eating disorder uk essay

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Eating Disorders, Essay Example

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Introduction

Eating disorders affect men and women of all ages, although adolescents tend to be the age group that is more susceptible. This is because, as their bodies are changing, they may feel more pressure by society as well as peer groups to look attractive and fit in (Segal et al). Types of eating disorders include Anorexia, Bulimia and Compulsive Overeating, which can also be related to the first two. The reasons behind Eating Disorder usually stem from a reaction to low self-esteem and a negative means of coping with life and stress (Something Fishy).  Eating disorders are also often associated with an underlying psychological disorder, which may be the reason behind the eating disorder or which may develop from the Eating Disorder itself. Mental health disorders that are often associated with Eating Disorder include Anxiety, Depression, Multiple Personality Disorder, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, BiPolar, BiPolar II, Borderline Personality Disorder, Panic Disorder and Dissociative Disorder. The longer a person suffers from ED, the more probable that they will be dealing with another mental illness, most likely Anxiety or Depression (Something Fishy). The eventual outcome of Eating Disorder can be deadly. “Some eating disorders are associated with a 10-15% mortality rate and a 20-25% suicide rate. Sometimes, anorexia, bulimia and compulsive eating may be perceived as slow suicide (Carruthers).” In order to prevent the deadly consequences of Eating Disorder and to prevent it from becoming more pervasive in society, it is necessary to recognize the correct treatment method for this disease.  Traditional treatments have focused on providing risk information to raise awareness of the consequences of Eating Disorder (Lobera et al 263). However, since Eating Disorder is a mental illness, a more effective treatment is one that offers psychological evaluation, counseling and treatment. Cognitive Behavioral Therapy is emerging as a more robust and effective method that can be used not only to treat Eating Disorder but the associated mental illnesses that may accompany it.

The Problem

Eating disorder is pervasive in society and can have deadly consequences on those that suffer from it. Many time Eating Disorder goes undetected by family members and friends because those suffering will go to great lengths to hide their problem. However, there are some signs and symptoms that can be clues that a person is suffering from some sort of eating disorder. According to Segal, these signs can include:

• Restricting Food or Dieting: A change in eating habits that includes restricting food or excessive dieting. The person my frequently miss meals or not eat, complaining of an upset stomach or that they are not hungry. A use of diet pills or illegal drugs may also be noticed.
• Bingeing: Sufferers may binge eat in secret, which can be hard to detect since they will usually do it late at night or in a private place. Signs of potential bingeing are empty food packages and wrappers and hidden stashes of high calorie junk food or desserts.
• Purging: Those who suffer from bulimia will force themselves to throw up after meals to rid their body of added calories. A sign that this is occurring is when a person makes a trip to the bathroom right after eating on a regular basis, possible running water or a fan to hide the sound of their vomiting. They may also use perfume, mouthwash or breath mints regularly to disguise the smell. In addition to vomiting, laxatives or diuretics may also be used to flush unwanted calories from the body.
• Distorted body image and altered appearance: People suffering from Eating Disorder often have a very distorted image of their own body. While they may appear thin to others, they may view themselves as fat and attempt to hide their body under loose clothing. They will also have an obsessive preoccupation with their weight, and complain of being fat even when it is obvious to others that this is not the case.

There are several possible side effects from Eating Disorders, both physical and psychological. Physical damage can be temporary or permanent, depending on the severity of the eating disorder and the length of time the person has been suffering from it.  Psychological consequences can be the development of a mental illness, especially depression and anxiety. Some sufferers of Eating Disorder will also develop a coping mechanism such as harming themselves, through cutting, self-mutilation or self-inflicted violence, or SIV (Something Fishy).

Physical consequences of Eating Disorders depend on the type of eating disorder that the person has. Anorexia nervosa can lead to a slow heart rate and low blood pressure, putting the sufferer at risk for heart failure and permanent heart damage. Malnutrition can lead to osteoporosis and dry, brittle bones. Other common complications include kidney damage due to dehydration, overall weakness, hair loss and dry skin. Bulimia nervosa, where the person constantly purges through vomiting, can have similar consequences as Anorexia but with added complications and damage to the esophagus and gastric cavity due to the frequent vomiting. In addition, tooth decay can occur because of damage caused by gastric juices. If the person also uses laxatives to purge, irregular bowel movements and constipation can occur. Peptic ulcers and pancreatitis can also common negative heath effects (National Eating Disorders Association).  If the Eating Disorder goes on for a prolonged time period, death is also a possible affect, which is why it is important to seek treatment for the individual as soon as it is determined that they are suffering from an Eating Disorder.

Once it is recognized that a loved one may be suffering from an Eating Disorder, the next step is coming up with an effective intervention in time to prevent any lasting physical damage or death. The most effective treatment to date is Cognitive-behavioral therapy, an active form of counseling that can be done in either a group or private setting (Curtis). Cognitive-behavioral therapy is used to help correct poor eating habits and prevent relapse as well as change the way the individual thinks about food, eating and their body image (Curtis).

Cognitive-behavioral therapy is considered to be one of the most effective treatments for eating disorders, but of course this depends on both the counselor administrating the therapy and the attitude of the person receiving it.  According to Fairburn (3), while patients with eating disorders “have a reputation for being difficult to treat, the great majority can be helped and many, if not most, can make a full and lasting recovery.” In the study conducted by Lobera et al, it was determined that students that took part in group cognitive-behavioral therapy sessions showed a reduced dissatisfaction with their body and a reduction in their drive to thinness. Self esteem was also improved during the group therapy sessions and eating habits were significantly improved.

“The overall effectiveness of cognitive-behavioral therapy can depend on the duration of the sessions. Cognitive-behavioral therapy is considered effective for the treatment of eating disorders. But because eating disorder behaviors can endure for a long period of time, ongoing psychological treatment is usually required for at least a year and may be needed for several years (Curtis).”

  Alternative solutions

Traditional treatments for Eating Disorders rely on educating potential sufferers, especially school aged children, of the potential damage, both psychological and physical, that can be caused by the various eating disorders .

“ Research conducted to date into the primary prevention of eating disorders (ED) has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behavior in the  target population (Lobera et al).”

The current research has not shown that passive techniques, such as providing information, reduces the prevalence of eating disorders or improves the condition in existing patients. While education about eating disorders, the signs and symptoms and the potential health affects, is an important part of providing information to both the those that may know someone who is suffering from an eating disorder and those that are suffering from one, it is not an effective treatment by itself. It must be integrated with a deeper level of therapy that helps to improve the self-esteem and psychological issues from which the eating disorder stems.

Hospitalization has also been a treatment for those suffering from an eating disorder, especially when a complication, such as kidney failure or extreme weakness, occurs. However, treating the symptom of the eating disorder will not treat the underlying problem. Hospitalization can effectively treat the symptom only when it is combined with a psychological therapy that treats the underlying psychological problem that is causing the physical health problem.

Effectively treating eating disorders is possible using cognitive-behavioral therapy. However, the sooner a person who is suffering from an eating disorder begins treatment the more effective the treatment is likely to be. The longer a person suffers from an eating disorder, the more problems that may arise because of it, both physically and psychologically. While the deeper underlying issue may differ from patient to patient, it must be addressed in order for an eating disorder treatment to be effective. If not, the eating disorder is likely to continue. By becoming better educated about the underlying mental health issues that are typically the cause of eating disorder, both family members and friends of loved ones suffering from eating disorders and the sufferers themselves can take the steps necessary to overcome Eating Disorder and begin the road to recovery.

Works Cited

“Associated Mental Health Conditions and Addictions.” Something Fishy, 2010. Web. 19 November2010.

Carruthers, Martyn. Who Has Eating Disorders?   Soulwork Solutions, 2010. Web. 19 November 2010.

Curtis, Jeanette. “Cognitive-behavioral Therapy for Eating Disorders.” WebMD (September 16, 2009). Web. 19 November 2010.

Fairburn, Christopher G. Cognitive Behavior Therapy and Eating Disorders. New York: The Guilford Press, 2008. Print.  

“Health Consequences of Eating Disorders” National Eating Disorders Association (2005). Web. 21 November 2010.

Lobera, I.J., Lozano, P.L., Rios, P.B., Candau, J.R., Villar y Lebreros, Gregorio Sanchez, Millan, M.T.M., Gonzalez, M.T.M., Martin, L.A., Villalobos, I.J. and Sanchez, N.V. “Traditional and New Strategies in the Primary Prevention of Eating Disorders: A Comparative Study in Spanish Adolescents.” International Journal of General Medicine 3  (October 5, 2010): 263-272. Dovepress.Web. 19 November 2010.

Segal, Jeanne, Smith, Melinda, Barston, Suzanne. Helping Someone with an Eating Disorder: Advice for Parents, Family Members and Friends , 2010. Web. 19 November 2010.

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98 Eating Disorders Essay Topics

🏆 best essay topics on eating disorders, 👍 good eating disorders research topics & essay examples, 🎓 most interesting eating disorders research titles, 💡 simple eating disorders essay ideas, ❓ eating disorder research questions.

