Eating Disorders & Covid 19

The Phipps Family have circulated this opinion piece about eating disorders during isolating times.

Do YOU think that it is harder or easier to live with eating distress when you are isolated at home with your family?

What ELSE can you tell us about your eating disorder thinking right now.
Here is what some people might be thinking. What can you do to help them; if you have these thoughts, how can you soothe yourself

“If there is a shortage of food in the shops then I’m not worthy to eat any of the food within the family/to take food from the shops which people like nurses and doctors need more than I do.”

“If I can’t get the food that I need then I won’t be able to eat anything, so I won’t eat!”

“With you all at home, I can’t do my secret exercise routine as there is no space to do this. How am I supposed to manage?”

“How can I make you understand that the alternative you have offered is not an alternative in my mind?”

“How, if I can’t get out and run my normal 15km each day am I going to be able to eat my second snack?!”

“If the gym is closed and I can’t do my normal work-out then I haven’t earnt the right to eat so I can’t.”

“Having you at home means I can’t skip my meals.”

“How can I cope with eating if with everyone at home I can’t then secretly purge?”

“There are too many people at home now everyone has come back home to be together because of the virus. There is no way I can eat with so many pairs of eyes on me, everyone will be judging me”

“I’m sure that all my peers are doing more exercise than I am as ‘Judith’ has a treadmill at home and ‘Daniel’ keeps posting videos of using his rowing machine. I’m so fat and lazy”

“I’m different to other people so it doesn’t matter if I go out, I’ll be fine. What’s more important is that I get out for all my runs”

The Phipps family says: We know that this is just the tip of the iceberg when it comes to challenges you and your loved ones will be facing in your homes, possibly even as you read this message, but help is already in your hands; remember to take that step back and breathe.

They suggest: Try to be as calm as you can; show your loved one you understand and then try to walk calmly alongside your loved one, to ease the pain. This will not only ease your loved one’s pain but it can help ease yours too because you know you will have done the best you can in the difficult situation we all find ourselves in.

Eating Disorders Awareness Week: Useful?

Eating Disorder Awareness Week. Time To Go.

It is about to hit us. Or did it come and go? Whatever, I think it is time to be stopped. Years ago, no one knew anything about eating disorders.  No one understood and knew how to recognise the signs and symptoms in either themselves or other people. This is no longer true.

I agree that people with eating disorders are stigmatised. ED awareness hasn’t changed that. In fact, I fear that ED awareness week normalises eating disorders and can make them “cooler”. Even doctors regard people with bulimia as young and silly; They regard anorexia as a vanity illness suffered by wilful and irrational people. The public still regards compulsive eaters as weak. The new rash of articles about men with eating disorders is helping to bring sufferers into treatment but these articles don’t change the general image of people with eating disorders as being mentally ill. Parents want to keep their children away from someone with an eating disorder in case of infection. You wouldn’t want to ask them home for tea.

Well-meaning people in their hundreds go into schools to teach Health and Education studies about eating disorders. We KNOW that this is not a useful way to do prevention. It does little to change the incidence of problems. In some cases makes the situation worse by sensitising vulnerable girls and boys about issues of food and weight.

Eating disorder activists don’t like to read this; but I publish the evidence in good faith. I know what kind of prevention doesn’t work. Many times I have tried to persuade a former ED sufferer not to go into schools to warn about the dangers of self-starvation or purging. If you tell someone not to do something, chances are they will.

When people with eating disorders get to an investigative journalist, they are portrayed in sensationalist ways. Does this help? Or does it enhance a sense of disgust and revulsion among onlookers.  You even get a chance to hear about purging in 3D.  Let’s face it, the symptoms of an eating disorder are unpleasant; people do terrible, unbelievable things to themselves because of their apparent fears of fatness.

People respond to this with fear and disgust rather than compassion.

I really get cross about eating disorder charities that run Marathons to raise eating disorder awareness. It’s one more excuse for sufferers to burn calories to remain thin. Why not do some good in local communities like pick up the trash or clean the beaches?

And, I’m worried about fetishism of eating distress. I wonder why we don’t have Depression Awareness Week, or Borderline Personality Disorder Awareness week? Self-harm awareness week? There are enough mental illnesses these days to occupy our thoughts every day.

What is this going to do to people who aren’t suffering from a mental health disorder? Feel left out?

