Obesity And NICE

Posted on by ncfed

Obesity!  There has been a lot in the press about obesity this week with the publication of NICE guidelines for obesity treatment, information that our girls are the fattest in Europe and publication of research associating sleep in the light with obesity. Even I have had my say, see me on the BBC website

In the London Times today an article shows us that low fat custard has more calories than ordinary custard (thanks, Asda).

Fat is on my mind as well because I am about to train a group of 70 obesity professionals from all over the world.

Oh dear, do I really think that the NHS should be spending billions on 12 weeks of free attendance at slimming clubs?  Do I really think that 3% weight loss will save the NHS a lot of money on medical problems associated with obesity?   Well I don’t think I do.

The chances of people maintaining a 3% weight loss I think are nil. That’s based on evidence. It’s not going to cure diabetes or liver disease. It isn’t going to make fat people feel better or even look better which is why they try to lose weight in the first place.  How did these idiots come up with such a stupid idea.

Ah I think I know why …. lobbying pressure from the slimming club industry!  Money!  If only I had shares in a commercial weight loss company!

On the other hand, lots of people are fat because they are ignorant about what a healthy diet really is. Do we believe, as the food industry would have us do, that sugar coated frosties are better than no breakfast at all?

Do we think, as they would have us think, that low fat yoghurt full of sugar is better than normal yoghurt (which is a low fat food).

People need to wake up and get real about what is in the food we eat. Its right to correct ignorance which the slimming clubs might do. But I think that many of the so-called army of helpers are also ignorant and improperly trained. Perhaps the Government should invest in properly trained obesity specialists who can do the same job in the community, like practice nurses. These people won’t just give out diet sheets, they will understand motivation and proper nutritional wisdoms, and they will know what kinds of activity really can help – not just “going to the gym”.

FAT CHANCE!

 

I Am Not My Eating Disorder! And I’m Better!

Posted on by ncfed

Here is what one of our people has written about her recovery with one of our therapists.

When my journey with H began in May/June 2013 my life revolved completely around my compulsive disordered eating behaviour. I was caught up in a relentless ritual of binging and purging averaging 30 times a day, which had persisted for nearly 10 years. This had pretty much robbed me of my twenties, and I had been told by a GP that I was to quote; ‘a hopeless case’ and ‘would be inflicted with my disorders’ for the rest of my life.  My health, studies, finances and relationships were in constant jeopardy. It seemed both my secretive and public displays of compulsive binge eating had robbed me of any dignity and self-worth. I was also engaged in cycles of dangerous binge drinking behaviours around every 6-8week. These resulted in week long black outs, which rendered me bed ridden and often in various A&E departments through physical injury or dehydration.

Below I have summarised a non-exhaustive list of treatments I had received in the 10 years of being afflicted with my bulimia/compulsive binge-purge behaviour. None of these really had any significant impact on my rituals or associated psychology, some even had a negative impact.

2004-2013

  • CBT & CAT (NHS)
  • 1 outpatient treatment admission (4 weeks – NHS)
  • 4 x Inpatient admissions (Woodbourne Priory –for 9 months, QEPH for 1 month (+ 2 x self-discharge short stays))
  • Counselling (private, NHS, University practitioners)
  • Hypnotherapy (4 x practitioners)
  • Homeopathy and acupuncture
  • Anti-depressant and anxiolytic drug therapy (x6 flavours)
  •  Alcoholics Anonymous and Over Eaters Anonymous

Below I have outlined the main areas in which my work with H has helped transformed me from the former shadow of myself into the person I could and should really be. This is my path from up to £30 of food consumption, <8h binges and <50 vomits DAILY, to someone at a consolidation phase of full recovery.  Structure – and commitment to it!