• Eating Disorders in Adult Population The major part of this paper is the design of the group proposal about group therapy and its application in the eating disorder in adult population.
• Essay on Eating Disorders in Adolescents Young people have issues with their body weight and image, thus often suffer from eating disorders because they have a preference for certain food types.
• Effect of Social-cultural Factors on Eating Disorders Research however shows that women get the disease at a lower age compared to men, with most of them beginning at adolescence.
• Eating Disorders in Adolescents: Causes and Treatment People should have regular checkups for any disorders, especially when they start noticing body changes anytime they eat a certain type of food.
• Inpatients’ Eating Disorders and Countermeasures This paper explores the efficacy of meal supervision, patient and nurse education as the tools for improving the efficacy of nutrition, and enhancing patient outcomes.
• Anorexia Nervosa: Psychological and Physiological Therapy The design of therapy of anorexia nervosa needs to incorporate both psychological and biological components so the patient could resume proper dieting and gain weight.
• Anorexia Nervosa: Perspectives and Treatment The purpose of this paper is to review the causes of anorexia nervosa and to propose a treatment plan for patients experiencing this health problem.
• Normal Dieting and Eating Disorders Healthy dieting behaviors are essential for people’s health and well-being. This paper discusses the difference between normal dieting and eating disorders.

• Anorexia Nervosa, Its Etiology and Treatment One of the eating disorders that affect a significant number of young individuals nowadays is anorexia nervosa.
• Anorexia Nervosa as a Brain Disorder Anorexia nervosa is an eating disorder characterized by an uncontrollable desire to be thin, low weight, food restrictions, and a fear of gaining pounds.
• Plausible Causes for Male Eating Disorders These days, however, things have changed significantly and out of five million Americans who suffer from eating disorders each year the percentage of males is tangible.
• Treatment of Eating Disorders Eating disorders are major health challenges currently and in the future if appropriate measures are not taken, so each individual should take a closer look at health issues.
• Anorexia Nervosa: History, Diagnosis and Treatment Anorexia nervosa among the eating disorders which is considered in the psychiatric illness. There are categories that have been advanced in the diagnosis of this illness.
• Eating Disorders: Why Do We Need to Control Our Nutrition? People with confirmed diagnoses of eating disorders need qualified help from specialists since neglecting a healthy diet is fraught with dangerous health outcomes.
• The Problem of Anorexia Among College Students Anorexia nervosa and eating disorders in college students and adolescents are the problems that require immediate intervention.
• Anorexia Nervosa: Signs and Symptoms, Treatment One of the types of eating disorders is anorexia nervosa, which is widely spread nowadays, especially among young girls and women.
• Orthorexia Nervosa and Eating Disorder Orthorexia nervosa is becoming a serious problem for the patient’s physical and psychological health, hence the attention of nutritionists should be focused on studying this disorder.
• Genetic Factors as the Cause of Anorexia Nervosa Genetic predisposition currently seems the most plausible explanation among all the proposed etiologies of anorexia.
• Binge Eating Disorder: Information for Patients The paper highlights Binge-eating disorder as a serious eating disorder in which you frequently consume unusually large amounts of food and feel unable to stop eating.
• “The Globalization of Eating Disorders” by Susan Bordo This paper analyzes the text of an article written in 2002 by Susan Bordo, an American professor, and philosopher, whose works are marked by several prestigious awards.
• Eating Disorders Like Bulimia Nervosa and Anorexia Nervosa Though the loss of weight might be a positive aspect of healthy diets, people with orthorexia Nervosa do not have a disordered body image nor a determination for thinness.
• Orthorexia as an Eating Disorder in the DSM Adequate nutrition ensures quality of life, including the level of health and the body’s ability to cope with physical, mental, and psycho-emotional stress.
• Anorexia Among Young Adults and Family Treatment The population needs to encourage family teaching to intervene with anorexia since parents are frequently unsupportive of their children with complexes.
• Eating Disorders in Adult Women This paper discusses eating disorders in adult women and treatment alternatives to reverse the health care challenge, which is threatening the health of this group.
• Eating Disorders: Diagnosis and Treatment Anorexia nervosa is a severe eating disorder that is characterized by a distorted perception of weight and a strong fear of gaining it.
• Teen Anorexia: Mental Illness and an Eating Disorder Adolescents have increasingly been diagnosed with anorexia. They often have a nervous type of pathology, which is a psychological illness and is accompanied by an eating disorder.
• Swan’s Case as an Example of an Eating Disorder Being focused on success in ballet and becoming a recognized dancer, Swan demonstrates anxiety because of the possible weight gain.
• Anorexia and Eating Disorders Treatments In the research paper, the source could be used to discuss research gaps related to anorexia treatments and raise the topic of controversial practices in treating EDs.
• Eating Disorders: Types and Causes This paper will focus on such conditions as anorexia nervosa, bulimia nervosa, muscle dysmorphia, and obesity.
• Anorexia Nervosa and Bulimia Nervosa People do not always understand the severity of eating disorders and the difficulty of their treatment. Anorexia Nervosa and Bulimia Nervosa are serious psychiatric disorders.
• Obsessive-Compulsive and Eating Disorders in Children In both OCD and ED, developmental milestones are crucial to consider because they can help indicate points of positive versus adverse health.
• Bulimia Nervosa Diagnosis and Procedural Plan The patient has been showing the tendency to vomit after every instance of food intake, which is the primary sign of bulimia nervosa.
• Media Effects on Eating Disorder Symptoms In terms of modern technology-based society, media exposure has significantly increased its influence and role in the lives of its large audience.
• Food Allergies and Eating Disorders Along with food allergies, mental health disorders are widely spread diseases. Eating disorders, such as anorexia, bulimia nervosa, and binge eating, are common among young women.
• Eating Disorders: “Out of Control?” by Claes et al. The study “Out of control?” by Claes et al. aims to investigate variations between restrictive and bingeing/ purging eating disorders.
• Eating Disorders: Finding the Right Treatment An eating disorder is becoming a significant health concern among people. There are many factors connected to the root cause of eating behavior.
• Eating Disorders and Social Interactions The paper indicates that social surroundings can make people feel insecure and push towards the development of eating disorders.
• The Scoff Questionnaire: Risk of Eating Disorders The paper discusses a method to identify children at risk of eating disorders. The children were provided with both relevant referrals and treatment.
• Eating Disorders and Programs That Address Body Image Issues The paper states that excessive weight and disordered eating are significant public health issues in America and other western countries.
• Anorexia Nervosa & Bulimia Nervosa Anorexia nervosa and bulimia nervosa are both eating disorders; due to the peculiarities of the course of disorders, it can sometimes be difficult to distinguish them.
• Social Control in Eating Disorders The need for food is a basic need aimed at maintaining homeostasis and obtaining the energy and nutrients necessary for life.
• Eating Disorders Among Athletes The pressure from the necessity to become successful is one of the major factors contributing to the emergence and development of eating disorders in athletes.
• Eating Disorders and Therapeutic Support Eating disorders are significant mental and physical diseases that entail complicated and harmful interactions with food, feeding, exercising, and self-image.
• Theoretical and Methodological Considerations for Research on Eating Disorders and Gender
• Body Dissatisfaction and Eating Disorders
• Eating Disorders Among Different Cultures
• Causes, Effects, and Solutions to Eating Disorders
• Adonis Complex Eating Disorders
• Are Eating Disorders Really About Food
• Eating Disorders and the Treatment Applicable Effectiveness
• Linking Eating Disorders With Genetics
• Childhood Sexual Abuse and Eating Disorders
• Nutrition Intervention for Eating Disorders
• Photoshopping Images and How It Impacts Eating Disorders
• Eating Disorders and Its Effects on the Lives and Relationships
• The Correlation Between Social Media and The Development of Eating Disorders
• Eating Disorders Affecting American Women
• How And Why People Develop Eating Disorders
• Theories Behind Eating Disorders: Negative Impact on Young Youth
• Examining Eating Disorders and Social Learning Theory to Draw Useful Conclusions
• Hidden Eating Disorders During Bodybuilding
• Eating Disorders and Methods of Its Treatment
• The Relationship Between Ghrelin and Eating Disorders
• Body Image and Eating Disorders Among Young Ballerinas
• Eating Disorders Are Common Among American Children
• Fashion Triggers Eating Disorders
• Bulimia and Anorexia: The Dangers of Eating Disorders
• Cognitive Behavior Therapy and Eating Disorders
• The Three Major Eating Disorders in the United States
• Childhood Factors and Eating Disorders Symptoms
• Causes and Analysis of Eating Disorders and The Theory of Social Learning
• The Prevalence and Causes of Eating Disorders in the United States
• The Role Of Social Identity In Eating Disorder
• Why Do Athletes Struggle With Eating Disorders?
• What Is the Connection Between Body Image and Eating Disorders?
• Can Affirmations End Binge Eating Disorder?
• Do People With Eating Disorders See Themselves Differently?
• What Is Eating Disorder Most Common Among College Students?
• How Does Beauty Standards Cause Eating Disorders?
• Why Is Looking in the Mirror So Hard for People With Eating Disorders?
• Do Athletes Struggle With Eating Disorders?
• How Can a Patient Overcome an Eating Disorder?
• Which Personality Trait Is Linked to Eating Disorders?
• Can You Control if You Have an Eating Disorder?
• What Kinds of Medicine Are Helpful to Patients With Eating Disorders?
• Do Eating Disorders Have a Genetic Link?
• Which Eating Disorder Is Most Likely to Be Helped by Antidepressants?
• Can Perfectionism Translate Into Eating Disorder?
• What Interpersonal Factors Can Cause Eating Disorders?
• Is Clinical Depression Associated With Eating Disorders?
• What Are the Four Main Psychological Emotional States That Associated With Eating Disorders?
• Which Personality Type Is Most Likely to Have an Eating Disorder?
• Can Stress Cause Eating Disorders and Depression?
• Why Might There Be a Strong Connection Between Eating Disorders and Depression?
• Which Eating Disorder Has the Highest Mortality?
• Do Females Have the Same Rates of Eating Disorders as Males?
• What Is the Most Important Part of Treating Eating Disorders?
• How Does Social Media Influence the Prevalence of Eating Disorders?
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These essay examples and topics on Eating Disorders were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

