Eating Disorder

Awareness
Myth Busting & Story Telling
Luke Evans, Beat Young Ambassador
What are Eating Disorders?

• EDs:
• Are complex
• Are damaging (deadly!!!) & all-consuming
• A frenemy?
• Come in many shapes & sizes
• Are a big problem…
• … But are not untreatable!

• According to NIMH:
• “Eating disorders are actually serious and
often fatal illnesses that are associated with
severe disturbances in people’s eating
behaviors and related thoughts and
emotions.” [1]
 Persistent restriction of intake → reduction
in body weight (BMI < 17.5 = underweight);
fear of weight gain or behaviour that
interferes with weight gain; distorted
Patient does not meet full beliefs about body weight/shape, often
criteria for an ED, and the does not realise severity of illness.
person diagnosing does not
wish to be more specific.
Anorexia
nervosa**
*Based on the DSM-5 criteria
**2 types: restrictive type &
binge-purge type, which is not
the same as BN!
***… but are not limited to…
I was diagnosed with AN…
Bit of a shock!

Unspecified
feeding or eating
disorder Eating
Binge
disorder* eating
disorder
Other specified
feeding or eating
[2]
disorder Patient experiences recurrent episodes of
binge eating; features of the binge include***
eating more rapidly, eating excessive
Bulimia amounts of food when not hungry; marked
Includes***: nervosa distress; usually occurs at least once a week
1. Atypical AN for 3 months; no compensatory behaviours.
2. BED (of low frequency/limited duration) Patient experiences recurrent episodes of
3. BN (of low frequency/limited duration) binge eating; there is persistent use of
4. Night eating syndrome compensatory behaviours; usually
5. Purging disorder occurs at least once a week for 3 months;
negative self-evaluation based on shape
& weight; not associated with AN.
Who gets Eating Disorders?
is Affected by Eating Disorders?

• Who is at highest risk? [3]

• Adolescents
• Diabetics
• Athletes
• Women
• But, of course, not exclusive to these
groups!

• Who is affected?
• Friends
• Family
• Society…
• … A whole lotta people!
Who gets Eating Disorders?
is Affected by Eating Disorders?
• Eating disorders often co-occur with other
psychiatric disorders.
• Chicken or the egg? It depends!

• Common comorbidities include: [4, 5]

• Anxiety disorders
• e.g. OCD, social anxiety
• Autism
• Mood disorders
• e.g. major depressive disorder, bipolar disorder
• Personality disorders
• PTSD
• Substance use disorders
• Self-harm/suicidal tendencies
• Psychosis
Why do People get Eating Disorders?

• We’d struggle to cover it all in an

hour’s talk, never mind half an hour!
• Very complex!

• We can divide the risk factors for EDs

into 4 categories: [6, 7]
• Biological.
• Psychological.
• Social
• Environmental
• “Biopsychosocial” model of disease.
Why do People get Eating Disorders?

Biological factors [6, 7]

• Genetics
• ↑ risk if a close relative has an ED, or mental
health condition in general!
• Chemical imbalances in the brain
• Endocrine dysfunction
• Adolescence associated with big changes here!
• Energy output > Energy input
• Or vice versa
• Type 1 diabetes
Why do People get Eating Disorders?

Psychological factors [6, 7]

• Perfectionism
• Low self-esteem
• Associated mental health conditions
• Behavioural rigidity
• Autism
• Conflict avoidance
• Competitiveness
• Body image dissatisfaction
• High concern about the judgement of others
• Belief that high achievement → love
Why do People get Eating Disorders?

Social factors [6, 7]

• Cultural, professional or recreational
emphasis on body weight.
• Valuation of people according to external
appearance.
• Pressure to achieve & succeed.
• Bullying/teasing
• Loneliness
Why do People get Eating Disorders?

Environmental factors [6, 7]

• Major life events
• Dieting
• Ineffective stress coping mechanisms!
• Trauma
• Relationship issues
Which Parts of the Body are Affected?

• Pretty much every part of the body!

• Our body is a very busy place – our metabolism is
constantly running and it needs an energy supply.
• Too much energy is also a big problem!

• Health consequences vary between EDs [8].

• AN – related to energy deficit; breakdown of Digestive system Nervous system Endocrine system
body’s own tissues for energy, low energy supply
to tissues, also very bad!
• BN – electrolyte imbalances and nutrient
deficiencies; damage and wear of body structures
e.g. teeth Blood & cardiovascular Integumentary Immune system
system system
• BED – related to overeating which may lead to
obesity, associated with cardiovascular disease
etc., other damage such as stomach rupture!
How can we Help?

