Eating disorders don’t typically resolve on their own. Those who suffer with an eating disorder may require specialist support from health carers who have expertise in this area. Eating disorder treatment from the NHS can be provided in a number of different ways:
- Some people may be able to recover with outpatient support. This could include a weekly visit to a clinic for medical monitoring, psychological therapy, and/or potentially some medication.
- Others might need more intensive support in a daycare setting, with more help with meals and therapy throughout the week.
- Some may require support in hospital, in an inpatient setting with greater medical input.
One of the challenges at present is that many NHS services have long waiting lists for treatment, which makes it hard for some people to access eating disorder treatment from the NHS when they need it.
And while the NHS has amazing and talented doctors and therapists working in its services, pressure on the NHS continues to rise and there’s a limited amount of resource available.
Understandably, services are unable to see everybody who presents for treatment, quickly. To help them make the difficult decision as to who gets seen first for treatment, they must constantly assess risk and prioritise patients who need life saving treatment.
Furthermore, if your presentation does not meet full criteria for an eating disorder, as described in the DSM (the Diagnostic Statistical Manual of Mental Disorders), specialist services are less able to provide treatment to you.
Consequently, some people may find that they go to their GP, hoping to receive help, but are unable to access eating disorder treatment from the NHS and the care that they need.
An overwhelmed public healthcare service
There’s always been tremendous pressure on the NHS, but more so during and following the COVID-19 pandemic. The pandemic was an incredibly stressful life event, and many people became ill or relapsed. Mental health services within the NHS have, sadly, been pushed to overcapacity, with the increase in referrals to eating disorder services peaking at 180% in November 2020.
Clients who’ve come to Altum Health for treatment have explained the challenges they’ve faced accessing NHS care. For some, it has even felt as though they weren’t ‘thin enough’ to be seen, as despite expressing great distress, they were placed on long waiting lists for therapy.
When you think you have an eating disorder, it takes a huge amount of courage to go to your GP. Being told you don’t meet the criteria to access specialist treatment, is hugely invalidating.
Because it de-emphasises the psychological distress you might be in, it can make you feel that you’re somehow wasting precious resources, that you’re ‘making a mountain out of a molehill’, or that you’re not deserving of care.
There’s also a sense of there being a ‘hierarchy’ within the eating disorder community, with anorexia at the top. In comparison with other eating disorders, anorexia does often require more medical intervention in order to keep people physically safe. But it doesn’t mean that you’re suffering any less psychologically if you struggle with another eating disorder, or if your weight isn’t so low that you require physical intervention. You’re not more deserving of help for your mental health if you’re severely underweight.
Eating disorders aren’t just about a number on a scale
With eating disorders, physical health is just one part of the illness. Your weight isn’t the cause of the problem, it’s a symptom of the problem.
Your eating disorder is a result of what’s going on in your mind, and the level of distress you’re experiencing. The restrictive behaviours of an eating disorder can serve a number of psychological functions, including a powerful way to help regulate your feelings and emotions.
It can sometimes be the case that people living with an eating disorder can struggle more – psychologically – when at a higher weight, because they’re not regulating their emotions with restriction and haven’t yet learned healthier and more functional coping strategies to help them cope with their big feelings.
So, just because you’re underweight, it doesn’t necessarily mean you’re in more need of help for your mental health. You may be in more need of physical intervention, yes, but psychologically, you could be in deep distress. You could have a ‘normal’ weight or BMI and still be highly disordered with your eating, and very unwell in your mind.
Relying on food and weight to regulate emotions
Using food and weight to regulate emotions and help you feel more in control is problematic as it can impact your ability to enjoy a normal life, lead to serious physical health problems, or even death.
- You may be dealing with a level of obsession that’s affecting your ability to hold down a job, maintain relationships, etc.
- Your relationship with food may have changed for the worse. Perhaps you spend a lot more time thinking about what you eat, calorie counting, lying about food or how much you’re exercising, etc.
- You may find you’ve become more socially rigid. You pass up the opportunity to be social and find yourself becoming closer to your eating disorder than your real friends.
And while it is tremendously important to ensure you keep physically safe, for us, addressing why you’re engaging in these behaviours, and helping you to find alternative ways to cope with anxiety and distress, should be the focus in treatment.
Getting ready to change
Some people have an expectation that when you come to a clinic, such as Altum Health, for eating disorder treatment, you’re immediately ready for change. For the ‘action’ phase.
This can feel scary, as while there may be a part of you that wants to change, there may be another part that most certainly doesn’t, or is terrified of making changes. Often with eating disorders, the ideas you’re engaged with are acceptable to the self; after all, diet and restriction is validated by the society we live in.
Just because you’re not in the ‘action phase’ of change, doesn’t mean that therapy cannot be useful for you.
Sometimes, therapy is about looking at the pros and cons of change, your beliefs about your ability to change, your fears about change, and what change might look like if you decided to do it.
In short, there can be a lot of ‘prep’ work to be done first, before you eat more or increase your weight. And actually, you’ll be changing during this initial prep work, even if it’s not always outwardly obvious.
Change is hard, but this stage of your recovery shouldn’t be overlooked.
Specialists in the treatment of eating disorders
As stated, an eating disorder is about more than just a number on the scale. Our specialist team is here to support you throughout your eating disorder recovery, and we urge you to get in touch to receive the help you need.
Trust your ability to recognise the impact your eating disorder is having on your life. You’re the one experiencing the preoccupation and the distress, so you’re best placed to assess for yourself how you feel.
The sooner you get treatment for your eating disorder, the more likely you are to recover. So if you’re suffering with an eating disorder, and have been unable to access eating disorder therapy from the NHS, please contact us. We offer a free initial consultation with our licensed professional therapists, which you can book here.
Dr Courtney and the Altum Health team
For further support and information for those suffering with an eating disorder, including a free helpline, contact registered charity, Beat.