In this blogpost, I discuss the various support options if you are seeking help for an eating disorder, from visiting your GP to deciding what kind of counselling is right for you
Eating disorders are complex. There is no single cause or trigger, and nor is there a one-size-fits-all 'profile' which can determine whether or not someone will develop an eating disorder in their lifetime. While most people develop an eating disorder in their teens and early twenties, this isn't always true across the board; likewise, while a lot of people become unwell in response to stress or trauma (as opposed to a unipolar desire to 'get thin,' as is often wrongly presented on TV) that may not always be the case, and not everyone who experiences stress and trauma will go on to develop an eating disorder.
Some examples of eating disorders include anorexia, bulimia, binge eating disorder and 'other specified feeding or eating disorder' or OSFED, the symptoms or associated behaviours of which may not fit those that apply to other eating disorders when doctors make a diagnosis, but which can still be very serious in terms of how they affect someone's mental or physical health.
According to the UK's leading eating disorder charity Beat, 80-85% of people with eating disorders are not underweight. There is often an assumption - which the media tends to fuel in its portrayal of people with eating disorders - that you have to be very thin in order to a). be diagnosed with an eating disorder and b). actually have an eating disorder. However, it is becoming increasingly clear among health professionals that the most reliable indicators of eating disorders are not those related to weight; rather, they are more to do with people's feelings and thoughts around food and/or their body image, and related behaviours (I prefer to use the term 'coping mechanisms,' but I'm going to use the word 'behaviours' in this blog post in order to be consistent with other examples of eating disorder-related literature). This means that you could have a healthy BMI but your thoughts and feelings towards food can be such that they are affecting your health.
For that reason, it is important to be as open as possible if you or someone you know visits a GP to discuss getting support for an eating disorder. Your GP or equivalent health professional- an advanced nurse practitioner, for example - should be your first port of call if you are worried, and they will ask you a series of questions about your relationship with food, your body image, and exercise. This may feel quite intrusive, but it is important that the medical professional you see is able to build up as detailed a picture as possible about your feelings, thoughts and behaviours in order that they can refer you on to the most appropriate services.
Weighing you and measuring your height is part of standard practice in order to calculate your BMI, and if you are underweight, you will be referred to a specialist inpatient or outpatient unit. This means you will be seen by a specialist team whose job it is to offer you a holistic care package; this means you will see a variety of specialists from dieticians to counsellors, nurses to family therapists (if appropriate), so that the support you receive takes the 'whole' of you into account, as opposed to just your relationship to food. The idea behind this is that you feel supported enough to explore the background to the eating disorder, identify factors in your environment and thought patterns that could be keeping it going, and - crucially - develop alternative ways of responding to whatever difficult thoughts and feelings might trigger fear or discomfort around food.
If your BMI is considered healthy, that doesn't mean you don't have an eating disorder. There are various options available to you in terms of help and support, chief among which is counselling through your local NHS team. Your GP will probably refer you for counselling through a service called IAPT, which is free at the point of use and offers 6-12 (though sometimes more) sessions with a counsellor or psychotherapist who will help you explore what has lead to the eating disorder, and what might be making it hard for you to re-establish a healthy relationship with food. You may also be offered cognitive-behavioural therapy - a therapeutic approach which is a form of counselling, looks at the relationship between thoughts, feelings and behaviours and is often a bit more 'task based' that standard talking therapy - and/or an online programme with a similar premise. Your GP will be keen to review how you're doing, and will probably ask you to arrange a follow-up meeting in a few months' time.
If you are at school or university, seeing your school counsellor, or visiting your university counselling service, is often a good place to start. You will usually be offered 4-6 sessions with them, and they have the resources to refer you forward if they feel you need more support. Other options are private one-to-one counselling or - if appropriate - private family therapy. While this is a more costly option, waiting lists are much shorter than those related to IAPT or other NHS services, and there is scope for doing much longer term work. If you are in the Harrogate area, please get in touch and I will be happy to share my knowledge of local therapists with eating disorder specialisms, or talk you through the therapy that I can offer.
It can often take a long time to recover from an eating disorder, and recovery can look very different for different people. Some people find that while they may recover 'physically,' associated thoughts and feelings remain for some time, while others find that they are able to put their eating disorder behind them altogether. Others may go for long periods of having a 'healthy' relationship with food, but may experience the occasional relapse. It is important to remember that eating disorders, and the way people try to get better from them, can manifest in many different ways and take lots of different forms; something I hear time and time again when counselling people with eating dosrders is how lonely and misunderstood a struggle it can be, so try to seek support as soon as possible: you don't have to suffer alone.