Can an Eating Disorder Service also offer Obesity Treatment

Posted on by ncfed

Yes, if the service is specified as two -sided and clear about the distinction between eating disorder treatment and weight loss coaching.

At the National Centre for Eating Disorders we do a holistic assessment of a person to ensure that no significant eating disorder is present; if it is present we make it clear that there are to be no weight loss attempts during treatment for the eating disorder and such a person might not in the future be suitable for intentional weight loss.

It is incorrect to assume that all people wanting weight change have an eating disorder.

If we agree after assessment to support a client in their weight change intentions, we will engage in a manner consistent with good practice and we have transformed many lives. Some of our clients have had a history of binge eating / bulimic disorders and have gained weight throughout the years because they have not had timely treatment for their eating disorder. We empathise with their desire to change weight if the time is right.

In such a case we would not do anything that would reactivate their eating disorder.

Weight loss “guidance / therapy”, does not imply dieting or food rules or boot-camping nor does it have goal weights. Nor does it require endless searching into childhood adversity. Nor is it HAES although they have some but not all, very good points.  The service includes bariatric counselling. Some people, with our help, decide that they are happy as they are. The ultimate outcome is flourishing.

We market obesity treatment because of the numbers of desperate people INCLUDING therapists who seek our help. It must mean something that over the course of 40 years no one entering our service has complained about stigma.  No therapist training with us over the same period has raised a complaint about anti-fat bias.

Activists who have not done our training are pitching against us with total ignorance about what we do. It interests us that while they are intolerant of the word “obesity” they bandy the term “fat” as if it means something different. Really?

What worries us at NCFED is the number of activists who actively try to deny people from having access to good weight change help; who wish to prevent therapists from learning about strategies that might work, and who wish to withhold from the public factual information about some health risks of living in a larger body. On top of this, no activist is able to come up with a single client or psychotherapist trained by NCFED who has been “traumatised” by weight stigma.

The NCFED has no need to make a big deal about inclusivity. We have therapists of all genders, races, religions, tribes and colours. We treat people without needing labels. Inclusivity is woven into our trainings and the first thing we do is delve into the history, generational issues, declared identity and value systems, of each individual in a place of complete acceptance.

I will not give the litmus of attention to angry people. Certainly, it is right to question the old “sacred cows” and reflect on their meaning and purpose. Having reflected, we feel good about what we do and we will not kowtow to aggression. People in the community who do not have a clinically significant eating disorder, who desire intentional weight change, deserve far better help than the traditional diet and lifestyle methods that do not work. They can come to us for that help, given by people we trust.

Meanwhile, Our amazing course, Essential Obesity: Psychological Interventions, next date June 2022

BACP advertising unethical Weight Loss Plan

Posted on by ncfed

I and my colleagues are angry and disappointed that a weight loss consultancy company advertised for “weight loss counsellors” in Therapy Today, the main journal from the British Association of Counselling and Psychotherapy (BACP).  This Company is selling Very Low Calorie diets based on milk shakes and “treat” such as “protein bars” to help people supplement the boring shakes with tid-bits that will help “keep them on track”.

Weight loss counsellors are paid according to their success in motivating clients to stick to the programme and to buy the Company Products. So, the counsellors are invested in tricking, or persuading or coercing people to stick to the programme.  Why wouldn’t they?  After all there is money in it for everyone except for the poor client who will be led to think that what they are doing is good for them.

As for the company (Cambridge) – having a “trained counsellor” on board means that their diet is legitimised.  The “trained counsellor” can deal with the psychology while the diet helps with the fat. Win-win all round for everyone concerned.

Can you see what is going on? It is horrible. Extreme weight loss plans like Cambridge can be dangerous, can lead to eating disorder behaviour, and liver damage. They are guaranteed to cause runaway weight regain in most people who embark on programmes like this in hope and desperation. There is a high risk that a person will end up fatter than they were before they invested their hard-earned money on a quick fix solution to their weight issue.  I know that most of you don’t want to read this, but diets like this don’t work.  Extreme calorie restriction teaches the brain that there are famines to come and your weight thermostat tends to rise. There are other ways to bring the thermostat down but this deserves another blog.
So, you might argue, would a counsellor help someone to avoid that kind of risk and somehow help a client stick to the diet and maintain the weight they have lost?  Perhaps they will tweak your emotional life or do some work on your early adverse experiences.  Perhaps a compassionate buddy will help you to be the 1 in 100 success case from a milkshake diet.

