Why do people have eating disorders?

They may suffer from low self esteem (feeling ‘not good enough’ inside) and so their efforts to change their appearance may be an attempt to feel better, or to cope with their emotions. For many people with eating disorders, they suffer from anxiety and depression and/or find it difficult to understand their emotions, so the eating disorder can become a way of coping with their distressing emotions. It may provide a temporary sense of relief or control in the short term. However, it doesn’t solve the underlying problems and over time, it causes more problems. The eating disordered behaviours begin to take over the person’s life, preventing them from enjoying themselves. It can also impact on their moods (leading to more anxiety, irritability and depression) and extreme dieting can also increase the chances of developing a habit of binge eating.

Busting those myths

It can be confusing, frightening and stressful for parents, families and friends to see your loved one suffering from an eating disorder. It can be difficult to understand and hard to know what to do to be supportive. Many people believe that the sufferer should just be able to ‘snap out of it’ and stop worrying about it. But this is an unrealistic expectation because it is simply not that easy. This belief can cause more conflict in families, increasing frustration and blame towards the sufferer. It is important to remember that people who struggle with eating disorders did not choose to have these difficulties. They are not being vain or deliberately trying to be difficult or trying to gain attention. If they are refusing to eat, it may be because they are very afraid and often do not know what to do to manage the situation (or their emotions) differently. It can be very scary for them to consider changing their patterns when they have not yet developed other ways to cope. Try to remember that the person suffering is in distress and needs your support through patience and understanding.

Why is it so hard to stop?

Eating disorders become habits over time. This means that even though the person may be fed up with the consequences, they can still find it very difficult to change. They can also feel very reluctant to give it up because they have come to rely on it to feel good about themselves and it may be their only way of coping with stress. Once they gain support, it will still take time before changes will be obvious. This is because learning new skills to manage stressful situations differently is a process that takes time. It is important to remember to be patient.

What services are available?

There are some excellent services available to support people in the Hunter New England Area. These services are free, voluntary and offer confidentiality:

The Child and Adolescent Mental Health Services sees children and adolescents up to 18 years of age, with a range of mental health concerns, including eating disorders. They offer predominantly family-based interventions for young people with eating disorders, as well as dietetic support. There are currently teams based in Newcastle, Wallsend and Maitland.

The Eating Disorders Service at the Centre for Psychotherapy provides treatment for adults from 18 years and also provides support for their families or spouses. They offer a range of individual therapies, group therapy and dietetic support.

Rural areas:

For people living in rural areas, there are skilled professionals at the local community health services that can provide support.

The Central Coast Area:

The Central Coast Early Intervention Eating Disorders Service provides treatment for all ages and offers a day program. 4356 9418

How does therapy help? The therapist helps the person to understand the patterns that may be contributing to the eating disorder and to help them learn to identify their emotional needs and to learn skills to manage their emotions differently. They can also help people learn to accept themselves and to improve the quality of their lives.

How does family-based interventions help? They help to restore the parents confidence in their ability to parent, to reconnect them with their skills, remain together during challenging times, to build a supportive structure so that they can work as a team within the family and to build strong social supports outside of the family.

How do dietitians help? Dietitians help people to have a healthy relationship with food by learning to have a flexible approach to healthy eating and to improve their nutrition, so that they have the energy to live their lives to the fullest.

The Hunter New England Area Health Service is improving existing services
Eating Disorders are now receiving more attention on a National level and efforts are being made to consider how to improve existing services, as well as targeting how to prevent these illnesses from developing and the best ways to provide early intervention.

A current research study: The Child and Adolescent Mental Health Services are currently seeking feedback from parents who have previously sought support for their child with Anorexia Nervosa in the past three years, and who is now at a healthy weight. They would like to hear what they found helpful in order to continue to improve services. Parents will be asked to complete a survey and an optional interview. If you would like to participate, contact Kath Wood (Senior Social worker) in Newcastle on 49257800.

Providing education to General Practitioners: HNEAHS have developed a comprehensive information package for GPs that helps them to understand the needs of people with eating disorders, to provide better care and to help people to gain appropriate support.

A message for sufferers

Many people find it very difficult to acknowledge these difficulties and avoid seeking help for a very long time. Sometimes this is because people feel ashamed and expect that they should be able to overcome it on their own. They may also worry about being judged or bullied into making changes before they are ready. You may not feel ready to even consider making any changes yet. That’s okay. It can take time to think about what you want and to get prepared, before you are ready to do something about it. You are still welcome to gain support. It can help to talk to someone about your worries and to find out what options are available, so that you can decide what you might like help with. Recovery is hard work, but it is certainly possible. We are here to help you when you are ready.

