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Eating Disorders Micki Bennett RMN Jess Griffiths I*EAT Executive Director


What are Eating Disorders? • Anorexia Nervosa • Bulimia Nervosa • Binge Eating Disorder • EDNOS 2


Risk Groups • • • • • • • • •

Perfectionists Children, especially girls Children expected to achieve Those with low self esteem Self esteem based on single characteristics Achievement focused families Bulleying victims Abuse victims “Good kids”


What are Eating Disorders? • Not just about food. • Coping with emotional distress. • Mental health problem with physical symptoms and highest mortality rate of any psychiatric illness.

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Signs & Symptoms: A.N. • Sudden weight loss/ low weight (body weight 15% or more lower than norm) • Cold, white feet and hands. • Muscle weakness. • Dry skin & hair. • Wearing baggy clothes. • Growth of fine hair on body and face. • Skipping meals, eating small portions and avoiding fattening foods 5


Signs & symptoms: A.N. • • • • • • •

Hiding food in room (not eating it). Drinking large amounts of diet drinks/ water. Playing with food at mealtimes. Cooking for others/ collecting recipes. Excessive exercise Eating strange combinations of food Restlessness

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Signs & symptoms: A.N. • • • • • •

Poor sleep patterns. Feeling cold all the time. Preoccupied with weight/weighing. Believe they are fat when slim/underweight. Rigid about good/bad foods. Menstruation stops/loss of sexual interest in men.

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Signs & symptoms: B.N. • • • • • • • •

Frequent changes in weight. Swollen glands. Broken blood vessels in the eyes. Tooth decay. Constant sore throat/ husky voice. Sores on knuckles (vomiting). Morbid feat of fatness. Desire to lose weight. 8


Signs & symptoms: B.N.

• Persistent preoccupation with eating, irresistible cravings for food. • Bingeing (large quantities of food) followed by: • self-induced vomiting, laxative use, periods of starvation/ restricted eating, abuse of appetite suppressants or diuretics

• Avoiding eating in public, secret eating, large amounts of food disappearing. 9


Signs & symptoms: B.N.

• Avoiding eating in public, secret eating, large amounts of food disappearing. • Going to the bathroom/ toilet immediately after meals. • Drinking large amounts of fluid around mealtimes/ eating. • Excessive Exercise

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Precipitating factors • Adolescent crises – • Transition to new roles, expectations and responsibilities • E.g. New School • Leaving home to go to university • Physical changes of puberty • Relationships with opposite sex • Interpersonal conflict

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Perpetuating Factors • Reinforcement & valued functions: • Positive comments about appearance (A.N. & B.N.) • Feelings of control (A.N.) • Feelings of protection & safety (A.N.) • Sense of identity – rules, goals, values (A.N.).

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Perpetuating Factors • Sense of achievement about weight/ shape (A.N & B.N.). • Numbing effect on emotions (A.N. & B.N.). • If person looks ill – • care and attention, • permission to avoid feared transitions/ events/ responsibilities.

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Effects on physical health • • • • • • • •

Osteoporosis Osteopaenia Dehydration Low blood glucose Poor gut function Painful stomach Constipation Fatigue

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Sensitivity to cold Poor circulation Bone marrow failure anaemia Cardiac problems Thin, dry skin – bed sores Muscle weakness 14


Effects on physical health • Liver damage • High blood cholesterol • Kidney infection/ stones • Electrolytic imbalances • Seizures

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Stunted growth Oedema (fluid retention) Peptic ulcers Oesophageal rupture Periods stop

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Added risks when BMI <12.5 • • • • • •

Falls Hypothermia Heart failure Heart attack Kidney failure Liver failure

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Re-feeding difficulties Skin breakdown – ulcers, bed sores etc.

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Effects on psychological health • • • • • •

Sleep disturbances Poor concentration Depression Obsessions Compulsive behaviour Preoccupation with thoughts of food

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Complex thought impaired General anxiety Social anxiety Perfectionism Irritability Social withdrawal

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Treatment - NHS

• Referral through GP • Under 18s – CAMHS team • Over 18s – April House


Self Help Organisations

• IEat www.i-eat.org.uk 07590 378822 Tuesdays and Thursdays office@i-eat.org.uk • B-eat Helpline.01603 621414. Web site: www.b-eat.co.uk

Eating disorders  

eating disorders presentation

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