Recipe for treating eating disorders

The constant need to get the right weight and look can have disastrous consequences for young people in today’s.

Mary Synott, a registered psychiatric nurse and a humanistic and integrative psychotherapist accredited member of IAHIP and IACP, based in Ardnacrusha treats eating disorders and obesity management.
The centre was set up to support sufferers, parents, carers and professionals by providing support, information, advice, counselling and training to anyone looking to develop a better understanding of this condition.
During the course of her work as a psychiatric nurse, she was struck by the lack of public services for people with chronic eating disorders. It prompted her to complete the necessary training to help people with eating disorders and obesity.
In addition to an increase in the number of people suffering from these disorders, Ms Synnott warns that adolescents are presenting at a much younger age with this problem.
Ten years ago, she said it was unusual to see a 15 year-old boy with an eating disorder. Nowadays, national school children as young as 12 are showing signs of having some sort of condition. Sometimes periods of transition can trigger this potentially life-threatening problem.
“The prevalence of eating disorders is rising. It is an increasing problem and one that is often undetected for a number of years. Eating disorders have the highest mortality rate of all the psychiatric illnesses and they can also occur in boys and men.
“Boys and girls want to be like their peers. There is societal pressure to look good and your value is judged by how you look. Young people, particularly young children and adolescents, are greatly influenced by the media.
“Children in particular mirror what is around them and they admire celebrities who present a glamorous image that isn’t real. Young girls who are becoming more anxious about their body weight are at risk of developing serious problems later in life.
“Eating disorders are usually triggered by a diet initially. Dieting is dangerous as it teaches us to discontinue eating,” she said.
She explained that most children and adolescents are best treated at home with their parents but it doesn’t work for every family.
While more people are presenting with food-related and body image issues within the health services, she claims less people are there to meet their needs due to reduction in staff numbers.
There is also a deficit in the availability of specialist centres and therapists treating eating disorders in Ireland. Clare sufferers often end up in the psychiatric unit at the Mid-Western Regional Hospital, Limerick, where they are accommodated without receiving specialist treatment.
Public in-patient beds are provided in St Patrick’s Hospital, Dublin, for patients with voluntary health insurance. In certain cases, the HSE will fund a bed for a patient but this can take time to arrange.
Ms Synnott warns that eating disorders can be hidden for years.
“Early intervention is the key and if you can identify the problem early, treatment is possible. It is vital to give patients and families hope for a recovery,” she says.
There are three main classifications to eating disorders – anorexia nervosa, bulimia nervosa and binge eating disorder.
Anorexa nervosa, the most common disorder, is the most difficult to hide and serious cases require hospitalisation. It is characterised by deliberate weight loss and a refusal by the person to eat, often to the point of emaciation.
Mary explains that a person suffering from anorexia never reaches the weight they want to be as they always move the goalpost when they get there in their desperate for perfection.
Although anorexia means “loss of appetite”, the sufferer does in fact have an appetite. However, the fear of gaining weight creates a need to control the appetite to the point of eating very little and in some cases nothing.
Some people binge and purge but maintain a low body weight. Others hide food or take laxatives or slimming pills in a bid to reduce the “perceived” weight.
Bulimia nervosa, which is equally dangerous, can be kept hidden for a lot longer and can result in heart failure. It involves an eating pattern that takes place in a short space of time involving large amounts of food, a lack of control over eating and what is being eaten. Recurrent inappropriate compensatory behaviour in order to prevent weight gain as a result of eating pattern tend to go hand in hand such as self induced vomiting, misuse of laxatives, diuretics, or other medications, fasting or excessive exercise.
Compulsive overeating or binge eating disorder is similar to bulimia. It is characterised with a loss of control and distress about the binge eating behaviour. These episodes with food may occur when alone, at night and have an emotional association with loneliness, unhappiness or low self-esteem.
Unlike the bulimic, Ms Synnott explains they do not resort to vomiting or purging to control their weight so as such are likely to have weight or become overweight.
“Some people don’t fit strictly into one of these categories. That does not mean that they don’t have an eating disorder. Many individuals struggle with disordered eating. There is no doubt that individuals who struggle with disordered eating find it extremely distressing and it can be very difficult to break free from the thoughts and behaviours without specialist help,” she says.
Ms Synnott admits it is difficult for a family member to approach a sufferer as they don’t know what to expect and may have previously got an angry response.
“A sufferer may feel ashamed to admit their behaviour or they feel ‘in control’ and don’t want anyone to ‘make them fat again’.
“An eating disorder is often a way of coping with deeper problems that it may take a long time to tease out. Each case is different. It is thus really hard to give advice that is proper for each individual case,” she explains.
She suggests a person should show concern, but not to get over-involved or take responsibility for the health of the sufferer. The best advice is to get professional help. Family members may also need professional help and support in order to handle their own emotional responses to the sufferer.
Ms Synnott warns help for eating disorders is patchy at best. GPs are not formally trained to understand or treat eating disorders, she says, although their help in managing physical risk is invaluable.
“Services available through the HSE usually are only made available to serious cases of anorexia or bulimia and, due to demand, there may be long waiting lists or only help in non-specialist mental health units. Adequate follow-up post treatment is a vital part of recovery.
“A form of therapy called CBT adapted for eating distress is recommended for bulimia and compulsive eating. Many counsellors and psychotherapists claim to treat eating problems and may do so with success, however specialist skills are recommended.
“A good, competent therapist will be willing and able to answer people’s questions. It is necessary to liase with a GP to ensure that the client is medically stable. The physician must treat any medical or biochemical conditions that contribute to the eating disorder as well as any symptoms that arise as a result of it,” she adds.
Mary can be contacted via the website www.eatingdisorders.ie.