The essay topic collection was published on May 10, 2022 . Last updated on September 12, 2023 .

Essay on Eating Disorders

Students are often asked to write an essay on Eating Disorders in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Eating Disorders

Understanding eating disorders.

Eating disorders are serious health problems. They occur when individuals develop unhealthy eating habits that can harm their body. They often start with an obsession with food, body weight, or body shape.

Types of Eating Disorders

There are three main types of eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Each has different symptoms but all can be harmful.

Impact on Health

Eating disorders can damage important body parts like the heart and brain. They can also affect mental health, causing anxiety or depression.

Getting Help

If you or someone you know has an eating disorder, it’s important to seek help. Doctors, therapists, and support groups can provide treatment and support.

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250 Words Essay on Eating Disorders

Introduction.

Eating disorders, a category of mental health conditions, have been a subject of increasing concern in contemporary society. They are characterized by severe disturbances in eating behaviors and related thoughts and emotions, often driven by body dissatisfaction and distorted body image.

The most common types are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Anorexia is defined by a refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Bulimia involves frequent episodes of binge eating followed by behaviors like forced vomiting to avert weight gain. Binge Eating Disorder is characterized by frequent overeating episodes but without subsequent purging actions.

Sociocultural Influences

Sociocultural factors play a significant role in the onset of eating disorders. The media’s portrayal of an ‘ideal’ body size and shape can contribute to body dissatisfaction and consequently, disordered eating behaviors.

Health Implications

The health implications of eating disorders are severe, impacting both physical and mental health. These can range from malnutrition, organ damage, to increased risk of suicide.

Eating disorders, therefore, are serious conditions that require comprehensive treatment. Increased awareness, early diagnosis, and interventions can significantly improve the prognosis and quality of life for those affected.

Packed in 152 Informative Pages

500 Words Essay on Eating Disorders

Introduction to eating disorders.

Eating disorders represent a group of serious conditions characterized by abnormal eating habits that can negatively affect a person’s physical and mental health. These disorders often develop from a complex interplay of genetic, psychological, and sociocultural factors.

The Types of Eating Disorders

The most common types of eating disorders are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Anorexia Nervosa is characterized by an intense fear of gaining weight, leading to self-starvation and excessive weight loss. Bulimia Nervosa involves cycles of binge eating followed by compensatory behaviors like vomiting or excessive exercise. Binge Eating Disorder, the most common eating disorder in the U.S., involves recurrent episodes of eating large amounts of food, often very quickly and to the point of discomfort.

The Underlying Causes

Eating disorders are typically multifactorial and can’t be attributed to a single cause. They often coexist with other mental health disorders such as depression, anxiety, and obsessive-compulsive disorder. Genetic predisposition plays a significant role, suggesting that eating disorders can run in families. Sociocultural factors, including societal pressures to be thin, can also contribute to the development of these disorders.

The Impact on Physical and Mental Health

The physical consequences of eating disorders are profound and can be life-threatening. They range from malnutrition, heart conditions, and bone loss in anorexia, to gastrointestinal problems and electrolyte imbalances in bulimia. Binge eating disorder can lead to obesity and related complications like heart disease and type 2 diabetes.

The mental health consequences are equally severe and include depression, anxiety, and increased risk of suicide. Eating disorders can also lead to social isolation and impaired functioning at work or school.

Treatment and Recovery

Treatment for eating disorders typically involves a multidisciplinary approach, combining medical, psychological, and nutritional therapy. Cognitive-behavioral therapy (CBT) is often effective, helping individuals to understand and change patterns of thought and behavior that lead to disordered eating.

Early intervention is crucial for recovery. However, stigma and lack of understanding about these disorders can often delay treatment. Therefore, raising awareness and promoting understanding about eating disorders is essential.

Eating disorders are serious and complex mental health conditions with significant physical and psychological consequences. Understanding their multifactorial nature is crucial for developing effective prevention and treatment strategies. The importance of early intervention and the role of societal attitudes in both the development and recovery from these disorders cannot be overstated. As a society, we must strive to promote body positivity and mental health awareness to help those struggling with these debilitating conditions.

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What is ARFID? The eating disorder that’s often dismissed as just being a picky eater

ARFID could affect as much as 15% of the population

What are the symptoms of ARFID?

How is arfid treated, what is it like to have arfid.

It would be easy to dismiss people seemingly turning their noses up at a variety of foods as picky eaters, but in reality, their limited diets could be a symptom of a little-known eating disorder.

Avoidant/Restrictive Food Intake Disorder, known as ARFID, is a recent eating disorder diagnosis that only officially entered diagnostic manuals in 2013. Because it is such a new diagnosis, not a lot is really known about it – but it can have a severe impact on sufferers’ lives.

Here’s everything you need to know about ARFID, the symptoms to look out for and the treatment available.

What is ARFID?

In its simplest terms, ARFID is an eating disorder where sufferers avoid certain foods or types of food.

However, unlike other eating disorders, like anorexia or bulimia nervosa, ARFID is not necessarily driven by body image.

“ARFID can be driven by sensitivity,” explains Martha Williams, the Senior Clinical Advice Coordinator for eating disorder charity, Beat .

“Sufferers can be sensitive to things like the texture or taste of certain foods, or fears about eating food due to previous experiences choking. In some cases, it may just be driven by disinterest in food.”

ARFID can also be a concurrent symptom of a wider disorder, and is commonly found in people who fall on the autistic spectrum . One study found that in a group of 536 children, the 58.3% who had an ARFID diagnosis also had autism.

Taking a long time to eat at meal times, struggling to eat a variety of foods, becoming distressed or mentioning a sensitivity to certain meals are the stereotypical signs of ARFID, which can be spotted over time. We could also see sufferers only eating ‘beige’ meals or having the same food every time they do eat.

Williams explains that, like a lot of eating disorders, ARFID can present differently in different people.

“It means ARFID is often difficult to diagnose,” she continues. “It doesn’t present like other eating disorders, where we can see people rapidly drop weight quickly, for example.

“Because of the restrictive nature of ARFID, we can see those with the disorder losing weight, but they may still be in the normal parameters of weight.”

It’s also something that can be dismissed as ‘fussy eating’, particularly in children, with many parents assuming their child’s aversion to food will be something they grow out of.

“It’s important to highlight that ARFID is not just the way the patient is around food,” William adds. “It’s also psychological. It’s about tackling the dominant thoughts and feelings around food.

“It’s crossing that bridge from picky eating to a serious health concern. Are they limiting their intake to the point they’re deficient in nutrients? There’s no clear way of diagnosing it, it’s about having a look at those more subtle symptoms over a long period of time.”

As the disorder is still relatively new, there is no set way to treat ARFID, but numerous methods and treatments can be employed to ease symptoms.

It tends to begin with the patient having goals set around their eating habits, which build up over time.

These goals could include:

• Trying and eating a larger range of foods
• Becoming comfortable eating around others
• Reducing anxiety around eating
• Becoming less afraid of choking or vomiting

Psychological interventions may also be employed to help ease fears around food, including cognitive behavioural therapy, exposure therapy and further nutritional support.

However, the sort of treatment patients may receive for an ARFID diagnosis can be varied.

“It can be a postcode lottery,” Williams says. “Because ARFID is so new, there’s no one set pathway to treatment.

“There’s still very limited research into the field, and so it’s up to each care provider in how they treat the disorder. Someone suffering from ARFID in London may see a totally different treatment path than someone diagnosed in Northumbria. There may also be long waiting times for treatment – some doctors may find themselves reluctant to implement anything as it’s so specialist.”

And if you’re in a position where you’re concerned about a loved one who may have ARFID? Williams says the best thing to do is to educate yourself.

“It’s important to do your research,” she explains. “It can really help if you can learn a little bit about food yourself.

