Eating Disorder Awareness Week 23rd Feb- 1st March 2015

This week is national charity B-eat’s Eating Disorders Awareness Week. B-eat aims to challenge stereotypes and increase understanding for the 6.4% of the adult population who show signs of an eating disorder, as well as their friends and families.

When attempts to diet get out of hand, and the pattern with food impacts on other areas of life, such as friendships, relationships, health, work or study, people are often thought to have an eating disorder. Usually people with eating disorders worry a lot about the physical appearance of their bodies.

Many of those experiencing eating disorders are students. In fact, First Step (Bristol’s primary care eating disorder service) receives more referrals from the Students’ Health Service than any other surgery in the city.

First Step is a free specialist service for people with eating disorders, including anorexia and bulimia. We offer advice and Cognitive Behavioural Therapy (CBT) sessions at Hampton House.

‘Over-evaluation of weight or shape, and their control’

Eating disorders have been characterised by Christopher Fairburn as an over-evaluation of weight or shape and their control. This state of mind is maintained by behaviours such as dieting, bingeing, exercise, purgeing, body checking and avoidance. The associated consequences of these behaviours, such as weight changes, preoccupation and social withdrawal tend to further increase the degree of importance given to body image and the need to control it.

One of the early challenges for people with eating disorders who are doing CBT is to experiment with eating three balanced meals and snacks per day. As other behaviours are reduced and consequences change, body weight and shape usually begin to feel less important. Body image dissatisfaction is also directly addressed in CBT.

So, we must love our bodies…?

One of my early lessons when training as a therapist was not to expect anyone to do anything that I wouldn’t be willing to do myself. I have endeavoured to carry on this ethos throughout my practice.

Last year, on a workshop with about 200 therapists, we were asked to raise our hands if we loved our bodies. One person raised their hand. It wasn’t me. This highlighted to me the danger of thinking of body dissatisfaction as a ‘symptom’ confined only to those with a diagnosable eating disorder.

‘Over-evaluation of weight or shape and their control’ is also not about vanity or a personal failing. It is a reflection of the culture that we live in, where the media links ever changing and increasingly unrealistic ideas of beauty to our fundamental human need for connection and acceptance from others. If everyone believed that they looked fine, and would be loved regardless of appearance, the diet and fashion industry would go under and the economy would take a serious hit.

So, you weren’t designed with an inbuilt immunity to the messages around you? Try not to beat yourself up about it. Neither was I. Feeling displeased with aspects of our appearance is a pretty normal reaction to our current times. People with eating disorders have often had these messages reinforced either subtly or explicitly by events in their lives.

 

Think you might have an eating disorder?

You can talk with your doctor at the Students’ Health Service about your situation and about referral to First Step. Choosing to do treatment is rarely easy, but it might be one of the most important things that you ever do.

 

 

The Succeed Foundation’s Vision is “A World Free From Eating Disorders”

The Succeed Foundation has a simple mission to free the world from eating disorders. Through fundraising and investment in innovative research, and the promotion of ground-breaking evidence-based treatments and preventions, the charity aims to tackle eating disorders in measureable ways.

Every individual with an eating disorder is unique. They will not all respond to the same treatment. In partnership with researchers and clinicians, we develop a broad range of approaches and transform the science into practical tools that sufferers can beneficiate in their daily life as a self-help tool. We want to move from awareness to action.

The Succeed Body Image Programme

 The charity has a wealth of sound scientific research behind it thanks to its association with a number of academic institutions; including the University of the West of England; their Centre for Appearance Research is monitoring the Body Image programme in the UK, headed by research fellow and Doctor Phillippa Diedrichs.

The Succeed Body Image Programme (SBIP) is a cognitive dissonance-based intervention.

Dissonance theory suggests that if individuals act in ways that contradict their beliefs then they will typically change their beliefs to align with these actions. The Succeed Body Image Programme therefore, actively engages its participants in of a series of verbal, written and behavioural exercises that critique the unrealistic, ultra-thin-ideal standard of female beauty.

