Types of Eating Disorders we work with
Our specialist eating disorder team has experience in working with children, teenagers and adults with a wide range of eating disorders and with those whose eating-related problems don’t fit neatly into any category. Problems we commonly work with include anorexia, bulimia, binge eating and selective eating.
Anorexia Nervosa and similar conditions
People with anorexia tend to have a strong desire to lose weight or avoid weight gain. This results in some combination of eating less, excessive exercise, vomiting or other behaviours that are intended to result in weight loss. With weight loss comes a range of emotional difficulties (e.g., irritability, rigidity) and physical difficulties (e.g., tiredness, low concentration).
People with bulimia also have a desire to lose weight that results in reduced eating. Unfortunately this results in a cycle of eating little and then losing control and over eating (or bingeing) followed by guilty feelings and vomiting.
Binge eating disorder
This is characterised by episodes of overeating with loss of control, but not followed by vomiting.
Selective eating is generally seen in children this relatively common condition involves the eating of only a narrow range of foods.
People are of course more complicated than the descriptions above and often do not fit into neat categories. Our highly skilled and experienced team is used to working with the full range of difficulties and also those whose eating difficulties exist alongside mood, relationship or other problems.
The principles underlying our treatment approach are as follows:
Treatment is always guided by a thorough assessment.
This means that the client and their family (where relevant) and the clinicians have a shared understanding of both the nature of the problem and the way forward. An assessment may be provided by a therapist or by one of our psychiatrists who will then be able to coordinate and organize further care. In most cases, and all cases involving a child or adolescent, the assessment and treatment will include other family members.
Treatment is about both moving on from problems and improving quality of life. Treatment is directed to the eating problems, which are causing concern, but also to the impact these are having on the client’s life. A fundamental goal of treatment is support clients to return to a healthy normal life.
Our approach is to work in partnership with our clients.
This means that are clients are not passive patients, and are in fact members of the treatment team. This partnership extends to other members of the family, who can be so important in providing the support that facilitates recovery. To facilitate this partnership and sustain motivation, we offer ‘psychoeducation’, which involves sharing information about the eating problem, associated medical risks, how the problems have developed, and the treatment plan.
Specific treatments for Eating Disorders
We work as a team to offer a range of support for clients with eating disorders. Depending on the problem, clients may see one or more members of the team.
The roles of the team’s psychiatrists include:
- Where appropriate to carry out a thorough comprehensive assessment
- To identify and treat problems that commonly exist alongside eating disorders, such as depression, anxiety and obsessive compulsive disorder
- For complex cases to maintain an overview, provide support and guidance and coordinate various aspects of treatment
- To provide aspects of individual and family treatment
Family therapy plays an important role in the treatment of eating disorders, particularly for children and adolescents but may also be helpful for adults. The function of family work is to aid the family to support the client as the family is thought of as a resource for recovery. Family therapy may also help a family through the impact the illness may have on everyone. Sometimes this is a question of supporting the struggle to cope and move forward whilst increasing understanding. Other times it is a question of identifying and addressing patterns of family interaction that may feel ‘stuck’ or problematic.
CBT and other individual therapy
Cognitive Behavioural Therapy is an evidence-based approach that aims to help people to understand how their problems developed, and then make changes in order to move on. In CBT for eating disorders, the main focus is on working out what is keeping the eating disorder going. For example, in a CBT session you might draw out vicious cycle with your therapist (e.g., eating too little and then bingeing) to work out together how to break the cycle. Sometimes eating disorders develop as coping strategies that help people to manage difficult feelings and CBT can also help people to find new coping strategies.
For some people, different psychological approaches are helpful either instead of CBT or alongside. Examples include mindfulness and motivational treatments.
Many of those suffering eating disorders have an inadequate diet in terms of the amount eaten or the balance of the foods eaten. Our specialist and experienced dietitians use evidence-based information to educate clients on nutrition and advise on an eating plan that will lead to a healthier relationship with food. This can involve working with the client to draw up a meal plan or setting goals to help them achieve their recovery aims. These may include weight gain, weight maintenance, reducing effects of starvation or use of behaviours, improving nutritional adequacy, or increasing variety. The dietitian can also help the client rediscover what it is to eat normally again, and to challenge difficult foods and improve variety.Contact us