A message for parents

If you are a parent, try to encourage your family to eat together regularly and notice what your children are eating. Healthy eating means eating good food regularly. Check that your children are getting enough nutrition (especially if they are actively involved in a lot of sports). More boys are developing eating disorders and they are often not noticed, partly because eating disorders are still viewed as a girl’s disease. Males with eating disorders tend to over-focus on trimming fat and building muscle, rather than weight loss. If your child or adolescent appears to be avoiding normal meals or is questioning what is a reasonable amount of food to eat, it is important to trust your judgement about what you know is reasonable to expect. Try not to let your child’s concerns undermine your confidence in your knowledge. If in doubt, talk to someone for advice.

Don’t underestimate the importance of spending regular time with your child enjoying their company and taking an interest in their interests. Encourage them to talk about any things that worry them and take the time to really listen (this is often more helpful than giving advice!). This will help them to develop healthy self esteem and to learn to cope with stress more effectively.

Early intervention

If you are concerned that a child or adolescent is developing symptoms of an eating disorder, it is important to encourage them to seek support as early as possible because the sooner they get help, the easier it will be to recover.

What do I do if I am concerned about someone I know?

If you are concerned about someone you know, raise the issue sensitively by asking if they have any concerns themselves. If they acknowledge it, encourage them to seek help. If the person is reluctant to seek help and you’re not sure how to be supportive, ask them how they would like you to support them. If you would like support or advice yourself, you can contact us on the above numbers, or call the Butterfly Foundation support hotline on: (02) 94124499.

How can people seek support?

If you want to gain treatment, or have any concerns, talk to your GP, who can make a referral for you. Once you are referred to the health services, we will offer you an initial appointment to explore how we can best support you. If you would like to talk to someone about your options for support, or if you do not yet have a GP, you can call the health services directly. You will still need to see a GP once you have accessed the serives, because they do not provide medical services (numbers below):

The Adult Eating Disorders Service

At The Centre for Psychotherapy, Watt Street, Newcastle, 49246820

Child and Adolescent Mental Health Services

Newcastle area: 621 Hunter St, 49257800
Lake Macquarie area: Wallsend, 49246200
Hunter Valley area: Maitland, 49392449

The Central Coast Early Intervention Eating Disorders Service

Located in Wyong, 4356 9418

Crisis support

If you require urgent support regarding mental health issues, the 24 crisis number is: 1800 655 085

Medical support

If you have health concerns please contact your local GP. If you require urgent medical advice phone John Hunter Hospital: 49213000.

Support groups

Support groups are available in Newcastle for people suffering from eating disorders, and also for their parents/carers. You can contact the Butterfly Foundation for more information: (02) 94124499.

Prevention: promoting positive body image and high self esteem

You can help build self esteem and a healthy body image by encouraging people (especially young people) to appreciate themselves for who they are, and accepting their unique differences. Take an interest in what they are interested in (their hobbies and what is meaningful to them). Try not to focus on their appearance or to over-focus on achievements. Don’t make judgemental comments about others and discourage others from criticising or bullying others about their appearances. Instead, share the message that people can be healthy in all shapes and sizes. Focus on having a healthy well balanced lifestyle, by doing activities that will improve their mental health (like socialising with friends, spending time outside, and getting some physical activity).

How can I find out more information?

The Butterfly Foundation

Based in both Victoria and New South Wales, this is a unique service that provides support and information for those affected by eating disorders (and their families). They can suggest counselling centres in your local area.

They also offer free support groups in Sydney and rural NSW.
They have an information help line: (02) 9412 4499.
Website: http://www.thebutterflyfoundation.org.au

They also offer support via email: support@thebutterflyfoundation.org.au

Sane Australia

SANE Australia is a national charity working for a better life for people affected by mental illness – through campaigning, education and research.
They provide information about eating disorders and a downloadable fact sheet.
"http://www.sane.org/information/factsheets/eating_disorder.html" http://www.sane.org/information/factsheets/eating_disorder.html

Sane Helpline (information and advice): 1800187263

By:
Stella Dyer
Clinical Psychologist
Centre for Psychotherapy
James Fletcher Hospital