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Specialist Treatment for Eating Disorders

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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/

 

Reflections on Body Image

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Last month the Students’ Health Service had a visit from our local MP Stephen Williams, a member of the All Party Parliamentary Group on Body Image. He was interested to hear about our work with students with eating disorders, but we also talked through the challenges of being a student with a condition such as Body Dysmorphic Disorder, and the misuse of body building drugs such as anabolic steroids in some parts of our population.

Negative body image underlies much of the mental health work we do, whether it leads to low self esteem (which can itself lead to depression or self harm), anxiety, social phobia, and more obviously anorexia and bulimia.

The report highlights more positive ways to view ourselves and our bodies, such as the Health At Every Size movement, which focuses on health rather than weight/ Body Mass Index. This movement tries to encourage us to eat healthily and engage in appropriate amounts of physical activity and has been shown to lead to higher levels of self esteem, and better blood pressure and cholesterol levels.

Anecdotally the medical community is certainly becoming increasingly wary of using BMI as a ‘one size fits all’ measure, as we watch the generations increase in height and muscle mass. Even traditional children’s measurement charts have had doubt thrown over them, with a current study from the University of Worcester identifying healthy children as being incorrectly labelled ‘obese or overweight’ by the National Child Measurement Programme. This could then lead to those children developing neuroses about their height and weight in the future, in our ‘weight obsessed society’.

Fixating on a particular weight may not be the best approach for us, and it might be better to take a more holistic approach  with better health being the best outcome measure to aim for; focus on Fitness rather than Fatness, if you like.

If you are worried about your weight/ shape or health, then please do come and see us to talk it through. We are very used to discussing these issues, and I hope you will find us good at listening and keen to help.

 

http://issuu.com/bodyimage/docs/reflections_on_body_image