MHM Magazine

38 | MENTALHEALTHMATTERS | Issue 2 | 2021 MHM • Eating disorders have a physiological impact on the sufferer , such as loss of bone density, heart problems, gastro-enteral dysfunction, loss of menstruation, fertility problems, teeth erosion and the list goes on. Often the sufferer would present with a physical complaint, and the eating disorder goes unrecognised as the cause. Examples might include constipation, IBS, poor energy levels, fatigue or insomnia. Sufferers of eating disorders can go to great lengths to keep their behaviour a secret as a result of shame. Weight changes could be praised by professionals as a sign of improved health, without recognising the medical and psychological risks associated. Individuals with Eating Disorders wouldn’t necessarily express concern to a medical professional about their weight fluctuations in the same way someone without an eating disorder might. For instance, they could present in an ER after fainting without looking like or admitting they have restricted their intake. Some professionals might make incorrect assumptions based on lack of insight, such as “you must have a problem with binge eating” to someone who is in a bigger body. Some might suggest a diet or personal trainer in response to a complaint about dissatisfaction with a patient’s weight. Extremely important to note: Individuals who binge usually do so in response to starvation from dieting or restricting intake severely, the restriction needs to be treated in order to reduce bingeing. Common signs to look out for: • Significant distress due to obsession around food, weight or body image. This can include body dysmorphia, where one becomes obsessed about perceived flaws in appearance. • Impact on a person’s social life which become dictated by the presence or absence of certain foods. They struggle to enjoy food-related activities (birthday parties, dinners out, weddings, family meals) without significant distress. • Relationships with their loved ones can lead to conflict around food, anger, irritability, impulsivity, shame and guilt, as well as other relational problems. • Eating disorders have a high co-morbidity with other mental health disorders, especially mood disorders including depression and bipolar, anxiety disorders, substance use disorders and personality disorders. • Eating disorders reveal themselves with extreme thinking around food and body such as “I can’t live if I don’t lose weight” or “I don’t deserve to eat unless I exercise everyday” “I would rather die than put on weight”. Some of what we offer and find effective in treating people with eating disorders. • Outpatient individual and group therapy. • Family educational talks and family therapy. Making the family and loved ones allies in the treatment significantly improves the prognosis. • Dietetics support and nutritional therapy. Treating a person with an eating disorder requires special understanding of the nuances of this illness, and is more than prescribing a meal-plan. • Peer supervision and support References are available on request.