“The problem is that there’s just not too much awareness around it. Cases get missed, or children don't get diagnosed, because people don't know what to look out for.

“If it’s a child you’re concerned about, you’re going to be the one that has to advocate for them. In the first instance, you should always speak to a GP, who will be the ones to make the referral to the correct specialist.”

Elena* was diagnosed with ARFID in 2020, after she went to private clinic. She was also diagnosed with autism as an adult.

“I always knew I wasn’t ‘just’ a picky eater,” the 27-year-old explains. “A picky eater will eat the foods they dislike if they're hungry enough. A child with ARFID, like me, would starve for days if they couldn't get food their brain perceives as edible.

“My brain doesn't perceive the foods I dislike as food; it perceives those things the same way other people's brains perceive human waste, and you wouldn't eat human waste no matter how much you were starving.”

Elena adds she was not taken seriously when she spoke about her feelings around food, particularly when she was younger, with her parents often forcing food she found physically repulsive.

“Only my friends respected my boundaries around food,” she says. “ARFID as a term is pretty new, so for many years people like me suffered alone.”

Milk, fish and meat are among the foods Elena can't stomach.

“Milk is so slimy. I have no problems with non-liquid foods made out of milk - I just don't like milk as a liquid," she explains. “As a general rule, I don't like most flavoured liquids. Liquids have to be flavourless. Tea is the only exception.

“I dislike so many meats and types of fish that I just decided to go vegetarian for simplicity's sake.”

There are some foods in combinations that Elena also avoids.

“I can't handle desserts, such as cakes, that have fruit on top or inside of them. I eat fruit on its own just fine, and I eat cakes on their own just fine, but I can't stand the combination of the two,” she says.

“I can't eat salads because I don't like meals that have many chunks of different objects mixed together - but usually, I eat every salad ingredient separately, on its own, just fine.

Elena says she manages to get the mix of nutrients she needs by learning what food she can and can’t handle

“I mostly enjoy uncooked foods. I like most fruits and berries. I like seeds and nuts.

“When it comes to home cooking, I love a lot of pasta recipes, such as penne al arrabiata.

“When it comes to processed foods from the grocery store, I can't help but love potato chips. I used to love breakfast cereals, but nowadays I'm indifferent towards them; same goes for milk chocolate and cookies. I still like ice cream, though. I love buns with spinach filling and garlic bread. I like yogurt, but I have to be careful because many of them contain gelatine, which is not vegetarian. Out of cheeses, I love brie the most, but I like most cheeses.”

Eating in restaurants is a rare occurrence for Elena, but she manages to find some safe options.

“I loved most vegetarian pasta, pizza marinara, pizza margherita, and the four-cheese pizza. Fries are always an option. Most restaurant desserts are fine as long as they don't contain chunks of fruit.”

Elena now works to try a new food once a week to expand her dietary repertoire.

“I must emphasise that 'trying', to me, sometimes is just sniffing the food and touching it without putting it into my mouth,” she says. “I have never had a meal whose smell I found nasty that I suddenly liked when I put it into my mouth. Never ever. So I trust my nose. I respect my body's boundaries.

“I'm currently working with adopting rice. I have liked rice plenty of times before, at restaurants and made by my friends. But the rice I make is nasty. I'm trying to find a way to make it taste like it wasn't cooked by me.”

“I did not find new foods by eating anything that disgusted me, though,” Elena continues. “If my sense of smell told me I wouldn't like it, I didn't try it. If I touched it and didn't like the texture under my fingers, I didn't try it. If I didn't like it after the first bite, I spat it out and didn't force myself to eat further. I would try something new once a week, but only when I was alone.

“With my current discoveries, I eat the recommended amount of protein and fibre, as well as most vitamins and minerals. I take a daily multivitamin just in case.”

Now balancing what she perceives safe foods, Elena feels she has her ARFID under control – but doesn’t think it’s something she’ll ever be without.

“I now consider it another part of my life,” she explains. “It's impossible to rewire my brain to perceive food differently.”

* Name has been changed

If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, 365 days a year on 0808 801 0677 or beateatingdisorders.org.uk .

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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Can I Write About My Eating Disorder In College Essays?

A crucial part of appealing to the college admission board is writing a good personal essay. The topic isn’t limited to anything as long as it’s that student’s personal experience. Some of the well-known compositions found amongst college students are related to family members and the part they played in their life.  Here we will see about Can I Write About My Eating Disorder In College Essays?

Eating disorder is a mental illness that many remain uneducated about, so it’s generally recommended not to write an essay about it. People familiar with various eating disorders have either friends or family who dealt with it or dealt with it themselves. Many people have false assumptions about this mental illness based on loose descriptions shown in TV shows and movies. 

When it comes to writing a college essay, people will recommend a student to write about something that highlights the positive aspects of their lives. It could be about how you solved a difficult problem that you faced during a tough moment, personal growth essays about if anything happened in your life that made you change your beliefs, and many more. The main theme remains that you learned something positive out of it. 

Recovering from an eating disorder can indeed be an amazing topic, but there is no guarantee that everybody would look at it the same way. If a student is determined to write an essay about this topic, they should word it carefully and focus essentially on the recovery part of the eating disorder than the tough times that it put you through. Unfortunately, many people still view mental illnesses as a crucial weakness in a person and you never know who’s going to be the one reading your essay and their personal experiences with the topic. 

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As long as you keep the focus of your essay on how powerful your growth out of an eating disorder has been, it can be a good college essay. 

Write about Eating Disorder and Other Mental Illnesses in College Essays

People often suggest against delving into issues that involve mental illnesses to write college essays, it’s often recommended that if you want to include your battle with an eating disorder in your essay, do it in a manner so that it doesn’t remain the focus of the essay. Why do people say that and why is it often recommended not to write about this?

The truth is that even though a student might highlight how much they’re fought to overcome the psychological imbalances in their body, it doesn’t leave a good impression on most college admission boards. Shifting from high school to college is a big deal, and it’s like the first step into adulthood where you won’t be confined to the safety of your home. College is much more stressful and competitive than high school where you have to stay on top of the game to excel in your field. 

A student that holds enough value to the mental illness that they fought to the point where they write about it in their college essay, there is a chance for relapse. College is a stressful environment where even the students that don’t suffer from mental illnesses suffer mental breakdowns. If you put a person who already dealt with that in the past, it’s uncertain how they’d react to this change even if they’re on medication or they’re still getting counseling. 

If a student’s desired college has a high acceptance rate, they could write about their journey recovering from an eating disorder and still get accepted. If they’re aiming for a top school with a less than average acceptance rate, then it’s recommended to choose a topic that sheds most of the light on the positive moments of their life and qualities that show their mental strength. 

Colleges with a low acceptance rate and high graduation rate only choose students who show the determination to thrive under a lot of stress. If a student discusses mental illnesses such as an eating disorder in their essay, there are high chances of them not getting accepted even if they have amazing grades and good references.

You Make The Ultimate Decision

The truth is that some essays surrounding an eating disorder can be well-received by your college of choice. It depends vastly on chance. The chances of getting into a top school with an essay like that are low because many people choose to write about various mental illnesses that they suffered from. 

The bottom line is that it depends on how you word it and how your college admission board will perceive it. Some exceptional writers can word their essays in a captivating way and engage the reader to emotionally tune in to their growth from this eating disorder. They strategically weave how much they grew from their experiences and shed as much positive light as they can upon their character after they overcame their mental health issues. 

There are no restrictions when it comes to writing a personal essay for college. As long as the experience was yours or if you feel strongly about the topic you chose, you’re free to write about it. This is one of the first things your college will look at when they look at your application and it shapes the way they view you as a person. If you’re confident about writing about your eating disorder and believe that it will shed a positive light on your application, you can write about it. 

Frequently Asked Questions:

What Eating Disorder Is Common Among College Students?

Anorexia and bulimia are not only common among college students but also two of the most common types of eating disorders globally. College students might also suffer from other types such as BED (Binge eating disorder) and EDNOS (Eating disorder not otherwise specified).

What Should I Avoid Writing In A College Essay?

Students generally avoid writing about controversial topics (such as related to politics), negative experiences they’ve had with high schools and academia in general, and a whole essay dedicated to the awards and achievements you’ve won since you were a child.

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Eating disorders and diabetes

Some people with diabetes can develop an unhealthy relationship or fixation on food. this can lead to something called disordered eating behaviour or possibly an eating disorder..

Diabetes and food are closely linked. Having diabetes can mean a bigger focus on diet, weight and body image, so it’s not surprising that some people can start to feel negatively about food. Here we look at eating disorders and diabetes and explore what can be done to overcome this.

Disordered eating isn’t the same as having a diagnosed eating disorder. But the signs and behaviours are similar, like skipping insulin for weight loss, or binge eating and making yourself sick. But one can lead to the other, so it’s really important you get help before things get worse.

These eating problems are more common than you think – you’re not alone in this. And they can happen to anyone, not just because you have diabetes. Here we’ll help you recognise disordered eating behaviour, find out what can cause it and you’ll read how some people have overcome this.