Think again.

I train many fully trained counsellors to work with eating disorders and obesity.  Up to half have serious eating disorders themselves, regularly go on and off diets and are struggling to control their own weight. Weight and eating issues simply do not form a good-enough part of the general counselling curriculum.  So, after they qualify, many counsellors stick eating disorders and obesity on their marketing material, but do not (yet) know what they are doing.  Some of them think (wrongly) that obesity and disordered eating is all about trauma. It is not.

I don’t want here to argue a case against all diets, because many people who control their weight do adjust their eating habits and manage their weight reasonably well. There is a difference between lifestyle change and the thousands of weight loss plans out there. However, a weight loss plan that relies on calorie restriction, fasting, or carving macronutrients out of your life though, works in the short term but makes things worse long-term. The only people who might be suited to a short term fix like this is someone suffering from Diabetes Type 2 – and only then under medical supervision. To impose this kind of diet on the public is harmful. Liver damage, gallstones, reactive binge eating, bulimia nervosa are common side effects, not to mention the stress of having to eat differently from the people you love.

For a counsellor to understand the psychology, the neuroscience and the physiology of eating and weight problems requires a large amount of additional specialist training. If you don’t use a counsellor with this training is like asking a GP to conduct brain surgery. You just wouldn’t let him or her loose on you.  And, to harness counsellors to sell diet Milkshakes for weight loss is not only wrong, it is wicked. For counsellor to engage with this  is also unethical unless they can prove their appropriate qualifications.

For one thing, agreeing with a client that they “need to lose weight” contributes to the weight stigma that may have led to their problems in the first place. People exposed to stigma find it harder to motivate themselves to eat well, and to engage in activity. They engage in more emotional eating and are likely to be black and white in their thinking. They divide food into good and bad, if they eat a good food, they are worthy people and if they eat a bad food they call themselves weak-willed and greedy. Restrictive diets plus stigma forces a client into a very all-or-nothing relationship with food and with themselves.

 I and my colleagues from the NCFED have spoken several times to the BACP advertising department and their Ethics team to express our opinions. We have also dredged up evidence to demonstrate to the BACP some of the dangers of extreme liquid diets.

The advertising department has ignored us, and as for the Ethics Team, we have had nothing other than an undertaking, since disappeared, to alert counsellors to the ethics of promoting themselves as weight loss consultants without appropriate training.  It seems that counsellors have to promise to regulate themselves and they do not. On a counselling forum recently that clients do not read, one counsellor confessed to having a binge eating client. She wrote “I will deal with all the other things and leave the binge eating alone”. I was horrified – the binge eating was probably causing all the emotional fallout that this poor client was experiencing. The counsellor should have referred the client straight to an eating disorder specialist but thought that it was not important. Maybe she just needed the money.

On another Facebook page peopled by counsellors, it was suggested that obesity was caused by trauma, and most of the members agreed that this was so. When I tried to explain that there are alternative explanations of why people gain weight, I was shouted down. There are a lot of charlatans out there and some of them may be the Cambridge counsellor consultants.

If you want to work with a proper weight change counsellor, you need to find a person who is properly trained to work with body image and the psychology of eating. You will need someone who understands the effects of weight stigma including the stigma that a rises in the counselling space, and to understand the physical and mental health effects of engaging in dieting practices.  Obesity is a very complex condition and its association with mental health is also complex and bi-directional. A Counsellor more than anyone should be aware of fostering the belief that weight loss is desirable and will bring happiness and success in life.  While it is true that weight change can greatly improve QOL, there are good and bad ways to achieve this and it is not a quick fix.

As part of their ongoing training, the counsellor will have done a great deal of work on their own relationship with food.   Quoting an eating disorder advocate – “there’s a sad irony to advertising weight loss consultancy to the very people who are key in helping others with their mental health”.

By encouraging this KIND of dieting, especially restrictive diets like the Cambridge one, Therapy Today/ the BACP are contributing to the harm caused by the diet industry and are encouraging eating disorders. This is unacceptable and unethical.

