Eating Disorders Awareness Week 2016 #EDAW16 by Dr Hugh Herzig

Did you know that next week 22nd – 29th Feb is Eating Disorders Awareness Week? Perhaps you already feel bombarded by news bulletins about the rising incidence of EDs… or how these days younger and younger people are affected. So why the need to be made more aware of EDs?

At Student Health we have good reasons to want to raise awareness of EDs:
• Eating disorders are not rare and exotic illnesses. They are common in the UK population, particularly so in adolescence and early adult years, and particularly so in student populations.
• They have a profound effect upon mental health, eroding well being and self esteem, so that nothing the sufferer does is ever good enough.
• They have serious physical effects on pretty much every biological system of the body such as skin and dental damage, gastrointestinal and heart problems, bone marrow and liver damage, hormone suppression and hastening the onset of osteoporosis. In fact, EDs lead to greater mortality than any other group of mental illnesses.
• Living with an ED can make life very hard indeed… friendships and social activities are deprioritised, leading to people feeling more and more isolated, anxious and depressed.
• Concentration and stamina can be much affected, so the sufferer cannot perform physically and academically to her/his potential
• Family and friends often don’t know what to say, or worry they will cause upset or have their head bitten off if they express their concern
• Some of our patients at Student Health get so unwell that they need to take time out from university. For those such as medics, vets and dentists whose degrees lead on to accreditation with a national professional body, their ED may make them unfit to practice as a registered professional.

ED Awareness week may provide an opportunity to break the taboo that surrounds EDs.

You may feel able to bring up this sensitive topic with that friend you’ve been worrying about, but who seems always to want to keep herself to herself. It is likely that doing so will help her… even if she seems not to appreciate it at the time.

If you have severe eating and weight anxieties yourself, this week may be the time to tell someone a bit about it, allow a friend to support you, maybe even seek help from your doctor. All the staff at Student Health are experienced in helping people with EDs, and in Bristol we have good services to treat eating disorders, including the First Step service which offers psychological treatments in our very own Health Centre

We are here to help YOU!

LGBT+ and your health; a student writes…

There are a lot of ways people like me – LGBT+ people – struggle in life due to society’s stigmatisation of us. Doctors and healthcare services, which exist to care for us, as for everyone, are invaluable and essential to the poor health that arises from these struggles, for complex reasons, so it is very important that healthcare challenges received ideas. The Student Health Service kindly invited me to write a blog on LGBT+ peoples’ issues relating to healthcare, which is definitely a really encouraging thing. I realised it was a difficult topic to be able to cover fully, but I’ve tried to bring together thoughts, evidence and memories that will hopefully be illuminating.

Firstly from my own life, I thought about the way being queer has affected me in terms of my health and the way I access healthcare. Lots of complicated thoughts came to my mind.

I’ve thought about the way, for example, in which fear of rejection for my orientation has prevented me from being ‘out’ to any therapist I’ve had. The effects of not being straight on my mental health have also been very strong, including the damaging shame and anxiety created by realising that I was not straight, as well as the issues it has created in my friendships and family relationships, including fear of rejection.

One time from my life also really stands out to me – I actually thought of when I was younger, of my experiences to do with gender expectations, and not fitting them. I am a woman, and someone who’s seen by others as a woman. However, as a teenager I developed facial hair- I didn’t realise that the feeling of shame about this supposed fault with me and my body, was actually a false shame put upon me from outside, and I didn’t realise I could push back with my own narrative and ideas about how my body should be – perhaps if the doctors I saw about this problem had questioned whether it was really something by necessity negative, I wouldn’t have been ashamed for so long. As I got older I realised that society has strict binary definitions of male and female that are so ingrained and hegemonic it’s easy for many of us to barely notice them. This dictates as wrong, and somehow lesser, those, for example, whose bodies don’t match these definitions. I am cisgender (I understand myself as a woman, and my body’s sex is considered as female), so it has been much easier for me that for those who are transgender, whom I know this gender binary affects very strongly.

How then can doctors help? How could my interactions with doctors have gone better? I’m not sure, and I think it’s a difficult task for doctors that want to help, to do so. I suppose two things to think of are the way in which our health is looked after specifically in relation to our gender, sex, sexuality etc, and of the way in which our general health is looked after, aside from these issues. I thought  that even if doctors simply take a stance of providing a respite from oppressive ideas, actively countering dominant ideas about LGBTQ+ people, that would be a very helpful thing.

I’ve only been able to speak about my own particular experiences here, so I’ve looked for examples and information to shed light on other ways in which LGBT+ affects people’s health. One thing that affects LGBTQ+ people disproportionately is mental ill health, and this was reflected in pretty much every piece of research I found.

The NUS research ‘Education Beyond the Straight and Narrow’ notes that Chakraborty “affirms that discrimination can be analysed as a predictor of mental disorders.”

The research also tells us that “42 per cent of LGBT respondents to the Youth Chances28 survey reported having experienced depression or anxiety, compared to 29 per cent of non-LGBT respondents”, and that this is linked to experiences of discrimination and harassment.