The SBIP is designed to help individuals across all spectrums to establish and maintain a positive body image. Using highly interactive, peer-led, small groups, it is a two-day, intervention program designed by experts and implemented through trained peer leaders on college campuses throughout the UK.  As the first peer-led, evidence-based eating disorders prevention program shown to truly work, The Body Image Program does not specifically focus on eating disorders; rather, it emphasizes creating and reaffirming positive and healthy personal body image through a variety of structured discussions, activities, and exercises. The phenomenal program has a proven track record – not only on improving body image issues, but on encouraging healthy confrontation and communication skills as well. It is the first scientifically supported evidence-based eating disorders prevention program designed.

Fat Talk Free

Fat Talk describes all of the statements made in everyday conversation that reinforce the thin ideal and contribute to women’s dissatisfaction with their bodies. We want to raise the nation’s consciousness about the danger of fat talk and our initiative is to eliminate that kind of talk from our lives and stop appearances critiques and accept the way we are.

This can be achieved by simply changing our conversation.

Our Success depends on collaboration and monitoring our work we want to focus in what works.

to access the support contact the Succeed Foundation Directly

www.succeedfoundation.org

Carers may find this link helpful too;

http://www.succeedfoundation.org/work/skillsforcarers

 

 

Self-injury awareness day

March 1st marks ‘self-injury awareness day’, a global movement signified by the wearing of an orange ribbon, which aims to increase the awareness of self-injury and challenge many of the misconceptions surrounding this.

What is self-injury? Self-injury, also known as ‘self-harm’ or ‘cutting’, describes how someone intentionally inflicts physical injury to their own body without any suicidal intent. It can take on any form, whether it is cutting, head banging, hair pulling, burning, recreational drug or alcohol abuse, non-lethal drug overdoses or taking excessive risks to personal safety.  It affects people regardless of age, gender or ethnicity, although it is known to be particularly common in younger people.  Due to the shame and self-hatred often associated with self-harm, many sufferers will go to great lengths to hide scars, making it difficult to identify those needing help, and also to estimate how prevalent this is.  Research suggests that at least ten percent of 15-16 year olds have self-harmed at some point in their lives.

Why do people self-injure? Self-injury is recognised as a coping mechanism for overwhelming emotional distress relating to current traumas or difficulties from the past.  The distress might be grief, anger, loneliness, emptiness, anxiety or self-hatred and sufferers may describe how the ‘real pain’ of self-harm numbs their emotional turmoil, and in some cases acts as a way of avoiding attempting suicide. Over time self-injury might become a person’s ordinary response to everyday stressors, sometimes increasing the frequency and severity of injury.

What to do if you are self-harming? GPs are well placed to provide confidential advice and support, put you in touch with local and national self- injury organisations (see below) and check for any underlying depression/ anxiety or eating disorder symptoms. The Student Counselling Service is also somewhere safe and non judgmental to go to.

Is there treatment for self-harm?  Yes there can be, and the aim of treatment may be to both minimise harm from acts of self-injury and to help the sufferer find new coping mechanisms and develop problem-solving skills.  Strategies to minimise harm include recognising triggers for self-injury, learning less dangerous ways/locations for cutting, carrying dressings and understanding the dangers associated with certain medications. However, stopping the self harm is not necessarily the aim of treatment, which may be more directed towards underlying issues.

Talking therapy (e.g. cognitive behavioural therapy/ dialectical behavioural therapy), creative therapy, support networks and the promotion of the development of self-help skills all help in supporting a sufferer to learn new coping mechanisms.  If self-harm is part of an underlying mental health illness, specific treatment for that condition may be warranted.

I am worried that my friend is self-harming?  It is upsetting to discover a friend is self-harming but it is important to provide non-judgmental support and acceptance, acknowledging that they are distressed. Encouraging them to talk to health care professionals or contact a local support group will show them that you care. Asking a person to stop self-harming will not help the situation as you are asking them to take away their coping strategy.

Will I/my friend get better?  There are no quick fixes for self-harm, but by getting a person the right support and treatment, they will start to learn new ways to deal with their emotional distress.

