Eating disorders

Eating Disorders are an issue for all ages

Written by Anne-Marie Bollen and Alison Seymour.

The term ‘eating disorders’ is a generic name for a range of clinically significant eating behaviours normally classified under the Diagnostic and Statistical Manual (DSM) system (Palmer 2014).

The DSM classification defines the most commonly known eating disorder categories as anorexia nervosa, bulimia nervosa and binge eating disorder. These eating disorders are serious and enduring mental health conditions which often have co morbidity with other complex mental health conditions such as depression, substance misuse and personality disorder.

Eating disorders primarily affect young women aged 12- 25, however they are not a respecter of age or gender and it is estimated that 11-20% of eating disorder sufferers are male

Recently, the media covered a new study which found that up to 3% of women in their 40s and 50s also report to have had an eating disorder within the past year. This contrasts with the estimated prevalence of eating disorders in younger women aged 15 –30 of 1%.

This study is the first of its kind to report the prevalence of eating disorders in this age group and it is thought that the findings are significant due to the quality of the study and the large sample size used. Some of the reasons suggested for women developing eating disorders at this stage in their lives include significant life events such as divorce, bereavement, financial difficulties as well as changes in body shape and weight due to the menopause. The study reported that many of the participants had not spoken about their difficulties or received any treatment. It was suggested that this could be due to a lack of access to appropriate treatment as well as a lack of knowledge of eating disorders in this age group by healthcare professionals.

Accessing support and appropriate treatment for eating disorders is an issue for people of all ages; a key factor in treatment is working collaboratively to involve the people who are experiencing these issues and their families wherever possible.

Following the publication of the Welsh Government Eating Disorders Policy Framework in 2009, there are now specialist eating disorders services for young people and adults throughout the Local Health Boards in Wales. These specialist teams link in with other tiers of healthcare services to provide a comprehensive approach to offering support and treatment for those with eating disorders:

Tier 1

Primary care and activities provided by health, social and community services. Generic services staffed by professionals who are not normally specialist in eating disorders e.g. GP, student counsellors, practice nurses.

Tier 2

Services provided by staff who have training in assessing and working with people with mental disorders e.g. community mental health teams.

Tier 3

Specialist services provided by multi-disciplinary teams who have specific expertise in working with people who have an eating disorder.

Tier 4

Highly specialised and intensive services requiring specific referral and review e.g. specialist in-patient eating disorders unit.

(The 4 Tier model for eating disorder services in Wales. Adapted from Improving Treatment for Eating Disorders 1000livesplus )

The Tier 3 specialist teams are headed by Clinical Leads and their contact details can be found on the Local Health Board websites. In addition, hundreds of interested people are also part of the All Wales Eating Disorders Special Interest Group which is chaired by Robin Glaze a Consultant in Adolescent Psychiatry at Betsi Cadwaladr University Health Board. Conferences are held twice a year in different venues across Wales often for a £10 fee or free to concessions.

Eating Disorders have the highest mortality rate of any mental illness and  undergraduate students in the School of Healthcare Sciences have lectures about them on their programmes. Additionally, following the delivery of several modules at Masters Level to 60  health and social care professionals, feedback has indicated that having someone who has lived experience of an eating disorder as well as having a carer of someone with an eating disorder as part of the teaching team, has been of paramount importance. The students had opportunities to reflect on their practice and by using triangulation were able to consider the stages of contact with services from the lived experience, the carer and the clinicians’ perspective.

Those practitioners involved with the module over the past seven years have noticed a change in their clinical skills development and demonstrate that they continue to use a collaborative approach in their daily work when engaging with people; assessing them for risk or when managing and providing a range of therapeutic interventions as recommended by the National Institute for Health and Care Excellence.

The UK national eating disorder charity Beat provides information and support to those living with an eating disorder and those supporting them.  From 27 February 2017 until 4 March 2017, there is a UK wide annual Eating Disorders Awareness Week.

The School of Healthcare Sciences is supporting this event on the 1 March from 10.00am to 1.00pm in Ty Dewi Sant, Heath Park Campus.  Students and staff will be wearing odd socks, sharing information on recent projects and research and collecting socks for local homeless and refugee projects as part of the University’s engagement with communities work.

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