Eating problems

Explains eating problems, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

Your stories

Not just a girl's disease...

Mark blogs about his experience with anorexia.

Mark Gould
Posted on 25/02/2011

Eating disorders are not a lifestyle choice

Georgina's blog for Time to Change on her experience of bulimia and anorexia and the misconceptions she faced.

Georgina
Posted on 29/11/2012

Abuse and eating problems

Georgie talks about how the abuse she's experienced relates to her eating disorder.

Posted on 24/02/2014

What treatment and support is available?

The help and support of friends, family and professionals can help you identify and resolve the underlying causes of your eating problems.

Without this, breaking free from a negative relationship with food can be extremely difficult. Receiving help early on, from people who are experienced in treating eating problems, is very important.

Ultimately, my psychologist, occupational therapist and dietician saved my life.

Contact a medical professional

You can contact your GP if you’re worried you may have an eating problem. They will need to check that any symptoms, such as weight loss or gain, are not due to another underlying physical illness.

Although they may not have the experience to offer you in-depth support, they should be able to refer you to more specialist services. This could include counselling or psychotherapy, group counselling or specialist support services. They may also be able to refer you to a dietician, who can give you advice about getting the right nutrients and reaching a healthy weight. The different people who give you support are known as your care team.

Talking treatments

Working with a therapist (sometimes referred to as a counsellor) can help you face – and cope with – the underlying issues which may be causing your eating problem.

Therapists use a range of different techniques. Some types of therapy may focus on the past and your general experience of life. Others will focus on your relationships with your family and other important people in your life.

Group and family therapy may also be an option, and can be a great way to help your family understand your eating problems. It can allow you and your family to look at ways of supporting and being open with each other. (See Making sense of talking treatments for more information.)

Common talking therapies for eating problems include:

You can access talking treatments through the NHS. Your GP should be able to make a referral. There can be long waiting lists on the NHS, so you may also want to consider seeing a therapist privately – but be aware that private therapists usually charge for appointments. You can find a private therapist through the British Association for Counselling and Psychotherapy (BACP).

If you are at school, college or university you may be able to access free counselling and support through student services. You could contact your student advice centre to find out.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a kind of talking treatment. It helps you to understand the way your thoughts and feelings affect your behaviour and actions, and to make changes. CBT may help you understand the emotions behind the way that you use restricting food or bingeing, and how you can change this pattern.

Many people find it helpful to work through CBT techniques with a trained therapist. You can use a CBT computer program like MoodGYM or Beating the Blues, which you access through your GP. (See Mind’s Making sense of cognitive behavioural therapy for more information.)

Cognitive behavioural therapy really helped me to change the distorted thoughts flying around my head and move on from my eating disorder.

Medication

The NICE guidelines on eating disorders say that talking treatments should be the first kind of treatment people are offered. You may also be offered medication. There are no drugs specifically for eating disorders, but you may be offered antidepressants or other mental health drugs to treat underlying causes of the problems.

The most common drug prescribed to people experiencing bulimia or binge eating disorders is an SSRI antidepressant. Your doctor may also offer you other types of antidepressants. (See Mind’s Making sense of antidepressants for more information on SSRIs and other types of antidepressants.)

If you have anorexia, you may be offered an antidepressant or a drug called olanzapine. Olanzapine is an antipsychotic drug, but can also be used to treat anxiety about food and weight. (See Mind’s Making sense of antipsychotics for more information on olanzapine.)

Being underweight can mean that drugs are absorbed more quickly into your bloodstream, which could make medication harmful or not as effective as it should be. Your doctor will decide whether to offer you medication, and you can decide whether you want to take it.

Admission to a clinic

If your eating problem is very serious you may need to go into hospital or to a clinic. This can happen if your doctor or care team feel you are very unwell or underweight, if other kinds of treatment haven’t worked, or if your home environment is making it hard for you to stay well.

If you are an outpatient or day patient, you will go home most evenings and weekends. If you are an inpatient, you will stay in the hospital or clinic for most of your treatment. How long you are admitted for will depend on how much help you need to recover.

You will normally receive a range of support as an inpatient. The staff at the hospital or clinic could include:

  • doctors
  • dieticians
  • psychotherapists
  • occupational therapists
  • social workers
  • family and relationship therapists
  • specialist nurses.

Treatment can include:

  • talking therapies
  • working in groups with other people experiencing eating problems
  • medication
  • refeeding.

Your weight and general health will normally be monitored. There may be guidance on buying, preparing and serving food, how to cope with stress and anxiety, how to be more assertive, and how to manage anger and communicate well.

What is ‘refeeding’?

Refeeding means being given food with the aim of increasing weight.

Specific foods may be chosen because they have certain nutritional values or are particularly good at helping people gain weight.

How this works varies from one clinic to another. Some doctors may do this over a longer period of time, allowing you to gradually increase your weight, whereas others will want to help you back to a healthy weight as soon as possible.

This can be a distressing process, especially if you do not want to gain weight, and may be something you want to talk about with your doctor in more detail.

There are only a few NHS eating disorder clinics, so you may not always be able to access treatment close to where you live. This may mean going to a clinic further away, or it could mean going to a general mental health hospital. You can ask your GP or care team if you’d like to know more about specialist clinics.

There are also private treatment centres. Some may offer similar treatment to NHS clinics, while others will have a wider range of complementary and art therapies. Beat has a directory of services that you can look at to see what’s available.

Before treatment can be really effective, you have to want to get better and accept that life will be different. This can take time. Good treatment, which helps you focus on recovery and on addressing the causes of your eating problem, can help reduce the risk of you relapsing.

Could I be forced to go to a clinic?

If a group of medical professionals agree that you are at risk of harming yourself or anyone else then they could force you to go to hospital against your wishes under the Mental Health Act. This is sometimes called being sectioned. This could happen if your eating problem is having a significant impact on your physical health, and medical staff are concerned that you won’t be able to recover without support.

If you are worried about being sectioned, you could look at The Mind guide to the Mental Health Act 1983 to learn about your rights. For more advice you can contact your local law centre or solicitor.


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