Every newspaper or magazine that we pick up has an article about a celebrity who is underweight, overweight, gained weight, lost weight – the media portrays a world where image is everything, where thin is a measure of beauty and success and perfection is measured only by your dress size.
Anna is a perfect example of a teenage girl who believed this, and as a shy, unconfident girl who was always conscious about her weight so she started to exercise in excess, reduce her food intake, and continued with this regime until she collapsed. It was at this point that Anna was referred to Dr Anne Stewart, Consultant Child and Adolescent Psychiatrist, with a specialist interest in young people with eating disorders and Anna’s story was the starting point for our February Health Matters at Science Oxford.
Anne started her talk by explaining the difference in the main types of eating disorders; anorexia nervosa and bulimia nervosa and discussed not only the numerous factors that can initiate the onset of an eating disorder, but more importantly the factors that drive a young person to continue to experience disturbances with their eating. One of the things that surprised the audience most was learning that people whose bodies are in starvation mode often experience no hunger cues, leaving them with no realisation of feeling hungry or consequently any desire to eat, thereby perpetuating the cycle of their disorder.
Eating Disorders affect approximately 1 in 200 adolescent girls aged between 15-19 and it is 10x more common in girls than in adolescent boys. Contrary to some belief anorexia nervosa does occur in non-western cultures, and the history books show that saints as early as the 16th century fasted to exercise an element of control over their lives. But, evidence shows that in today’s world a young person’s greatest chance of a successful recovery from an eating disorder is to be treated by a specialist team, using evidence based treatment.
Anne’s team has found through years of experience, and using the latest research as evidence to base their practice on that family based intervention is the most effective treatment and the young person will have a much higher chance of a recovery than if they were to receive individual treatment alone. This approach also focuses much less on the cause of their illness, but enables the family to move forward on their journey of recovery. Anne explained that when treating a young person with an eating disorder, the focus of their treatment is not solely based on weight restoration as this alone will not achieve full recovery – but all sufferers need to achieve psychological restoration as well to maximise their recovery and minimise their chances of a relapse.
Eating Disorders can affect every organ of the body, they can cause extreme imbalances within the body, and have the highest mortality rate of any mental illness. Anne presented research on patients’ experience which suggests that sufferers exhibit a “passion” for their condition which makes it hard to give up the disorder. It defines them, controls them and drives them to behave in extreme ways. Anne and her colleagues in CAMHS work with young people and their families to ensure that those bonds are broken, that weight restoration takes place over a measured and agreed period along with a development if a healthy identity and ultimately that no young person ever looks in a magazine, turns to their friend and tells them that they “would just die to be a little bit thinner…..”