“I’ve realised I’m not the only one who’s been through something like this. Peer support was invaluable to me.”  - Lynsey, who had an eating disorder

How common are eating disorders?

It is estimated that up to 30% of people with type 1 diabetes have an eating disorder. Eating disorders are twice as common in people with type 1 diabetes than people without the condition.

It is estimated that 5 to 9% of people living with type 2 diabetes have binge eating disorder, although there needs to be more research in this area.

How to recognise an eating disorder with diabetes

If you’re worried that you have an eating problem, it’s important to know the warning signs so you can get the right support at the right time. This information is also for family members or friends who are worried someone they know with diabetes is developing an eating disorder.

Here are some of the signs of disordered eating:

• increase in HbA1c or blood sugar levels that are going up and down a lot
• going into diabetic ketoacidosis (DKA) or near DKA episodes
• severely restricting what food you eat
• binge eating (eating a lot of food very often and not feeling in control)
• secrecy about diabetes management
• trying to lose weight by making yourself sick or restricting insulin
• fear of weight gain and concerns about body image
• depression and anxiety
• fear of hypos
• diabetes distress
• feelings of guilt, shame and judgement about eating habits, blood glucose levels and weight or body shape
• denial of the seriousness of symptoms and conditions
• exercising a lot without eating enough to balance it out.

Over time, disordered eating behaviours like this can lead to eating disorders, like anorexia, bulimia or binge eating disorder.

We’ve put together some questions to help you think about your relationship with eating. If you’re answering yes to some of these, it’s important that you talk to someone. 

Do you make yourself sick because you feel uncomfortably full or do you feel guilty or ashamed about what you’ve eaten? Do you worry you’ve lost control over how much you eat? Have you lost quite a lot of weight in the last few months? Do you think you’re fat when others say you’re too thin? If you take insulin to treat your diabetes, do you ever take less insulin than you should?

Lots of people with diabetes have overcome these feelings and changed their eating behaviours. We've put together some next steps for you to think about, to get the support you need to overcome this .

Eating disorders and type 1 diabetes

Type 1 diabetes with disordered eating (T1DE), also known as diabulimia, is when you reduce or stop taking insulin to lose weight. This can happen alongside other behaviours such as restricting the food you’re eating, over-exercising, binging, making yourself sick and using laxatives to try to control weight. Some people don't reduce or stop their insulin but instead control their weight and shape through food restriction or over-exercise, which indirectly limits the amount of insulin required. This is really dangerous, and can cause serious damage now and in the future too.

Lynsey had diabulimia and is now recovered. In her video she talks about  how diabulimia affected her and how she overcame her eating disorder. 

"I’m constantly still thinking about my weight but I don’t miss my insulin any more. I consider myself recovered from diabulimia.” - Lynsey

Binge eating and diabetes

Binge eating is when you eat a lot of food in a short space of time. Some people make themselves sick afterwards, but not everyone. This is a serious eating problem and you need to be aware of the damage it can cause to your body.

This behaviour doesn’t always develop into an eating disorder, but if it does it’s a very serious mental health condition.

It’s really important you talk to your healthcare team if you’re binge eating. They can help you start to look at food differently and change how you feel about it.

“Really having to look at my relationship with food and break down where so much of the negativity around it all has come from, so I can start breaking the cycle. It's a frustratingly slow process as it's been decades in the making, but with my family’s help, the psychologist I'm seeing, and studying ‘intuitive eating’, I can see that I'm making progress.” - Lucinda  has been battling with binge eating disorder

What can cause eating problems when you have diabetes?

Anyone can develop eating problems. They don’t just affect people with diabetes.

How they start is complicated and can vary for different people. Some people can feel depressed and binge eat for comfort, or some can get fixated with food because of certain pressures around them. 

You might feel:

• unhappy with your body
• your life is out of control
• diabetes is taking over too much of your life
• depressed or anxious
• pressured or controlled by others focusing on food
• fixated on blood sugar levels being perfect.

“My family will say things like, ‘You shouldn’t eat that!’. They have no idea how hurtful that is to me. I know they’re just trying to help, but I wish they wouldn’t. It just makes me feel so inferior, so bad about myself.”  - Julia, 45

These feelings and behaviours won’t always develop into an eating disorder. So understanding what might be causing these negative emotions can be the first step in overcoming them. Take a look at our information on feelings and food when you have diabetes .

How eating disorders can affect your body

Eating problems can seriously damage your body. This can affect you right now and in the future too. 

Short-term effects

Eating too much will make your blood sugar levels go too high. This is known as hyperglycaemia – hypers  can make you feel really tired and cause headaches.

Restricting insulin will also make your blood sugar levels go too high. And this can quickly lead to a serious and life-threating complication called diabetic ketoacidosis , or DKA for short. You need emergency treatment for DKA.

Restricting insulin not only affects your blood sugars, it can also make you lose weight. But losing too much weight can make your bones and muscles weaker, which will affect how well you can get around.

If you’re making yourself sick to try and avoid putting on weight, you’re affecting your mouth health too. There’s a lot of acid in vomit and this can damage your teeth and gums.

Long-term effects

If you have high blood sugar levels over a long period of time, it can seriously damage your blood vessels. Which can lead to complications  in places like your feet, eyes and heart.

This might all sound scary or you might think these complications won’t happen to you, but knowing what’s at stake could help you prevent more problems.

"I’m just desperate that it doesn’t happen to loads of other people. I’ve lost some of my eye sight, it’s just not worth it."   - Lynsey

How can I overcome an eating problem?

This isn’t going to be easy. Eating problems are serious and complicated. But reading this information and finding out more about eating problems is a good first step to overcoming them. We can help you take the next one.

You can find out about services available in your local area, using the HelpFinder on the Beat Eating Disorders (Beat) website .

If you are a young person between the ages of 16-25 with an eating disorder  you can self-refer to FREED  to get rapid access to specialist NHS treatment across England. 

FREED is aimed at targeting young people who have been living with an eating disorder for fewer than three years. Early treatment has shown to achieve results and help stop problems escalating.

You can self-refer through the website and you will be contacted within 48 hours. Treatment can begin as soon as two weeks later.

You may also find helpful information on The T1DE Podcast .

Talk to other people with diabetes

You’re not alone. You can chat anonymously on our online forum or go to a support group in person. Or follow us on social media to be part of our online communities and read what others are posting.

And if you’re a friend or family member of someone with diabetes and worried they’re developing an eating problem, show them this information and suggest they read our stories from Lynsey  and Lucinda . It might help them realise they’re not alone. 

Talk to your diabetes healthcare team

Whether you’ve been diagnosed with an eating disorder or you think you might have one, you can get specialist help from a healthcare professional. This could be your GP, a dietitian or your diabetes specialist nurse.

Your diabetes team is there to help you with all aspects of your diabetes, including how you feel about it. Share your feelings with them. They won’t judge you and together you can make a plan to manage your disordered eating. 

They might refer you to a psychologist too. Who will give you really specialist advice and support, and talk you through different treatment options like talking therapies or medication.

Beat have information on how to talk to your GP about getting referred . 

Write a food and feelings diary

Keeping a food and feelings diary can be helpful for understanding some of your eating patterns and emotions linked with food.

You can download My Food and Mood Diary (PDF, 36KB) .

This is a great way to track what food you’ve eaten and the effect it could be having on your mood and your diabetes. 

Think about bringing the diary to your next consultation (for instance, with a psychologist). They won’t judge you for anything you write down and it will really help them understand how you’re feeling. Try to be as honest as possible – the diary is there to help you.

Remember, whether you have diabetes or your family member or friend does, we’re here for you. Call our helpline  – our trained advisors are here to answer questions or just listen to anything you’re ready to talk about.

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© The British Diabetic Association operating as Diabetes UK, a   charity registered in England and Wales (no. 215199) and in Scotland (no. SC039136). A company limited by guarantee registered in England and Wales with (no.00339181) and registered office at Wells Lawrence House, 126 Back Church Lane London E1 1FH

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The Correlation Between Social Media and The Development of Eating Disorders

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Examining Eating Disorders and Social Learning Theory to Draw Useful Conclusions

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A Look into The Life of People with Anorexia Nervosa

Bulimia nervosa: causes, symptoms and treatment, the prevention and treatment of anorexia nervosa, food addiction: does it really exist, depiction of anorexia nervosa in the movie to the bone, a study of eating disorders in judaism and the impact of patriarchal values and pressures, the differences between anorexia and bulimia, social media as the reason of body dissatisfaction and eating disorders, the role of society in the development of anorexia in teen girls.

Eating disorders refer to a complex set of mental health conditions characterized by disturbances in one's eating behaviors and attitudes towards food, leading to severe consequences on an individual's physical and psychological well-being.

