die prematurely from complications.

By raising awareness, I’m hoping we can reduce these figures.

Just a couple of last points I want to make.

To people who are struggle…

You might be in denial but deep down, you know things need to change and you know you need help – I’m not going to pretend it’s easy, it’s a long and tough road but it is worth it, please, please, show yourself some compassion and give it a go, recovery is possible, life is there for the taking, you can do it.

To friends and relatives…

I know you will be in pain watching your loved one but it’s important to remember that only the individual can ask for help and follow through with recovery, no-one can do it for them or force them through it. You can be there for them but it’s also really important to look after yourself.