From my first session working with H I understood that beating this problem was going to be a team effort! I had to commit to my part of the deal – keeping organised, documented and structured eating times. I also had to abstain from highly refined sugars and carbs (which by my own admission I was addicted to).  The former is something I found particularly challenging, but even when I didn’t succeed the process knowing I had a plan to stick to really helped me get ‘in the moment’ about what and when I was eating. A large part of this work involved breaking habits (eating whilst driving, stopping for food at service stations and works canteen).  What really helped me with this at first (and still does), is having all the meals and snacks I need for the day prepared and taken with me for the day in discrete packages. I got my partner involved with this process; I trust his judgement implicitly so I know his definition of a ‘snack’ or ‘meal’ portion is going to be about right for my needs. This stopped all the canteen visits and unnecessary trips to the supermarket. 

The psychology of ‘taking control’ of my own recovery early on in the process gave me great confidence, and stood me in an empowered frame of mind for the more emotional work to come later.

 I am not my eating disorder – I am me, and I am OK!

I think a significant portion of work I have done with H has been focused around re-establishing my identity. I learned to acknowledge that my eating disorder was simply an exhibited behaviour and did not define me or reflect who I was. This freed me from punishing self-judgement and was very important re-establishing my confidence. Additionally, I learned that I should not define myself my successes or failures in life. I have come to understand the importance of being authentic and free to be myself, free from the fear of failure and the burden of perfectionism.

On a related theme, much work has been based upon how I respond to the opinions or comments of those around me. I have been learning to embrace the fact that I cannot change how other people chose to respond or behave towards me. I am free to vocalise my thoughts and feelings assertively and with immediacy in any situation. This approach reduces the probability of harbouring resentments the associated frustrations that comes with bottling emotions.

 I also need to be aware of getting ‘hooked in’ to peoples comments or opinions and that I have a choice as to how to respond. In short, I alone have control over my own emotions and how I feel about things. Ultimately whatever I feel about things should not lead on to negative behaviours such as binge eating/drinking. The Thought → Feeling → Behaviour pattern is something H has worked quite closely with me on, and having the ability to modulate my thought processes has certainly helped level out my mood states which have progressively improved over time.

 Tolerance! – ‘I can bear this!’

Tolerance of situations and circumstances that I find uncomfortable has been a significant work focus over the last 10 months. My perceived inability to cope with difficult circumstances has historically led to a heightened anxiety and an apparent need to comfort eat in order to ‘cope’. My tolerance of boredom and motivation to do tasks I find particularly challenging or difficult has in the past led me to use excessive eating as a procrastination tool and form of avoidance tactic.  Heather has helped me become aware of triggers which might lead me towards such a negative mind-set, and also evaluate previous similar situations as evidence that in reality I really can cope. Instilling an ‘I have done it before, I can do it again’ kind of mind-set is the best way I can describe it. I have a simple mantra of ‘I can bear this’ and ‘I am capable’ ‘just get on with this task’, which really helps stop me catastrophizing situations that really aren’t that big of a deal.

 Compassion

I have a tendency to be really hard on myself and can be quite self-punishing if I do not achieve my own personal expectations (or what I perceive others expectations to be). In session we have touched on the concepts of being compassionate to oneself (and others), and being vigilant about squashing negative internal dialogues. I have been encouraged to be aware of what kind of a story I am telling myself in my thoughts; is it unhealthy or unkind? Would I expect this of someone else? Am I viewing this in the right way? This has helped me be a little kinder to myself and be mindful about unhelpful thinking patterns. I am also aware of triggers that might lead me down such pathways (e.g. running a bad race, an experiment going wrong at work) and allow myself extra processing time to deal with them.

 Feel the fear and do it anyway

I think this heading is covered by little segments of all of the above sections. In a nut shell, FEAR doesn’t lead to FOOD (or any other emotion for that matter!). I can tolerate uncomfortable feelings, I practice uncomfortable situations with assertiveness and I bear misplaced feeling of hunger I understand are only in my head. I have learnt (and continue to learn) tools and techniques for dealing with my thoughts that have essentially made the eating behaviour redundant. I do not need it, it has become an unnecessary pathway and the less I use it the more unnatural it becomes. I am currently in the phase of relapse prevention, where I’m being shown how to deal with mishaps with compassion and re-assert eating structure quickly and effectively.  