Anorexia Nervosa: Anorexia nervosa is a psychological disorder characterized by an intense fear of gaining weight and a distorted perception of one's body image. People with this disorder exhibit extreme food restriction, leading to significant weight loss and the possibility of reaching dangerously low levels of body weight. Anorexia nervosa is often accompanied by obsessive thoughts about food, excessive exercise routines, and a constant preoccupation with body shape and size. Bulimia Nervosa: Bulimia nervosa involves a cyclic pattern of binge eating followed by compensatory behaviors aimed at preventing weight gain. During binge episodes, individuals consume large quantities of food in a short period and experience a loss of control over their eating. To counteract the caloric intake, these individuals may resort to self-induced vomiting, excessive exercising, or the misuse of laxatives. It is important to note that unlike anorexia nervosa, individuals with bulimia nervosa typically maintain a body weight within the normal range or slightly above. Binge Eating Disorder: Binge eating disorder is characterized by recurrent episodes of consuming a significant amount of food in a short period, accompanied by a feeling of loss of control. Unlike other eating disorders, individuals with binge eating disorder do not engage in compensatory behaviors such as purging or excessive exercise.

Distorted Body Image: Individuals with eating disorders often have a distorted perception of their body, seeing themselves as overweight or unattractive, even when they are underweight or at a healthy weight. Obsession with Food and Weight: People with eating disorders may constantly think about food, calories, and their weight. They may develop strict rules and rituals around eating, such as avoiding certain food groups, restricting their intake, or engaging in excessive exercise. Emotional and Psychological Factors: Eating disorders are often associated with underlying emotional and psychological issues, such as low self-esteem, perfectionism, anxiety, depression, or a need for control. Physical Health: Eating disorders can have severe physical health consequences, including malnutrition, electrolyte imbalances, hormonal disruptions, gastrointestinal problems, and organ damage. These complications can be life-threatening and require medical intervention. Social Isolation and Withdrawal: Individuals struggling with eating disorders may experience a withdrawal from social activities, distancing themselves from others due to feelings of shame, guilt, and embarrassment related to their eating behaviors or body image. This social isolation can intensify the challenges they face and contribute to a sense of loneliness and emotional distress. Co-occurring Disorders: Eating disorders frequently co-occur with other mental health conditions, creating complex challenges for those affected. It is common for individuals with eating disorders to also experience anxiety disorders, depression, substance abuse issues, or engage in self-harming behaviors. The coexistence of these disorders can exacerbate the severity of symptoms and necessitate comprehensive and integrated treatment approaches.

Genetic and Biological Factors: Research suggests that there is a genetic predisposition to eating disorders. Individuals with a family history of eating disorders or other mental health conditions may be at a higher risk. Biological factors, such as imbalances in brain chemicals or hormones, can also contribute to the development of eating disorders. Psychological Factors: Psychological factors play a significant role in the development of eating disorders. Factors such as diminished self-worth, a relentless pursuit of perfection, dissatisfaction with one's body, and distorted perceptions of body image can play a significant role in the onset and perpetuation of disordered eating patterns. Sociocultural Influences: Societal pressures and cultural norms surrounding body image and beauty standards can contribute to the development of eating disorders. Media portrayal of unrealistic body ideals, peer influence, and societal emphasis on thinness can impact individuals' self-perception and increase the risk of developing an eating disorder. Traumatic Experiences: The impact of traumatic events, be it physical, emotional, or sexual abuse, can heighten the vulnerability to developing eating disorders. Such distressing experiences have the potential to instigate feelings of diminished self-worth, profound body shame, and a compelling desire to exert control over one's body and eating behaviors. Dieting and Weight-related Practices: Restrictive dieting, excessive exercise, and weight-focused behaviors can serve as triggers for the development of eating disorders. These behaviors may start innocently as an attempt to improve one's health or appearance but can spiral into disordered eating patterns.

Psychotherapy: Various forms of psychotherapy, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and family-based therapy (FBT), are employed to address the underlying psychological factors contributing to eating disorders. These therapies aim to challenge distorted thoughts and beliefs about body image, develop healthier coping mechanisms, and improve self-esteem. Nutritional Counseling: Working with registered dietitians, individuals receive personalized guidance on developing a balanced and healthy relationship with food. Nutritional counseling focuses on establishing regular eating patterns, promoting mindful eating practices, and debunking harmful dietary myths. Medical Monitoring: This involves regular check-ups to assess physical health, monitor vital signs, and address any medical complications arising from the disorder. Medication: In some cases, medication may be prescribed to manage associated symptoms like depression, anxiety, or obsessive-compulsive disorder. Medications can complement therapy and help stabilize mood, regulate eating patterns, or address co-occurring mental health conditions. Support Groups and Peer Support: Joining support groups or engaging in peer support programs can provide individuals with a sense of community and understanding. Interacting with others who have faced similar challenges can offer valuable insights, encouragement, and empathy.

Films: Movies like "To the Bone" (2017) and "Feed" (2017) shed light on the struggles individuals with eating disorders face. These films delve into the psychological and emotional aspects of the disorders, emphasizing the importance of seeking help and promoting recovery. Books: Novels such as "Wintergirls" by Laurie Halse Anderson and "Paperweight" by Meg Haston offer intimate perspectives on the experiences of characters grappling with eating disorders. These books provide insights into the complexities of these conditions, including the internal battles, societal pressures, and the journey towards healing. Documentaries: Documentaries like "Thin" (2006) and "Eating Disorders: Surviving the Silence" (2019) offer real-life accounts of individuals living with eating disorders. These documentaries provide a raw and authentic portrayal of the challenges faced by those affected, raising awareness and encouraging empathy.

1. As per the data provided by the National Eating Disorders Association (NEDA), it is estimated that around 30 million individuals residing in the United States will experience an eating disorder during their lifetime. 2. Research suggests that eating disorders have the highest mortality rate of any mental illness. Anorexia nervosa, in particular, has a mortality rate of around 10%, emphasizing the seriousness and potential life-threatening nature of these disorders. 3. Eating disorders can affect individuals of all genders and ages, contrary to the common misconception that they only affect young women. While young women are more commonly affected, studies indicate that eating disorders are increasingly prevalent among men and can also occur in older adults and children.

The topic of eating disorders is of significant importance when it comes to raising awareness, promoting understanding, and addressing the challenges faced by individuals who experience these disorders. Writing an essay on this topic allows for a deeper exploration of the complexities surrounding eating disorders and their impact on individuals, families, and society. First and foremost, studying eating disorders is crucial for shedding light on the psychological, emotional, and physical aspects of these conditions. By delving into the underlying causes, risk factors, and symptoms, we can gain a better understanding of the complex interplay between biological, psychological, and sociocultural factors that contribute to the development and maintenance of eating disorders. Furthermore, discussing eating disorders helps to challenge societal misconceptions and stereotypes. It allows us to debunk harmful beliefs, such as the notion that eating disorders only affect a specific gender or age group, and instead emphasizes the reality that anyone can be susceptible to these disorders. Writing an essay on eating disorders also provides an opportunity to explore the impact of media, societal pressures, and body image ideals on the development of disordered eating behaviors. By analyzing these influences, we can advocate for more inclusive and body-positive narratives that promote self-acceptance and well-being. Moreover, addressing the topic of eating disorders is crucial for raising awareness about the available treatment options and support systems. It highlights the importance of early intervention, comprehensive treatment approaches, and access to mental health resources for those affected by these disorders.

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. 2. Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731. 3. Brown, T. A., Keel, P. K., & Curren, A. M. (2020). Eating disorders. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (6th ed., pp. 305-357). Guilford Press. 4. Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407-416. 5. Herpertz-Dahlmann, B., & Zeeck, A. (2020). Eating disorders in childhood and adolescence: Epidemiology, course, comorbidity, and outcome. In M. Maj, W. Gaebel, J. J. López-Ibor, & N. Sartorius (Eds.), Eating Disorders (Vol. 11, pp. 68-82). Wiley-Blackwell. 6. Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358. 7. Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., & Agras, W. S. (2004). Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin, 130(1), 19-65. 8. Keski-Rahkonen, A., & Mustelin, L. (2016). Epidemiology of eating disorders in Europe: Prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29(6), 340-345. 9. Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414. 10. Stice, E., Marti, C. N., & Rohde, P. (2013). Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. Journal of Abnormal Psychology, 122(2), 445-457.

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What Recovering From an Eating Disorder Is Really Like

By Kimberly Neil

TRIGGER WARNING: This story contains sensitive content regarding eating disorders.

We all get sick – from a minor cold to an infection that requires time in the hospital, the process of our body repairing itself is part of being human. Sometimes our bones break, sometimes our organs lose their ability to function properly. The cause of some illnesses take more energy to decipher, and these cases usually inspire episodes of Grey’s Anatomy or Mystery Diagnosis. The phrase “get well soon” explains how the average person views illness. Finding a cure, regardless of how small or big the problem may be, is what those who aren’t well and the people who love them wish for. In an ideal world, getting better is the best possible outcome.

What do you picture when you think about sickness? There are usually physical symptoms. Sometimes, we have to take time off from school or work. Can you imagine days in bed, chicken noodle soup, or negative side effects from strong prescription medication? Your discomfort is usually visible to those around you; and even if people can’t see your pain they can find a way to empathize once it is described. Mental illness is different.

