The number of people admitted to hospital for eating disorders has nearly doubled in six years, NHS figures show. Data from NHS Digital reveals admissions for conditions including anorexia and bulimia reached 13,885 between April 2016 and 2017 – the highest levels seen in six years.
The Department of Health has acknowledged “inpatient treatment should be seen as a last resort” for treating eating disorders. But accessing support isn’t always simple. Doctors, campaigners and MPs told the Guardian the rise in hospital admissions is due to failings in outpatient treatment, with long waiting times and underfunding creating a postcode lottery for treatment.
Getting treatment early is of vital importance. A spokesperson from eating disorders charity Beat told HuffPost UK: “The sooner someone with an eating disorder gets the treatment they need, the more likely they are to make a full and sustained recovery.”
With that in mind, if you believe you or a loved one may be developing an eating disorder, these are the first steps you should take in order to access the help you need as quickly as possible.
According to Beat, it takes three years on average before someone developing eating disorder symptoms seeks treatment for their mental illness.
“The best first step if you’re worried about anyone that you think might have an eating disorder is to encourage them to speak to their doctor as soon as they can, and to assure them that they are not alone with their illness,” the spokesperson said.
According to Dr Louise Theodosiou, from the Royal College Of Psychiatrists, people’s weight can fluctuate for a variety of reasons, but there are a few signs to look out for that may indicate an eating disorder.
“If someone is suddenly looking at calories a lot or if they are trying to avoid social situations that involve food, these might be subtle indications that can show someone is trying to restrict their eating,” she told HuffPost UK.
If you spot these signs, Dr Theodosiou recommended having an open conversation about food and eating habits with your loved one. “Say ‘I’ve noticed you’ve made changes to your eating, or to how you think about food, can I ask if everything is okay and why you want to lose weight?’” she said.
If you believe you might be developing worrying eating habits or struggling with an eating disorder, your first port of call for professional help is your GP.
According to Dr Theodosiou, your GP will ask you questions to try to get a better idea of what might be making you feel this way about food and your body. For example, they’ll ask you when you started to experience a change in feelings around food or if you’ve got a stressful event coming up. They’ll be looking to find out if you’ve experienced any life changes that may have triggered your current feelings, such as a breakup or bereavement. For younger patients, this could mean uncovering stress around exams or their parents’ divorce.
“When upsetting things happen, we all have pattens we fall in to,” Dr Theodosiou explained. “While some people may reach for carbohydrates if they’ve experienced a breakdown of a relationship, for example, others may restrict their eating. Sometimes if people feel like they’ve lost control in their life, that relationship with eating may feel like the one thing they have control over.”
Your GP will also ask about your eating habits, including how many meals you are eating each day and whether you are missing meals, avoiding certain foods or taking measures to purposefully suppress your appetite, such as smoking. They’ll also need to know whether you have tried any methods associated with eating disorders, such as using laxatives or making yourself sick. While these topics are sensitive, Dr Theodosiou said it’s important to answer them as honestly as possible so your GP can get a clear picture of your overall health.
“If you are vomiting that can upset the chemical balance in your body by raising the potassium levels, which can destabilise the heart,” she explained. “Your GP will need to know about vomiting because if this is happening, you’ll need to have an ECG to check on your heart health.”
If you’re a woman, your GP will also ask you about your periods to find out how regular they are and whether or not they’ve stopped. With your consent, they’ll usually weigh you, as the surgery keeps records of your weight over time to help doctors see whether you’ve lost or gained weight due to changes in eating habits. Finally, you will also be referred for general blood tests. “If you have been avoiding red meat or other sources of iron you may have developed anaemia, which can also lead to mood changes. A blood test can help identify this,” Dr Theodosiou explained.
If your GP is concerned about your relationship with food or believes you are developing or have developed an eating disorder, they will refer you on to a specialised eating disorder service within the NHS. The time you have to wait for your next appointment may vary depending on the area you live in, plus how urgent a GP considers your case to be. For example, if a GP finds your eating habits are negatively impacting your heart health, Dr Theodosiou said this would be considered as urgent.
Referrals are covered by the NHS 18-week maximum waiting time system, meaning you will receive a follow-up appointment within this time. However, according to Dr Theodosiou exact waiting times “will vary from area to area and from children to adults”. The Department of Health said it is aiming to provide treatment for eating disorders within one week for 95% of children and young people referred for urgent cases by 2020.
Under referral, you will get appointments with eating disorder experts in order to improve both your physical and mental health, depending on your individual needs. According to Dr Theodosiou, most patients are referred to a dietician who has specialist skills with eating disorders.
“If you have gotten very thin, you may need to safely expand the range of foods that you’re eating. A specialist dietician can help you structure your eating going forward, making sure you are having lots of things like calcium so you’re not getting osteoporosis,” she explained.
You will also be referred to talking therapy for your mental health, where a mental health professional will help you to locate the source of your feelings and work to change them. This may take the form of one-to-one psychological therapy for adults - such as cognitive behavioural therapy - or family therapy for children or young people, where the patient will speak to a professional alongside their parents and siblings. The latter is often recommended if communication within the family has broken down, perhaps due to parental divorce, and that is believed to be the trigger of disordered eating. The regularity of your appointments, plus how long they go on for, is also tailored to the individual, their preferences and their needs.
“We don’t just want people to get better, we want people to stay better and enjoy their whole lives, so we will help them to develop strategies to stay well,” Dr Theodosiou said.
If you are struggling to access the right help due to waiting times, you can talk to Beat between appointments for support and advice by calling the adult helpline on 0808 801 0677 or the youth line on 0808 801 0711.
Commenting on the number of hospital admissions due to eating disorders, the Department of Health said in a statement: “We know the numbers seeking treatment are rising and it’s encouraging to see an increase in patients getting routine care within four weeks, as well as a significant improvement in treatment times compared to last year.
“Inpatient treatment should be seen as a last resort, that’s why we have set out plans to expand community-based care for eating disorders – 70 dedicated community eating disorders services are being developed and recruitment to get the teams up to full capacity is under way.”
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