This NUS research talked about the very high rates of ill health, depression and anxiety for Trans students in particular, and this was strongly related to high levels of transphobia, unacceptably long waits for provision of treatment to transition, and stress and discomfort about seeing medical professionals due to dismissive or phobic attitudes.

I have also read, although not in this research in particular, about asexual people’s (people who do not or experience little sexual attraction) experiences of healthcare, including asexual identities being seen as problems or illnesses.

LGB+(Lesbian, gay, bi+) and T+ (Trans+) students were all more likely to consider dropping out than straight and cisgender students, with T+ students being proportionally most likely to consider dropping out due to health concerns, while LGB+ students being proportionally most likely to consider dropping out due to feeling like they don’t fit in (although both overlap significantly). This data reflects the complex nature of reality even more in that black LGB+ students, for example, had a higher likelihood of considering dropping out, suggesting lower levels of wellbeing that need to be considered.

Research also noted that mental health has an evidenced effect on physical health. This must be compounded by the fact that LGBT+ people report attending doctors less, or feeling put off or distressed by negative reactions by doctors, and this can be anywhere, from GP surgeries, to hospital emergency care.

So, in the end it seems to me that healthcare services often fail LGBT+ people if they have taken in societal biases and left them unchallenged, but I think they could definitely help in our lives if they are positive –because they’re at that central, delicate position in which people are going for help.

If you’re LGBT+, and uncomfortable seeing a doctor about something or uncomfortable to talk about something because you’re scared of being looked down upon, it can be hard. I thought that this quote (from the NUS research mentioned previously) was illuminating, even if it’s not directly related to health:

“I’ve had negative experiences or responses to being trans in every university building I’ve been in, including the students’ union (SU), but only in the SU have I ever been listened to about them and those experiences dealt with. So that makes me feel safer there than anywhere else.”

For university support you can contact;

For medical students;




Five Ways to Wellbeing at Exam Time

Exam time is a difficult time for everyone, though for some more than others.

So it’s important to remember that you can do things to help yourself remain calm and in control, throughout those weeks when your adrenaline can be flowing a little more rapidly.


Here are some evidence based ways that we can look after our mental health, a bit like a ‘5 a day for the mind and soul’.


  1. Keep Connected; stay in touch with the people around you, the people who care about you and who can support you in life
  2. Be active; go for a walk/ run/ swim, breathe in some fresh air. Exercise on the Downs. Release that adrenaline in a positive way
  3. Take Notice; notice the world around you, the changing seasons, walk around and observe what is happening. Be aware of your feelings
  4. Keep learning; learning new things can be fun if you make time for it, and for yourself too
  5. Give; do something nice for someone else. Cook a meal/ help out your community/ volunteer. It is scientifically proven that being nice to others releases a happy hormone (oxytocin) and makes you feel better too!


However, if doing all these things isn’t enough to support you through a difficult time then remember we are here to help, as are the Counselling service, and other services in the university, like the Multifaith Chaplaincy.

It is normal for exam time to be stressful, that adrenaline can help focus the mind and bring your performance up a notch, but if it feels out of control, and overwhelming then please ask for help sooner rather than later.

Good Luck!

Eating Your Heart Out

Many of us eat chocolate when we want a treat, or when we’re having a bad day – and where’s the harm in that? 


We don’t just eat for health; the fact is eating is one of life’s pleasures.  There’s no reason why we shouldn’t enjoy food or use it now and then to lift our spirits: as the saying goes, “all things in moderation.” The difficulty comes when comfort eating becomes our main way of dealing with upset. 


Comfort eating provides a distraction from difficult thoughts and negative emotions but when it’s our only way of coping it can easily get out of hand: a bar of chocolate or a slice of toast can be the trigger for a full on binge.  Many people who overeat like this say that whilst they’re bingeing everything else seems to stop: they feel in a world of their own where difficult thoughts and feelings can’t touch them.  It’s only afterwards that the distress returns, only when it does it’s made worse by uncomfortable bloating, concerns about weight gain, frustration, guilt and shame. 


Such negative feelings in the aftermath of a binge can erode self esteem and increase vulnerability to future stresses and from here it’s easy to see how a vicious cycle can develop: upset leading to binge eating and binge eating leading to greater vulnerability to future upset so making binge eating ever more likely.  Many specialists see such vicious cycles as being at the heart of eating disorders.


There’s no harm in eating for comfort now and then, but if you find yourself trapped in the vicious cycle then it can be useful to know that there are ways of breaking out.  Whilst many people can break out on their own and with the support of friends and family, some people will need professional help. 


If you are struggling to manage disordered eating then perhaps the Student’s Health Service can help.  The Service offers specialist support for people with eating disorders and many students have used it to turn their lives around.  If you think you might need specialist help then the first step is a visit to your doctor.  Whilst it can be embarrassing to talk about such problems, all our doctors are fully trained and highly experienced in working with people battling eating disorders.   they may refer you to the practice’s psychologist or on to a more specialised doctor. There’s no shame in seeking help: rest assured you’ll be treated in confidence, with respect and sensitivity.