My plea to counsellors is this. Please do not associate yourself with the Cambridge Weight Loss plan. If you really want to help people who struggle with their relationship with food and their weight, without implying stigma about their size and shape, get proper training.  I am certain that you will never again want to promote a milkshake diet. And let the BACP know how you feel about their behaviour and their failure to rise to the concerns of people who work on the coalface with eating and weight.

How to Help People with an Eating Disorder to Recover: Guest Blog

Posted on by ncfed

The term “eating disorder” covers a wide range of conditions such as anorexia, bulimia and binge eating. If you have a relative or friend suffering from one of these conditions, it is only natural that you will want to help.

The first thing you can do is learn about their particular eating disorder so you can understand what they are going through. There are many articles on our website. Another option is to persuade them to seek professional medical assistance. Unfortunately, this can often prove challenging. You cannot force someone to see a doctor if they don’t want to go (except in certain circumstances). It would be far better if you could encourage them to seek help willingly or even offer to accompany them.    

There are ways of providing support:

  • Help them build up their self-esteem. Tell them how much you appreciate having them in your life. This can give them confidence and help them feel better too.
  • Make them feel valued. A person with an eating disorder may feel depressed and less inclined to go out or join in with your usual activities. Nevertheless, ask them anyway; even if they decline, they will be happy that you made the effort.
  •  Lend an ear. This is sometimes not an easy thing to do, especially if your friend says something about themselves that you disagree with. such as that they are fine. Remember, you don’t want to argue, you just want to be there for them.        

Healthcare perspective on eating disorders

The NHS is aware of, and in fact alarmed by, the rising numbers of eating disorder sufferers. Many of these cases involve children. It is believed that the best option for people struggling with this type of mental health problem is for healthcare professionals to carry out an early intervention.

However, in the UK, only the most extreme cases get the help they need, or hospital treatment if it is appropriate. More often than not, your relative or friend if help is offered at all, they will need to attend counselling support as an outpatient. According to this article, one possible reason for this is that there are not enough mental healthcare nurses.

Treatment for eating disorders

The recommended treatment for an eating disorder is usually some form of talking therapy targeted specifically toward eating disorder behaviour. A therapist will try to uncover the motivation behind the patient’s refusal to eat, or behave in other ways that are harmful. Part of what keeps some one trapped in an eating disorder is that it has become a way to manage their feelings. The therapist could then help the person learn a better way of coping with emotional difficulties. Some people with eating disorders can benefit from a self help programme. They may also undergo regular health checks to ensure that they are sticking to their treatment. As a friend, you can accompany them on their journey and provide moral support.

Eating disorder treatment does not force people to change. Forcing people to eat is only possible if they have lost an extreme amount of weight or they are starving themselves to death. In either circumstance, a doctor’s approval is required for this type of drastic measure.

Recovery may take several weeks or even years if the eating disorder is severe. It is a slow process but it will at least ensure that your relative or friend has time to get accustomed to their treatment plan. The earlier the treatment is started, the better their chances of making a swift recovery.

Conclusion

People suffering from an eating disorder are likely to need the support of their loved ones, especially during the recovery process. It is important that you encourage them to seek professional help, especially if they are denying that anything is wrong or promising that things will be different tomorrow. They will also need to recognise how they can cope more positively even in challenging circumstances. An optimistic attitude is essential as recovery may take some time. Unfortunately, there is the possibility that they will relapse and return to their old ways. If this does happen, try to offer your support and help them get back on the path to good health.

The Crown: Netflix and Diana’s Bulimia

Posted on by ncfed

THE CROWN: Bulimia and The Princess of Wales

Netflix are about to broadcast their latest edition of The Crown showing Diana in the throes of bulimia nervosa. We are led to believe that her unkind and thoughtless treatment at the hands of the Prince of Wales was responsible for her decline into poor mental health and a ravaging eating disorder that dogged her life for years.

We are told, but will never know if this is true, that she first purged before her wedding, in the context of knowing that her future husband was close to another woman, Camilla Parker Bowles.

We will believe that dealing with a huge amount of stress was responsible for her poor mental health and eating issues. This stress included her loveless marriage, her unkind and dismissive husband, and the pressures of the expectations heaped upon her shoulders as a future queen.

If Diana had been put in this position in 2020, there is no doubt that she would have had access before even becoming engaged, to much better guidance and support than was available to her then.