 Summary

The above five points perhaps only scratch the surface of how working with Heather has helped me over the last year, but it has been a positive experience for me to consolidate what has been important to me in my recovery. I hope it provides insight into what kind of therapeutic approaches have been so profoundly beneficial for me in this wonderful year of personal growth. I am now in a position where I am for the most part completely free from bulimic and compulsive eating and drinking behaviours. Recently I have averaged around one vomit per month, which compared to 30+ daily is nothing short of miraculous and has far exceeded my wildest dreams in terms of recovery. I am also T-total in terms of alcohol, and have had no drinking episodes for a considerable time period. My physical health has recovered rapidly, I have more energy and concentration to focus on my studies. I enjoy running and cycling with my partner and a local club, and am competing in my first triathlon on Sunday. 

One final point I’d like to mention as it’s particularly striking for me is that with H’s work, it is not just the eating/drinking behaviour that has been abolished but all the compulsive thought patterns and emotions that accompanied it. Sadly, I have come across a lot of extremely miserable T-total alcoholics and people in recovery in the past. I had feared that if I recovered I would be the same; lost, empty and unfulfilled, like that part of their psychology persisted and just wouldn’t let them go. Reality has proven to be the complete opposite for my journey; I have so much head space to just be happy and free! I don’t crave binge eating/vomiting in the slightest, I don’t miss it, I don’t even think about it going about my daily business. It’s like that part of my life never existed, and it’s just awesome!

We need your help IF you have had inpatient treatment for an ED

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Have you had inpatient treatment for an eating problem? We need to know your experiences for an anonymous research project.

Melissa Snaith at the University of Oxford is carrying out an anonymous online survey, for participants living in UK, USA, Australia, New Zealand and Canada. The study will investigate posttraumatic stress disorder (PTSD) in women who  are now over the age of 18 year and have at some point experienced inpatient treatment for an Eating Disorder (ED).

The study will investigate whether people found some or all of their inpatient treatment to be traumatic. It will look at how people think about any trauma, their memories of it and the things they do to manage any symptoms.  The purpose is to identify which psychological factors predict the severity of PTSD symptoms, in those who have had an inpatient admission for an ED.

  https://oxfordclinicalpsych.eu.qualtrics.com/SE/?SID=SV_0PcdItxaI9hgu0Z

This study has been given full Ethical Approval by the University of Oxford Central University Research Ethics Committee (CUREC) – Medical Science Division.

Melissa Snaith,  Trainee Clinical Psychologist,  Oxford Doctoral Course in Clinical Psychology  Tel:07587024747

Men Get Eating Disorders Too: Guest Blog

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Anthony Organ, interning for a new journalism project called The Conversation, writes thus:

The widespread perception that only women suffer from eating disorders has ill-effects on men who also suffer from problems such as anorexia and bulimia. A new study in the “BMJ Open” points out that many men don’t seek help because eating disorders are perceived to be a “female problem”. This means they sometimes don’t identify their symptoms correctly and can face challenges discussing their problems with friends, family and healthcare professionals.

Eating disorders in men are understudied, though male cases make up 10% of reported cases in the UK. Qualitative research is needed in particular. This means talking to people about their experiences, rather than measuring frequency and identifying patterns.

Not a women’s issue

It’s important that we gain a better understanding of why men perceive eating disorders to be a “women’s issue” so that it doesn’t stay that way – which is a real danger in western society today.

My own work with men and eating disorders is about exploring their experiences. So, whenever something new emerges I look to see what’s challenging, what’s confirmed and how a new piece of insight might just shift our larger understanding of men and their relationships with their bodies, minds, food and society.