Let’s have an informed debate about what it is helpful to communicate – such as who is really qualified to help people with eating disorders; or, how to help schools develop an eating disorder policy to protect the healthy as well as the ill.  Or how to encourage young people to ask for help if they are unhappy – that usually goes before an eating disorder sets in.

I’m game for a reasonable discussion about this – contact admin@ncfed,com  or reply on our Facebook page if you disagree.

Access to treatment for Eating Disorders: Money or mindsets?

A Manchester health trust apologises for turning away Hannah Pearson aged 23 who is suffering from serious bulimia nervosa. Because she is not ‘thin enough’ nor ‘bulimic enough’ she doesn’t meet the criteria for an urgent appointment. She is on a waiting list for treatment and the Trust says it does not have enough funding to meet demand. Today I spoke with a few colleagues who are giving everything to help people with eating disorders in the NHS.  It is the same old story about waiting lists and only being able to help the sickest and the most difficult cases for anorexia, bulimia and binge eating associated with severe life-threatening obesity.

Everyone is a deserving case whatever their weight.

I set out my stall. I am passionate about getting people the right treatment and I spend my life trying to help people with eating distress. But I don’t think that anyone is thinking straight when they make complaints about long waiting lists as if it a problem that can be solved with just a little more dosh..

I hear that there are promises to step up to getting more help for eating disorder patients. The promise is great and the problem is HOW.  If there was enough money to both treat all patients in need and to pick up early cases before they get sick (clearly the best option) we would need £ BILLIONS to meet this demand.  Every year.  These £ BILLION would be spent on appropriate mental health prevention programmes; a whole set of new buildings for Camhs and adult services;  specially trained nurses, psychiatrists and psychotherapists; eating disorder qualified nutritionists or dietitians who know how to talk to patients with eating distress; and in/day patient places in hospitals.

Oh; and we need thousands of ancillary staff on permanent call to stop patients from doing the things that anorexia makes them do, such as water loading to deceive their weight or pulling out a feeding tube.

Because sadly, that is what many eating disorder patients do. They get their treatment but they fight tooth and nail against their helpers.  Sometimes physically.  Eating disorder patients deceive their carers and helpers, aggress against therapists and pretend to comply with meal plans that keep them safe, refusing to embrace the idea of change even if they want to.  One young sufferer getting the best possible help at the Maudsley told her carers ‘I would rather be happy at 35 kg than unhappy weighing more’ – and die she did, of the complications of her disease, having cost the NHS a pretty penny for a treatment that failed her. 
Sufferers cannot be blamed (so no trolls please),  because anorexia and sometimes bulimia are forms of madness with vicious, intrusive thinking making a person rather stay ill or be dead than be– in their own minds anyway – ‘fat,’ where fat is often just a delusion of the illness.

So eating disorder treatment is thwarted by the illness itself, where beds and access to help is blocked by a never-ending revolving door of need and money flowing out like a river. Services respond by letting sufferers go – even though they clearly need more help, possibly for a lifetime. But there are other needy people pounding at the door.  One might think that this could be solved by finding better treatments, but even this is not a question of spending more money. We are spending plenty of money and not getting as far as we would like.  

We do better with the overeating disorders like bulimia. But, despite all our efforts and our real-time experience, despite millions of pages of well-funded research, there is no known treatment guaranteed to work for anorexia. There never will be.  People with anorexia need to try everything before they find a fit; most will eventually find a fit and recover, some do it by themselves, some never get well.  Actually, most sufferers recover in time although the illness leaves a lot of scars. I never lose hope nor put my head in the sand that there is a magic bullet and that one day we will find it.

We cannot blame the poor old NHS for failing the public. There are too many people needing help. The NHS is groaning under the weight of having to provide medical and social care for an ageing population, treating drug addiction, confronting cancer. The NHS is a victim of its own success in keeping us alive. Mental health problems are a feature of affluence and no one wants to make us all poorer.  A small increase in funding will do nothing at all.

Because there is no point providing access for help if the people who deliver it just aren’t there.  It takes half a generation to get specialist psychologists, psychiatrists and health professionals like nurses and dietitians with the right academic training; who know what they are doing with people who are at war with food. Money won’t get them off the production line any time soon. How will we find (and fund) the places to create the 5000 new clinical psychologists (7 -year training) and 1000 new eating disorder psychiatrists (10-year training) to fill the provider gaps.  This is always going to leave big holes in service provision as mental health suffers spend time bonding with a healer and then the healer needs to go elsewhere.