I, like many viewers have struggled not to feel a great deal of pity for the situation in which this young woman found herself, together with anger about the unkindness of the family in which she had been thrust. But, I also find it hard to blame the Royal Family or any of its members for her eating disorder. With courage or confidence, she could have expressed her outrage differently, but then she simply didn’t know how.

We know that bulimia nervosa is not “caused” by anything. It has its roots in the personality of the sufferer and any adverse events they may have suffered in childhood that have weakened their self- esteem and stopped them from being able to express their wants and needs. One example of such a trauma was her mother; abandoning her at a very young age, leading her to believe perhaps that she was not important enough to the most important person in her world.

We know that people with bulimia tend to be sensitive, perfectionist, they tend to over-think and they lack a great deal of self-confidence. Diana will have brought all of these traits into her relationship with the Prince of Wales. A person carrying that deadly disposition to developing a mental health problem will not be able to cope when the going gets rough.

Diana has flagged up her eating disorder as a “cry for help” and perhaps she is convinced that it was, or maybe this was offered as an explanation by her various therapists. I prefer to think of bulimia nervosa as the preferred way of coping with emotions that are overwhelming when someone lacks the language of emotions or the permission to express what they feel.  It is no surprise, therefore, that bulimia lost its hold – and, she was able to tolerate being a healthy body weight, when she discovered her confidence and found a more authentic purpose for her life.

What triggered her act of purging in the first place will never be known. It pre-dated her marriage and from that moment the eating disorder was ready to blow up and engulf her.  I would imagine that blaming the cruelty and the thoughtlessness of other people did not lead to change even if she was only able to thrive outside of that toxic and loveless environment.  What helped her to recover was rediscovering her voice and gaining permission to deserve to eat. Anyone with bulimia nervosa will need specialist help to recover, by targeted focus on self and building something much bigger than the relationship with food.

Covid19, Obesity & weighing children

Posted on by ncfed

I’ve been watching the Twitterstorms and the media circus about the virus, lockdown weight gain, weight loss plans and weighing children in schools

I don’t approve of weighing children in schools after the age of 11. Secondary school children are too weight sensitive and have enough on their plate anyway without the additional shame and worry that is caused by weighing them.

Weight gain is part of adolescence anyway. Bones and organs are growing, boys are adding muscle, girls might be weighed before menstruation, when their weight might be a little higher than usual due to hormones.

Kids think that dieting is the best response to weight gain. What do they know! Dieting is a high risk factor for getting an eating disorder. It can provoke anorexia in some, compulsive eating in others, bulimia in a few. One an eating disorder has its claws in you, it doesn’t go away soon. So please please THINK AGAIN, this proposal is INSANE!

Weighing kids before 11 is OK if it goes along with the usual stuff, height, nits, foot health, weight. OK so we are worried about obesity? Well I accept that. We cant put our heads in the sand and pretend it doesn’t matter. If the virus likes a well-covered person too much, it is what it is.

Fat CAN make some people sick. Sedentary lifestyle can make some people sick as well. Even some healthy diets can make some people sick. Shame and body hatred makes people sick.

Weighing children could be useful if there was proper joined up thinking. The parents of an overweight child mustn’t get the dreaded fat-letter. What use is that going to be other than make them mad. Don’t call my child fat! Who cares anyway! Its only puppy fat!

Parents worried about their child’s weight need access to a coach, someone who is properly trained to help without conferring judgement, shame and guidance. They don’t need diet sheets or good advice given by someone who probably lives on salad and mung beans.

I did something on live TV last night. I forgot to point out that weight gain during lockdown isn’t a cause for shame, alarm, weighing or panic. I forgot to point out that some kids are growing normally. Here it is
https://www.mailplus.co.uk/tv/good-health/18961/what-has-covid-done-to-our-sex-lives-from-couples-who-cant-stand-each-other-to-singletons-hitting-the-dating-scene-we-investigate

Eating Disorders & Covid 19

Posted on by ncfed

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?

Posted on by ncfed

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?

Posted on by ncfed

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, many Ed patients who are very ill 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.  This is the nature of this terrible illness. 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 also other needy people pounding at the door of the money tree.  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 am shocked that the sufferer here did not reach out to the private sector – if she did 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

Posted on by ncfed

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

Posted on by ncfed

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.