In this new report, young men were interviewed about how they made sense of the symptoms they experienced, how they came to understand that something was wrong, their perceptions of barriers to care and what they experienced from the healthcare professionals who initially dealt with their cases. All of the men involved took a long time to recognise their symptoms as signs of an eating disorder. These experiences have been echoed elsewhere and in the male eating disorders stories I have analysed

Persistent sexism in society

Even if this research isn’t wholly surprising, it raises many questions. Why do men feel so “feminised” in the face of an eating disorder? What are we doing to change the fact that we still have a society that has raised men to believe that there can even be such a thing as a feminine mental health condition? Why do we continue to raise our boys and girls to tread such a narrow path of identity that when they grow up the lads daren’t go to a doctor for fear of ridicule that they have a “women’s illness”?

Slightly scarier still, why is having a “women’s illness” such a bad thing? Let’s suppose an eating disorder really was a “women’s issue” then, eating disorder aside, what have we done to our men to make them believe that being anything like a woman is bad or something to feel ashamed about? Apparently, we are in complete denial about the sexism that continues to be deeply instilled in boys by the society that’s supposed to nurture and enlighten them.

What’s really scary

The real shocker here is not the identity crisis that an eating disorder brings on when it challenges the masculinity we so passionately expect of men. This is relatively understandable. No, the real story here is the response that some (not all, I hasten to add) men received once they summoned up the gumption to get help from a professional. In this new research we find the experiences men report when finally seeing a health professional. One of which was a doctor telling the patient to “man up” or stop being weak.

The earlier questions I raised about men feeling like they have a female disorder take on an altogether uglier, deeper feel when we look at this closer. So, it’s not just the men themselves who feel weak or “feminine”, some of our healthcare provision does too.

It seems sexism may be rife in mental health services if a worrying few believe that the way to recover from something as life-consuming and debilitating as an eating disorder is a hefty dose of British grit, a reminder to be more of a man and firm, if figurative, boot up the backside to make sure weakness is shown the door. And so the very messages that stop some men even asking for help in the first place are perpetuated.

It’s important that more people learn that eating disorders are a men’s, as well as a women’s, issue, not least because prognosis is improved with early detection. It’s especially important, it would seem, in the case of some of the staff who care for us when we as eating-disordered men (myself included) finally fall into the abyss or gather the courage to get help.

Tips For Working With Anorexia

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A “Positive Disposition to Recover”.

Even if someone volunteers for treatment, if is often to seek relief from preoccupation with food, depression or physical symptoms. It could be due to rising concern about the risks of anorexia or to avoid the side effects such as infertility.  Does this represent a real positive disposition to recover from the illness (whatever that means)?

Recovery from anorexia  is not just about gaining weight. In many cases being willing to gain some weight is “conditional” on continuing to eat a very limited diet, often vegetarian or low in carbohydrate and fat. 

Eating more is often conditional on continuing to exercise a great deal. There  is a great debate about what constitutes “excessive exercise” and our opinions are clouded by views about the dangers of sedentary behaviour and the general approval which is given to people who “go to the gym”. 

So what is really a positive disposition to recover?  Many of the features of anorexia just will NOT go away if someone remains underweight. Cravings, depression, preoccupation with food and health risks do not go away if weight remains low. Many people want rid of the bad aspects of anorexia while continuing to have its benefits like staying abnormally  thin. That’s not easy to work with. People will not want to look like you.

A “positive disposition” should include the desire to be free from compulsion to exercise, and the ability to eat a wide diet, with other people, and freedom from the constant chatter about what foods can and cannot be eaten. A positive disposition will include the desire to welcome the feeling of food inside your stomach. This will never be possible if weight is low.

 Secretly though, I wonder how possible this kind of recovery really is –  because all  of these recovery outcomes are inconsistent with what gets someone into anorexia into the first place. The anorexic  desire for simplicity, the fearfulness, the ascetic drives –  are not features that can just “disappear”. These are aspects of personality which must persist forever. You cannot argue someone out of their basic personality.

So I’m not sure that I can demand a positive disposition to recover in what would suit me, and my expectations cannot be too high. I think that people and therapists must come to some sort of compromise with anorexia over what will be kept and what can go away for someone to live more happily. Experts might disagree with me.