So what we need, at the very least, is a conveyor belt of super- effective therapy for eating disorders and other mental health issues, so that new sufferers can enter the system fast as other people leave it, but mental health is not that simple to address.

Activists and journalists always point a finger somewhere for a failure of what they think is a lack of care, lack of attention, lack of priority or failure to spot early cases.  Even experts can not spot early cases because dieting is common. Eating in your room or being angry and withdrawn are normal adolescent behaviours. Behaviour that we used to call quirky, such as becoming a vegetarian, is both a symptom of an eating disorder and also mainstream. Activists make a big noise about not enough money being spent (true; but there will never be enough) and that we don’t know enough about treatment – which is a dangerous falsehood.

The real truth is that people who care about eating disorders (thousands) have spent their lives and their professional experience researching what works for eating disorder therapy and learning from the real people who enter our services.

When it comes to accessing treatment, I say; yes, it’s hard, but you are competing with a cancer case, a child with autism, a patient with post-natal psychosis and an alcoholic . You don’t just need to go and see your GP.  If people are worried about their loved one, one has to ask why not turn to the Independent sector where there are many professionals with varying levels of training ready, willing and able to offer support.  The argument that it is ‘costly’ doesn’t hold water. What price can be put on someone’s life? A proper assessment costs £65 with us at least. Therapy can cost less than an annual subscription to a mobile phone or your subscription to Sky.

6 months of valuable therapy at whatever the costs can give a person back their life. I’m somewhat shocked that Hannah Pearson is not reaching out to a private low-cost therapist pronto, to help reclaim her life. If she is, the article in The Times doesn’t admit to it; it just targets the NHS again, which is not helpful.  Until we accept this, we are all tilting at windmills and not thinking straight.

Anorexia Activism- tilting at windmills

Anorexia Activism, is it shooting in the right direction?

A former sufferer 20 years duration, has an article in the Guardian pressing for more investment in anorexia treatment. In theory why not. She has seen people die (of course, they do) and attributes her recovery to her psychiatrist, Dr Ayton, whose writings inform our own work with people who have anorexia.

I pointed out that we are already investing £millions on research into anorexia. In addition, we healers read the textbooks written by people like Dr Ayton and all the research worldwide. We go to conferences and we call upon our lived clinical experience with sufferers and their families.

It is not enough. People still recover, even after years, they will continue to recover and some will die, no matter how much money we invest. As one of my colleagues pointed out, more motorways don’t reduce the traffic. The problem with anorexia is partly clients themselves, fearing recovery and resisting treatment, often attacking the therapist, verbally or, physically. We understand that this is a symptom of the illness but we are just human, we have to be so lovingly strong and patient.

One of the followers of Lorna Collins was angered when I pointed out that money IS spent, people ARE being trained, books ARE being written to help the healers, and there ARE enough awareness campaigns.  She was scathing when I mentioned textbooks and suggested that I was being rude about recovered people. But who writes these books?  The writers of textbooks are people who want to share their knowledge and wisdom about the disease.

We know why people get better. Sometimes it burns itself out, sometimes people decide they don’t want the monkey on their back anymore, sometimes they fall in love and want to get better. And so on. The textbooks AND our experience tell us lots of reasons why people recover and we have more than enough anorexi-ographies to boost our understanding.

The outcomes for specific therapies like CBT-E, FBT, DBT or Mantra still are worse than we would like. People slip through the net. This is not attacking hope, its the truth. Hope is that people recover sometimes after many years each in their own way.

If Ms Collins recovered because of the work of a particular psychiatrist, then she knows at least why SHE got better. It was a specific therapist, not a treatment protocol. How do we bottle the personality of a specific psychotherapist?  And will it work for everyone?

When people recover from anorexia, many become activists. Activism can, at times, turn to aggression when the activist is not willing to listen to other points of view. Agitating for more “investment” in anorexia is not going to achieve much (where is it to be spent?)  and will leach resources from other mental health problems. Anorexia is a very particular mental problem, which has existed for centuries. It is foremost a disease that reflects the struggles of being human.

Binge eating disorder help

Binge eating disorder is an eating disorder that makes people very miserable. People suffer for many years before admitting that they need help.

People who come to us say I don’t really have an eating disorder. I am just greedy, or I have no willpower. They blame themselves. This is wrong. If you are able to spend just one hour of your time with us, we will explain why you lack control with food, and what can be done about it.