• There is loads we can do!

• Handy resources:
• https://www.beateatingdisorders.org.uk/recovery-
information/supporting-somebody
• https://www.nhs.uk/live-well/healthy-weight/supporting-
someone-with-an-eating-disorder/

• Recovery is not easy, and it becomes easier

for carers and sufferers alike when we
acknowledge this.
• Be there for them; beneath the ED, they are still
themselves.
• It’s okay to acknowledge the elephant in the room!
Where can we get Support?

• It can be difficult for a person with an ED to talk

about how they feel, even with their close friends
& loved ones!
• People with eating disorders have been found to
have ↓ trust in others, a reliance to disclose personal
information, and ↑ feelings of loneliness [9]

• There are many services available that provide a

vital lifeline in a non-judgemental environment –
see the handout!
• The GP
• CAMHS
• Online forums
• Helplines
• Resources (knowledge is power!)
Beat’s Services

• Beat is the UK’s leading ED charity.

• In 2017-2018, 17,573 people joined Beat’s
campaign and £450,000 was raised by
fundraisers!
• Beat works for change & aims to raise
awareness.

• Many services are available from

Beat:
• Helplines
• Web chat
• Forums
• Helpfinder
• Training & conferences
What Services did I Access?
• The GP
• Told I was “malnourished” and an appointment was made
for a month’s time
• My mother suggested bloods were taken.
• Child and Adolescent Mental Health Services
• Referred by a paediatric nurse when called into the
paediatric ward due to abnormal blood results.
• Meal supervision & outings, CBT, no dietician in our
health board.
• Beat
• Online forums & resources were super useful!
• Never used 1-to-1 chat or helpline, didn’t feel things were
that serious – but that’s wrong!
• Not exactly a service – but friends, family &
even school were always there!
• Can’t beat that!
 My Experience

Winter 2015 – 28th March,

Summer 2015
January 13th, 2000 Winter 2017 2019
First signs of ED.
Hello world! Time with CAMHS Hello Cardiff Met!

Summer 2013 Winter 2015 January 2018 –

First signs of trouble? • Went to GP present
(but not ED!) • Referred to CAMHS Wellness,
(but not by GP) independence, &
• First appointment Beat!
with psychiatrist
• Hospitalised over
Christmas
Thanks for listening!
Any questions? Ask away!

My email: LukeAEvans2018@outlook.com

Beat’s website: https://www.beateatingdisorders.org.uk/

(from here you can find points of contact, resources, and much more!)
References
1) National Institute of Mental Health. Eating Disorders. Available from: https://www.nimh.nih.gov/health/topics/eating-
disorders/index.shtml. [Accessed: 21/03/2019].
2) Eating Disorders Victoria. DSM-5. Available from: https://www.eatingdisorders.org.au/eating-disorders/what-is-an-eating-
disorder/classifying-eating-disorders/dsm-5. [Accessed: 21/03/2019].
3) Eating Disorders Victoria (2016). High Risk Groups. Available from: https://www.eatingdisorders.org.au/predisposing-
factors/high-risk-groups. [Accessed: 21/03/2019].
4) National Eating Disorders Collaboration. Comorbidity. Available from: https://www.nedc.com.au/eating-disorders/eating-
disorders-explained/types/comorbidity/. [Accessed: 21/03/2019].
5) Gadalla, T.M. Psychiatric comorbidity in eating disorders: a comparison of men and women. Journal of Men’s Health. 2008.
5(3). Available from: https://doi.org/10.1016/j.jomh.2008.06.033.
6) Eating Disorders Victoria. Risk Factors. Available from: https://www.eatingdisorders.org.au/eating-disorders/what-is-an-eating-
disorder/risk-factors. [Accessed: 21/03/2019].
7) NEDA. Risk Factors. Available from: https://www.nationaleatingdisorders.org/risk-factors. [Accessed: 21/03/2019].
8) NEDA. Health Consequences of Eating Disorders. Available from:
https://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/HealthConsequencesofEatingDisorders.pdf.
[Accessed: 21/03/2019].
9) Rotenburg, K.J. (2018). The Silent Suffering of Eating Disorders. Available from:
https://www.psychologytoday.com/gb/blog/matter-trust/201402/the-silent-suffering-eating-disorders. [Accessed: 21/03/2019].