References/ literature available:

 

  1. Life Signs Self-Injury Fact Sheet for Health Care Workers- www.lifesigns.org.uk
  2. Information resource pack- Bristol Crisis Service for Women –www.selfinjurysupport.org.uk
  3. NHS self injury fact sheet- http://www.nhs.uk/conditions/self-injury/pages/introduction.aspx
  4. MIND- ‘understanding self-harm’- http://www.mind.org.uk

 

Support Groups

Self Injury Self Help- support groups for women and men who self-injure in the Bristol area. www.sishbristol.org.uk

TESS- Bristol Crisis Support for Women, text or email support service for girls and women who self-injure- up to age 25.  www.selfinjurysupport.org.uk, or text 07800472908

MIND- for information sheets/ advice about local resources- www.mind.org.uk

 

 

Eating Disorders Awareness Week; 24 February 2014.

Beat, the Eating Disorders Charity, is running a national awareness week called ‘Sock it to Eating Disorders’ this week. It is a light hearted way to bring people together, do a bit of fundraising, and raise the profile of a devastating group of conditions.

As a GP at Students’ Health I deal with such conditions most weeks, and one can become too focussed on the medical aspects, so it’s good to stop and think occasionally about what these illnesses mean to the people who suffer from them, and their friends and families. And nothing brings that home like the Beat “Lasting Memories” page, which reminded me of the immense impact that such a potentially fatal condition can have.

What a long list of lost young people, mainly women, and so many aged around 18-20, like the students I look after every day. The messages left by family and friends are heart breaking, and this online wall of memorials is a sobering reminder of why I and my colleagues spend so much time and energy improving and developing local services for Eating Disorders in Bristol.

We have made it so much easier in the last 2 or 3 years to get help that hopefully such memorials will become rare, and fewer families will be turned upside down by such tragic deaths.

Here at Students’ Health Service we really do want to help you if you have, or think you might have, an eating disorder, so please do come and see any of the GPs, and talk about referral onto First Step, the new Bristol-wide community based service for assessment and therapy. First Step is led by a clinical psychologist, and you can have your appointment in the same building as the GP practice, no need to go to hospital. The average waiting time for an appointment with them is about 3 weeks, not long at all, so don’t hesitate if you are suffering… come and talk to us.

 

http://www.b-eat.co.uk/support-us/get-involved/lasting-memories/

 

http://www.awp.nhs.uk/news-publications/trust-news/2013/july/another-step-forward-in-eating-disorders-support-for-bristol/

Specialist Treatment for Eating Disorders

Despite references to eating disorders in texts dating from the time of the ancient Pharoes, and even a mention in Shakespeare’s Measure for Measure, the development of effective treatments has been slow. 

However, a treatment called cognitive behavioural therapy (CBT) is now yielding results.   Indeed, as a result of research demonstrating its effectiveness, CBT is now recommended as the first line treatment for people who have not responded to a self-help approach.  

 At the heart of CBT lies the deceptively simple idea that eating disorders are driven by an irrational fear of uncontrollable weight gain.  This fear leading to counterproductive forms of dieting which, whilst intended to prevent weight gain, often have the opposite effect and thereby cause more distress and further reinforce the original fear.  CBT tackles the belief that strict diets are the only way to prevent weight gain by encouraging clients to see what really happens when they give up dieting and take up healthy exercise.

 For many with eating disorders the idea of consuming between 1,900 and 2500 kilocalories a day just to see what happens is a terrifying prospect and indeed the treatment is not for the faint-hearted.  But what most people find is that their body burns the energy they consume and their weight remains within healthy limits. 

 Treatment therefore provides a safe and supportive environment in which to take the plunge, give up dieting and see what happens.  And, at the end of six months treatment, if people don’t like the results of their experiment in normal eating, then they are free to return to the diets they were using beforehand.  

 Evidence suggests that about three quarters of people who complete the treatment find it useful.  Whilst this is a promising start, the quest to refine the treatment and thereby improve recovery rates goes on.

Doing CBT is a substantial commitment.  It takes time, energy, hard work, determination, perseverance and courage.  As I tell my clients, “you have to do all the hard work yourself”.  But if living with an eating disorder is ruining your life then it might be worth considering if treatment could be right for you.  If you’d like to talk to someone about whether CBT could help you overcome an eating disorder your GP will be happy to discuss it with you and to make a referral for treatment if necessary.

http://www.bristol.ac.uk/students-health/services/eating-disorders/

 

The Olympic Games and the Untold Legacy

This blog is a personal viewpoint from the service’s eating disorders specialist…

Will Devlin, clinical psychologist and specialist in eating disorders for the University of Bristol, looks almost sheepish as he describes his mixed feelings about the great sporting achievements we watched with pride just a few months ago:

“…Don’t get me wrong,” he says, “there’s no doubt that the Olympic Games were a proud moment in the history of the country and many of us have been inspired by the achievements of athletes like Jessica Ennis, Jonnie Peacock, and Anthony Joshua.