I want you to imagine a time where you really, truly felt ashamed of who you are. A moment where the people around you didn’t get it, and more than anything, you wished the earth would open up and swallow you whole. My eating disorder has always been the personification of that very feeling. It began around the age of 11, and by the time I was 12, it had turned into something I carried around with me daily. That feeling was constant. It was my biggest, most embarrassing secret.

Though I wouldn’t describe it as a literal voice in my head, my eating disorder started with a feeling that I wasn’t good enough. This problem needed to be fixed, and controlling what I ate seemed like the perfect solution. I had no idea how easily avoiding certain foods would lead to eliminating them entirely. Though I could not put it into words as I became a teenager, I felt dirty from the inside out. Not eating specific foods turned into skipping meals, followed by days without food, replaced by days where the rules I had created for myself didn’t matter and all I could do was eat until I physically could not anymore. One day, I pushed myself past the point I thought I was capable of. It hurt, but I kept going – until my impulse changed entirely and suddenly I knew that I just had to get what I had eaten out of me.

Purging became my way of undoing: every mistake I made in class, at dance, or even with life in general, it was always something that I knew I could use as an outlet for all of the underlying negativity. I felt more in control with each meal or mistake that I tried to erase. I internalized the idea that something about me wasn’t good enough until that framed the way I saw myself. Being a teenager, a pre-professional dancer, and attending a competitive high school with amazing, intelligent, talented friends should have made me feel empowered. Sometimes it did, but because of my eating disorder, it became too easy to see myself as inadequate.

At one point, I realized that I loved certain parts of being a dancer. Ballet classes were always something I enjoyed, and I couldn’t get enough of costumes, makeup, or being on stage. Dancing gave me a way to become someone else. The downside of wanting to dance as a career while having an eating disorder was the way that no one around me said anything until I was deep into my illness. For the longest time, my friends and teachers complimented me whenever I lost weight. I noticed that the audition season for summer intensives magnified all of my insecurities. I inevitably was accepted into more pre-professional ballet programs when I was thinner.

I can remember two summers in particular where, in retrospect, I’m honestly amazed that I did not get “caught” in the chaos of my disorder. I was absolutely not healthy enough to dance 6-7 days per week from morning until as late as midnight, considering how out of control my disordered behaviors were. During one of those intensives, I also attended a summer chemistry class three days per week in between classes and rehearsal. I reached a point where I wound up leaving both. Between passing out a few times, feeling dizzy every single day, and eventually, throwing up blood – it all became too much.

Dance seemed like the root of my disorder at the time, but I had no idea how to let it go. I fought so hard to maintain my ED without losing ballet or modern. At one point, after receiving my first professional diagnosis of bulimia nervosa I withdrew from my selective enrollment high school, because my disorder essentially meant that I had to decide between my education and my dream of being a professional dancer. I eventually became so injured that dancing en pointe was no longer physically possible for me. Looking back, I believe that injury would have happened on some level even if I had been completely healthy. But I have no way of knowing if I would have still wound up in a place where dance was too painful to make the chance of a professional career a possibility, had I never developed an ED.

By Kara Nesvig

By Donya Momenian

There also is no way I can know with complete certainty that I wouldn’t have struggled with an eating disorder had I never danced in the first place. After losing dance, it took me a little longer than my friends to finish high school by home schooling myself. Education had always been an important aspect of my identity, and losing both dance and my high school also meant that I became more and more isolated, wrapped up in my ED. I wound up pushing most of my high school friends away out of shame and guilt. To this day, I am not sure if my teachers (both from every studio that I’ve danced at and from school) and friends really knew what was going on with me. Did they avoid reaching out because mental illness is stigmatized, and talking about it is really scary? Did everyone just think I was very driven and committed to dance, making it pointless to intervene? Or did people really not know — did I hide it that well?

Once the raw heartbreak from losing so much because of my ED began to fade away, I decided that I wanted to attend college. Had I graduated from my selective enrollment high school and been healthy enough to put the hard work into college applications, I think that I would have been accepted to at least one of my dream colleges with financial aid. The process of applying as a home schooled student is a little different, so I decided to attend a local community college for at least a year and apply to some of my dream colleges as a transfer student.

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Healing from an eating disorder is almost as stigmatized in discussion as admitting the problem itself. From books like Wintergirls to movies like Starving in Suburbia , the media presents a consistent message that the process of healing is a continuous, upward journey. I cannot speak for everyone with an eating disorder. I can admit how difficult it has been to tell my story at times, because my illness comes and goes in waves. I’ve yet to experience recovery, full stop.

There was a period of time between the end of high school and attending my first college class where my relationship with food became easier to manage. I took a similar DIY approach to recovery as I did to earning a high school diploma. My body became healthy again, and while I still struggled with depression, I felt my confidence come back slowly. I tried out for my [first] college’s volleyball team and not only made it, but received a scholarship offer as well – and I had never played before. I became involved with student government. Out of the four colleges I decided to apply to as a transfer student, I was accepted and offered aid by all of them, including my dream school. I made new friends. All of these aspects of freshman and sophomore year were wonderful, but I put a lot of pressure on myself to be the perfect student.

All of this resulted in a full relapse. It didn’t happen overnight, but my esophagus was healing from a serious tear by move-in day at the college I decided to transfer to. While my first few weeks at this amazing school on the east coast were everything I’d ever wanted out of my college experience, they were also moments that were painful and terrifying. Every single day I spent on this beautiful campus with new friends from all around the world was a day I felt torn between gratitude and self-hatred, and inadequacy. I eventually asked for help, and that lit a fire under my eating disorder. I went from feeling like recovery was possible to thinking it was something I didn’t deserve. I tore my esophagus for the second time, and simultaneously fell into restricting, abusing diet substances like laxatives and water pills, and exercising too much. I also started dancing again, and didn't feel supported by my college’s dance department at all. Even if I had felt that support, I don’t think it would have made a difference.

During the first week of October 2014, I took two cabs across the state of Massachusetts to an inpatient facility outside of Boston. I was 21 years old. It took 10 years for me to be hospitalized for my eating disorder, with an updated diagnosis of Eating Disorder Non-Otherwise Specified (EDNOS – now referred to as OSFED in the DSM-5), and that month was one of the hardest ones of my life. Inpatient was both the best and worst thing that has ever happened to me. I met people that changed my life. Both staff and other patients made me realize that maybe, the thing I was meant to do with my life all along was help other people who shared my struggle. Inpatient also made me realize how much my college meant to me, and how important education would continue to be in order to achieve my goals.

In November 2014, after leaving inpatient and returning to my college campus, I posted a poem on my personal blog. Because I also helped with a shared blog about EDs (that currently has over 40,000 followers) other people spread that poem around. The poem led to me becoming a contributor for Proud2bme , an online recovery community connected with the National Eating Disorders Association (NEDA). More recently, I even received a scholarship to attend the 2015 NEDA conference this October in San Diego, California.

My ED has given me a voice, and more importantly, it has given me a passion for helping others. It also hasn’t completely gone away. More than anything, I hope that someone out there, reading this, is able to look at their personal journey and hopefully feel less alone. I hope that someone that knows and loves someone with an eating disorder will read this, and feel inspired to really support that person through the ups and downs of recovery. Having an eating disorder is never a choice. When you’re sick, people expect you to get better. This is why compassion is essential. Healing takes nonstop effort and requires so much support, but it is possible. No one should feel ashamed of talking about the process, or receiving help along the way.

If you or someone you know is struggling with an eating disorder, the NEDA helpline is here to help at 1-800-931-2237.

Related: The Hidden Eating Disorder Side Effect That’s Both Extremely Dangerous and Far Too Common

By Ellen M. Burstein

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Essays on Eating Disorder

Overeating is a psychological disorder that spreads quickly across the United States. That is the reason why you can find a bunch of essays and research papers that are analyzing the eating disorder. Writing a research paper about eating disorders is tough as you need to be careful not to offend anyone. Every thesis ... you have need to be supported by argumentative evidence and examples that confirm your pieces of advice are valuable. These essay topics require an engaging introduction, valuable mid-part with interactive titles, and a strong conclusion that will truly boost the mental health of a person that struggles to solve this problem. However, keep the mind that you should make some sort of balance. You must not cause people to think that anorexia is something they should strive to achieve. If this seems challenging for you, essay examples on eating disorder will help!