Binge eating disorder can take many forms, it can be picking, nibbling all the time, or it can be mindless bingeing on large amounts of food.  Binge eating usually happens in secret and it can cost you a lot of money.  Very few people binge on celery sticks. The most common binge foods are those which are normally forbidden, large amounts of chocolate, biscuits, toast, cereal. Sometimes you try to put off a binge but have to get it over and done with. Sometimes whatever you eat is never enough.

You know by now that losing weight on a diet was never enough to stop you from binge eating. So there has to be another way to regain control of food. The way to regain control is not to talk endlessly about your early life, and it is not taking tablets for depression. You are depressed because of the eating disorder. You don’t binge eat because you are depressed or because you are simply comfort eating.

Help for binge eating disorder is just a phone call away. There is a wonderful, effective psychological treatment for compulsive overeating. It is not a quick fix, but it will change your relationship with food long-term. It can be hard work but it can also be fun. A properly trained eating disorder therapist can put this misery to an end.

If you would like to know more about binge eating disorder help for you personally, consider a one-off confidential assessment.
Help is just a phone-call away; call 0845 838 2040.

Bulimia Nervosa Treatment

So many people contact us and say that they are interested in bulimia nervosa treatment. First let’s be clear about what bulimia is. Bulimia Nervosa exists in people who are very concerned about what they weigh. They usually feel out of control with food at least some of the time. They binge eat, usually foods that they think will make them fat.

Then they throw up and / or take laxatives to try and avoid weight gain.  We call this “purging” and there are many other ways to purge, all of which can cause great harm.

Even over-exercising to prevent weight gain after overeating, or using diuretics, are ways of purging to avoid the effects of eating. It doesn’t really matter how much food you eat, nor does it matter how often you purge. If you do any of this at all and if this is happening in secret, you are suffering from Bulimia Nervosa

Some very thin people purge, even though the amounts of food they eat are small. They might be suffering from Anorexia rather than Bulimia Nervosa. Bulimia nervosa is an illness which can be treated with the right kind of help.

Some people have very mixed feelings about accepting treatment for their bulimia. They worry that treatment will make them fat. No, it will not.

Or they feel that their bulimia is a kind of friend, it helps them get through the day, it helps them to feel calm because nothing else does. Bingeing gives them a kind of comfort and purging gives them emotional relief. We understand all this too.

Bulimia treatment is a two-sided process. On one side, we will stabilise you physically, because as someone with bulimia,  you gain weight easily and you have cravings for food that are hard to manage.  You are unhappy in part because purging leaches away the neuro-chemicals which make you peaceful. We can teach you many new skills that will make it much easier to live in a world full of food and we will not judge you if you have to purge.

The other side of therapy is called enhanced cognitive-emotional therapy. This allows you to experience a deep, compassionate healing process which is hard to explain in just a few words so I will try to make it brief.

You will learn how to manage dangerous feelings that are being controlled by your illness. We may need to deal quickly with adverse events that have happened to you, so that you will feel more at peace with yourself. You will learn to be emotionally stronger than you have ever been before.

This therapy also attends to your mindset and to your self-worth which has been damaged by the shame and secrecy of the bulimia,. We attend to your thoughts about your appearance which are at the heart of your struggles with food.

Bulimia nervosa treatment is not just removing symptoms. People who complete this treatment feel happier, their life is transformed and they look forward to the future and to all that has opened up for them. One word of advice however. Bulimia treatment can only be done properly by someone who has been trained in eating disorder psychotherapy.

Many counsellors will tell you that healing is achieved through an accepting relationship. They may be wrong. The therapy relationship is important, and you need to work with someone you trust and you know that he or she understands eating disorders properly.  But the relationship is not enough. An eating disorder specialist has learned a lot of additional skills and tools to set you free from your struggles with food.

If you want to consider having a one-off assessment with someone who cares and who understands eating disorders completely please click here.  Or call us on 0845 838 2040 just to have a chat.


Eating Disorder Clinic

Do you need an eating disorder clinic or, some other help with your eating disorder?

Does eating rule your life? Does your eating disorder make you or your loved ones deeply worried?

If your eating disorder is severe, and making you ill, you may need inpatient treatment or day-care. You can look on our website for a list of the treatment services that we think are good. Please CLICK HERE to view our preferred list of eating disorder clinics in the UK.