“But what I can’t help wondering is what effect images of these almost superhuman, super lean, super muscled athletes is having on people who are unhappy with their bodies.  Very few of us have the genetic make up, let alone the motivation, dedication, sponsorship, training and time to develop the kind of body which we’ve seen so much of during the UK’s summer of sport.

“It’s one thing to be inspired to get fit by the Olympics, even I’ve been inspired to get back to the gym.  But the fact is,” Will says with a smile, patting his tummy, “like most of the population I’ll never have the body of an Olympian however hard I try! 

His fear is that amidst the pride and positive social change inspired by the Olympics, one untold legacy will be an increase in the number of people at risk of eating disorders: “I worry that if more of us end up unhappy with our bodies, then more of us might resort to unhealthy attempts to shape up as we aspire to a rippling six-pack, tight buns or super-pert breasts.

It’s not a popular view, that inspiring a nation with acts of sporting heroism could actually be bad for some people, but as I listen to Will’s concerns I do see his point: “Condemnation is growing on all sides at the use of size zero models on the catwalk, and Kate Moss was roundly criticized for endorsing starvation when she said, ‘nothing tastes as good as skinny feels’ …but it’s not easy to say that super lean athletes might have just the same effect as emaciated supermodels on those of us who want the perfect body but simply can’t have it.  “And don’t forget,” Will says, “the athletes themselves face these same pressures, eating disorders are rife amongst sports men and women, in fact it is estimated that more than one in 10 elite athletes may have an eating disorder.”

Will’s comments get me thinking about this untold legacy, and what some of the unintended outcomes of our summer of sport might be.  There’s no doubt that the efforts of Team GB and our paralympian heroes have the power to inspire a generation, but perhaps it’s also important to recognize that the pursuit of athletic success and the body beautiful may also have its downsides.

Will works at the University’s Student Health Service.  If you think you might have an eating disorder, talking to one of the service’s GPs will ensure you get access to the specialist help you need.

 

Mental Wellbeing Week (20/02/12)

Look around you.

Wherever you are, whatever you are doing,  1 in 6 of the people around you will be struggling with a mental health problem at this time. 1 in 4 will have a problem at some time in their lives. Maybe it’s you, maybe it’s your flatmate or friend, partner or another student on your course.

The important thing is to know how and when to get help if you or your friends need it, or advice if you’re not sure what to do.

At the Students’ Health Service 1 in 4 of our doctors’ consultations is for a mental health problem.

Students, like anyone, can develop anxiety, depression, social phobia, obsessive compulsive disorder, eating disorders, bipolar and schizophrenic disorders, as well as rarer problems such as body dysmorphic disorder and borderline personality disorder. (For more information see www.patient.co.uk )

If you are thinking of harming yourself, we want to help you.
If you can’t leave the house because of fear or low mood, we would like to hear from you.
If you think that life’s not worth living please talk to us.

If you know someone who is suffering, please encourage them to make an appointment with a GP or bring them in yourself. We don’t judge, we listen. We really want to help you.
This is what we do, this is why we are here.

It is time we as a society started talking more openly about mental health issues and how to deal with them positively.
Less stigma would lead to quicker access to help and better long term health.
So look around you… 1 in 6 of us is suffering.

Can you act today to help that person feel better?

Talk to the Students’ Health Service or Student Counselling Service for guidance, support or treatment.

Mental Wellbeing Week starts 20th February, at locations around the precinct, especially between Senate House and the Library, with free activities and much more.

 Students’ Health Service; 0117 3302720

Student Counselling Service

Other good sources of info;

Mind

Living Life to the Full  (depression advice)

Moodgym  (depression advice)

b-eat  (eating disorders information)

Bipolar UK  (bipolar disorder support)