Force Feeding The Anorexic

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Anorexia And “Force Feeding”- Self Determination Or Self Annihilation

A while ago I was listening to LBC radio. The subject was  a decision in favour of the so-called force feeding  of patient E.  On Saturday Norman Lamont suggested that the decision to force feed could be an intrusion on her right to self determination . What complicates this case is that the parents of this young medical student,- anorexic since eleven  years of age-wants their daughter to be left to die with dignity.

There is nothing dignified about anorexia or any other mental health condition for that matter. Also, I just wish that people would STOP using the term “force feeding”, which reminds us of the traumas inflicted on suffragettes on hunger strike to obtain the vote for British women. I just wish that people would use the proper term, which is ENTERAL FEEDING.

Many clinicians have been writing in favour of the judge’s decision on Linked In.  We talk to each other about things we know, which is that low weight impairs the ability to think clearly. That at low weights the anorexic voice drowns out logic, reason and happiness.

But not-one said it better than Kate, who came nervously to the radio to express her point of view. Kate has been anorexic since age 9 and in hospital many times during her young years. She said “I have no idea why I just didn’t want to eat, but I didn’t, and there were times when I would have been very happy to just fade away.

But they didn’t let me, and there were times when I was on a section and they threatened me with the tube…. No it wasn’t a threat, it was just something they said would happen but it felt like a threat at the time. Having no control over what they put in it was the worst thing imaginable for me.

But I somehow got to the age of 20 and I said to myself, I’m sick and tired of this anorexia. It took 11 years for me to admit I had a problem. So I made myself start to eat. I’m 24 now and life is so much better.  Life isn’t a bed of roses but anorexia is very hard work; and I had enough.

I spoke to my father about it and he admitted that he had something like me when he was in his teens, but being a man nothing was said or done about it.”

The interviewer asked, “Everyone is saying that it’s all the pressure on young girls to be slim, in magazines and so on?”

“Oh no”, she said, “When I was nine I hadn’t even seen a magazine. It’s nothing to do with magazines and models, it’s just the way the brain is wired”.

So there you have it from the people who really count. Clinicians know very little. Listen to the people who have looked into the pit and been dragged into the light, kicking and screaming. At all costs we have to arbitrate in favour of the wish to live.

Sisters of Anorexia Patients & Bulimia Sufferers Urgently Needed

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Chocad_BN_newChocad_AN_sisters_EEG (2)A study at the University of Reading needs YOU if you are a sister of someone with anorexia or YOU suffer from bulimia.

Dr Stefanie is studying how your brain responds to tasting chocolate.

You can find a link to their webpage below

http://www.ciaramccabe.co.uk/volunteers.html and there is  a facebook page: https://www.facebook.com/chocolateexperiment.

If you can help, do!  We need all the research we can to help people with eating disorders.

Sisters Wanted For Anorexia Research

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The University of Reading is doing a research project involving sisters of anorexia sufferers who have NOT had an eating disorder themselves.

If you can help, call Dr Stefanie on 0118 378 6946.

All Females Must See This Short Film

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AMAZING!  http://www.upworthy.com/5-minutes-of-what-the-media-actually-does-to-women-8?c=ufb3

Binge Eater? Don’t take Vyvanse!

Posted on by ncfed

Mr Ornskov, Chief Executive of Shire pharmaceuticals is seeking to expand Vyvanse into new areas, well he would, wouldn’t he. This is a HUGE market.

Vyvanse is an amphetamine – like drug which can lead to an addiction in a population already struggling with control issues. It may have an effect on impulse control, but impulse control is not the main issue present for binge eaters.

Lisdexamfetamine has a high risk for abuse. It may be habit-forming if used for a long period of time.  Abuse of Lisdexamfetamine may cause serious heart problems, blood vessel problems, or sudden death. We have been here before.

Will it cure binge eating?  I think not. Is there anything we can do to prevent Shire from getting approval to market this drug to a gullible public. I fear not.