If your eating disorder is not life-threatening, it is better to work on your eating disorder at home, where you can continue to work, complete your education and get on with your normal life.

Then you do not need an eating disorder clinic. An eating disorder clinic is costly and at some point, you will need the skills and support to help you to thrive in the real world.

Consider having a one- off assessment with someone who will tell you what you need right now. We have people all over the UK to advise you on the next step. If you want to see our counsellor list please CLICK HERE.

Binge eating help

Binge eating help for you

Do you need binge eating help? If so, stop here for a moment.

I know that you feel awful, that your willpower has deserted you; you would be ashamed if people could see what you do, scoffing all that food, eating all those biscuits, drowning in bread and butter, cereal, chocolate. Once you start eating these foods, it is never enough.

Stop here for a moment and be calm. Over 40 percent of all women say that they binge at times. But some people binge more than others and it is affecting their whole life. Please be assured, this can be treated.

Binge eating disorder takes many forms, it could be picking, nibbling, going backwards and forwards to the fridge, it is always done in secret. Maybe you eat normally in front of other people and then go for the binge when you are on your own? Some people with binge eating disorder throw up to avoid gaining weight, but there are many overweight people with bulimia, so please don’t try this, it isn’t a solution.

Binge eating disorder can be treated faster than you think. First we will discover your story, your joys and hurts, If something bad has happened to you – we will not insist on talking about it. We will figure out what kind of help will work best for you. The treatment is always personal for your needs.

We will attack the problem on two sides, the physical side and the emotional side. Here it becomes a little more complicated so I will try to make it easy.

On the physical side, your body will be hounded by the effects of chaotic eating. Sugar highs and lows will affect your metabolism and your hunger levels. So we will do something simple to put that right, and your cravings will subside. You will not be put on a diet.

On the psychological side, we will attack the problem in a number of different ways. If there is a great deal of comfort eating or too much stress, we deal with that with targeted skills. We will do many things that will build your willpower from the inside out.

We will never tell you to eat celery instead of chocolate. We will not pforbid you from binge eating. The binge eating will fade away. There is no need for a last supper before you start treatment. The treatment for binge eating disorder is not another diet programme and you regain control of food from the inside out.

Binge eating disorder treatment is based on CBT, but it is much more than that. The treatment for Binge eating is called ENHANCED CBT; which can only be delivered by a specialist. This treatment takes a few weeks, and even people who have struggled with eating and weight for many years are amazed to discover that they can get back in control of food,

Some people believe that binge eating is an addiction to sugar, or to food in general. It certainly FEELS like an addiction. At NCFED, we are convinced that compulsive eating is more like a needle stuck in a groove. You don’t need years of therapy about your childhood to get through this. If you would like to see how we can help you with binge eating, come and have an assessment. We will hear your story and we will explain exactly how we can help.

Anorexia Nervosa Treatment

Very few people really understand how to treat anorexia nervosa. This is why so many people who need help fall between the cracks

First you need to understand all the treatments and what they do.

Second, you need a therapist with the skills to use these therapies and the emotional strength to help people who may not wish to change.

The therapist will need emotional qualities of firmness with compassion and who knows how to talk to the anorexic Voice.

If you need treatment and you have been consigned to a waiting list you can get help in the meanwhile by getting us to build you a scaffold of support.

If you want to know more about treatment, click here and remember help is only a phone call away.

Jesy Little Mix Body Image

Watching Jesy do her programme on body trolling, all of us here were nearly in tears. How brave of her to do this and I hope that one day she will look back on this time and feel good about herself.
Poor body image is called Body Dysmorphia and the need for changing your nose, lips or anything else is a symptom. Eating disorders is always about poor body image. It broke my heart to learn that Jesy starved for a week to look thinner on a show. Jesy – this will only make you crave food even more.
Katie Hopkins, I rate some of your ideas – but calling Jesy a chub is a crime, for which I would willingly hang you out to dry or put you in the stocks.
A 9-year-old child I know, who is as thin as a reed, was fat-shamed “for fun” online a month ago.
I have something on this website information section about body image if you would like to read it.

And we can treat poor body image too.
Is your body the real problem or your OPINIONS about your body? Do you need HELP with internet bullying? Don’t suffer in silence. Don’t wage war on your body. Ask for help. Call us 0845 838 2040 This is something we can treat .