Eating Disorder Anorexia Nervosa

Glossary: Acupuncture – an ancient Chinese therapy using needles and herbs to revivify the body’s energy flow. Aromatherapy – the use of essential oils to relieve stress and relax. Anorexia Nervosa – a medical condition and or mental health condition that causes lack or loss of appetite for food. Bronfenbrenner’s Ecological Systems Theory – explains how the basic qualities of a child and his or her environment interactions influence how he will grow and develop. Cognitive Behavioral Therapy – a […]

The Differences between Eating Disorder

The Differences between Eating Disorder and Disorder Eating The main difference between disorder eating and the eating disorder is their magnitude. Although people suffering from disordered eating and ordered disorder may depict connatural behaviors, the later has less frequency and severity (Toni et al. 906). Albeit, the behaviors exhibited by an individual with disordered eating are less severe and frequent, American Psychiatric Association posits that they may be problematic and serious. According to Anderson, disordered eating is problematic because it […]

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Individual Developing of Eating Disorder

Reading the journal article, it was apparent that the authors main purpose of this journal is the finding of a link between weight overestimation and disordered eating behaviors among normal weight women (Conley &Boardmen,2007).The authors go on further explaining how there is little to no research done with associating normal weight women and their possibility with acquiring an eating disorder because of how they might overestimate their weight and might be at risk of developing anorexia nervosa. The key concepts […]

Eating Disorders Among Gollege-age Women

Among many college-age women with high weight and shape concerns, an 8-week, Internet-based cognitive-behavioral intervention can significantly improve weight and shape concerns for up to 2 years and reduce risk for the future eating disorders, at least in some high-risk groups. To our knowledge, this is the first study to show that EDs can be prevented in high-risk groups. Unhealthful weight regulation methods and body image concerns, which predispose people to clinical and subclinical eating disorders, are common among high […]

Different Eating Disorders in Society

In this society, many different eating disorders are happening lately. It is becoming a major problem throughout the world and most specifically in the United States. Everyone in all ages and gender have been suffering from different eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating. About over twenty-four million people have suffered from this in the United States. In this world, it has become worse but it can be prevented and people can help themselves by controlling […]

Generalized Anxiety Disorder

Imagine waking up every morning with the feeling of utter dread and worry not being able to comprehend why. It is a feeling that sticks with you throughout the whole day. Many people suffer from Generalized Anxiety Disorder (GAD). It is known to be the most common type of anxiety disorder that causes uncontrollable nervousness, unease, fear, and worry (Heering & Oji, 2018). People who suffer from GAD find it difficult to live an ordinary life with daily activities. They […]

Fad Diets and Eating Disorders

There is an undeniable certainty that in society there is a concerning amount of focus on how we look and what we eat. With magazines and blogs, such as Vogue and Goop, promoting diets and certain body types, of course there is pressure to look a certain way. These diets that are promoted, though have no scientific evidence that they actually are healthy for you and tend to rely more on pseudoscience, are called fad diets. These fad diets, such […]

Nature, Nurture and Eating Disorders

Introduction Eating disorders develop from various reasons. They are either genetic causes (nature), and environmental causes (nurture) and additionally could be both. There are three primary eating disorders. They are Anorexia (AN), Bulimia (BN) and Binge eating (BE). On the genetic, an imbalance in specific hormones can cause medical conditions leading to psychosis such as major depression, anxiety, and bipolar disorder. On the nurture side of things, there are many influences such as social pressure, idealization of body image, wanting […]

Defining Seasonal Affective Disorder

In the long vigorous winter months, there is a blanket of dark clouds and a grey sky that lingers over the earth. The white crystals that cover the ground aren’t always so beautiful, slushy and cold, and slippery making people dread having to walk their dog or wait for the bus. The air is stinging fingers and ears from the frigid temperatures. The trees losing their colorful leaves, the crops withering away, and the animals hibernating are some things that […]

Abnormalities have been found in the human race for a long time now. Humans over this time period have illustrated these abnormalities, how to understand these abnormalities, and how to reduce these abnormalities. Humans have understood that the only way to deal with these abnormalities is by gaining as much knowledge as possible about them. The perception of issues eventually becomes understood, and gives off responses to these problems. According to King(2017), “Abnormal behavior is understood as behavior that is […]

CHRONIC OBSTRUCTIVE PULMONARY DISORDER

 COPD is the third leading cause of mortality in the United States (Hinkle & Cheever, 2019), and can be properly managed through appropriate care principles that start with an accurate assessment and diagnosis. Applying appropriate and conducive interventions in company with other healthcare professionals will pinpoint and treat disease complications. Lastly, evaluating and offering alternatives to a patient’s lifestyle can positively impact their care and will illustrate a holistic, exclusive care experience. Pathophysiology and Diagnosis COPD can be described as […]

Vegetarian: is it Better than Eating Meat?

Who doesn’t like bacon? It is salty, meaty, goes with anything and everything, and there is just no substitute for it. People have even started cooking it into candy. When someone states that they are a vegetarian it appears like they are instantly better than those of us who are omnivores because they have a measure of control not to eat bacon that the rest of us don’t have. Most of us realize that vegetarianism is an expression of one’s […]

Personal Narrative Assignment: Major Depressive Disorder

Prior Knowledge The prior knowledge I have with Major Depressive Disorder is that this disorder is a mood disorder that creates an everlasting feeling of sadness. Most people who are diagnosed with this disorder live normal lives like those around them, but lack motivation in everyday tasks. Some of these tasks may include things like getting out of bed, cleaning, or going to work/school. I believe this disorder is more common than many people may realize, but also more self-diagnosed […]

An a Severe Type of Disorder

Also, a successful diagnosis includes a hypothesis about the causal processes and a distinction between factors that caused the onset of CD and factors that preserve the disorder. This distinction is essential because the clinician has to focus on the factors that he can modify in his treatment plan. The procedure Stage One: Before any interview, the clinician sends to parents a questionnaire list and a comprehensive standardized rating scale list. Both lists must be completed by parents, teachers, and […]

The Humanistic Approach to Borderline Personality Disorder 

In order to develop a treatment plan for any client, one must first develop a deep understanding of the diagnosis at hand. It is imperative that both the therapist and the client understand the weight, stereotypes, and historical value the diagnosis carries. And before creating a unique Humanistic Approach the therapist must fully understand the trials and errors of the approaches before in order to weigh all of the treatment options. Borderline Personality Disorder or BPD is classified under the […]

Social Media is the Main Cause of Eating Disorders

Today in society people care about making sure there life looks perfect on social media, so they get more likes or follower/friends. What people do not understand is that no one’s life is perfect, people just put up a fake shield over there life. Nowadays there is photoshop if a person doesn’t like their body. This editing can cause everyone to think there is only one perfect body image. When a person is already self conscious they will believe anything […]

Does Social Media Contribute to the Development of Eating Disorders in Young Adults?

Throughout the years social media has been identified as both a positive and negative role in the lives of young adults. The media today has expanded in a broad range of uses that consist of Facebook, Instagram, Snapchat and etc. The media allows individuals to have a glance at the lives of others simply by viewing one’s own images and videos of themselves. Although the media can play a positive effect in the lives of individuals it can also reinforce […]

The Role of Peer Pressure in the Development of Eating Disorders

Peer pressure increases the likelihood of young women developing eating disorders through social pressures to be thin, desire for approval from friends, and indirect competition within peer groups. Social Pressures to be Thin The pressure of society increases the likelihood of young women to develop eating disorders. In the words of Deanna Linville, an associate professor of counseling psychology and human services at the University of Oregon, eating disorders among young women aged 11-17 are associated with “criticisms of appearance […]

The Morality in Helping Others with the Anorexia Nervosa, a Psychological Disorder

Introduction Millions of people worldwide struggle with anorexia nervosa. Yet this disorder has the highest mortality rate than any others. Anorexia has a higher mortality rate than schizophrenia, and nearly 50% of schizophrenics attempt suicide. Every 62 minutes a person dies from a serious eating disorder and one out of five anorexic deaths are from suicide (Facts About Eating Disorders: What The Research Shows, n.d.). Of those struggling in the United States, only one third of anorexics will obtain treatment […]

Dogs and other Domesticated Animals Serve an Important Role in Modern Society

 As people consider their pets as part of their family, they are much more willing to spend money on their animals to ensure they live an enjoyable and healthy lifestyle. As a result of this increased monetary funding into the animal health field, further research has been conducted to better understand how to properly care for domestic animals and any diseases or disorders they may have. This includes, but is not limited to, psychological disorders. Although it may sound strange […]

Diagnostic Features Including Symptoms

Everyone experiences feelings of sadness at one time or another, but depression goes deeper. Depression affects a person’s daily life, whether or not they are able to function, and how well. Although sadness is usually triggered by a specific event, depression is not (Shelton, 2018). Depression can be triggered by anything, even activities that were once considered enjoyable. If sadness persists after a traumatic event and other symptoms develop it can turn into. To be diagnosed with Major Depressive Disorder, […]

DID is not a Weakness, but Rather a Strong Desire to Survive

 This is quoted from an anonymous survivor of DID. Dissociative Identity Disorder or DID was previously known as Multiple Personality Disorder. There are many different treatment methods, but the main focus in this paper is on the individual psychotherapy process. Symptomology Dissociative Identity Disorder is when one experiences a disruption of identity by two or more distinct personality states. People with DID may have a noticeable disturbance in their sense of self. They also tend to experience dissociative amnesia, or […]

“Black Swan” is an American Psychological Film

The movie examines how far one woman will push herself in order to achieve perfection. Nina Sayers suffers from three primary diagnoses: psychosis, obsessive-compulsive disorder (OCD), an eating disorder. Psychosis is a condition that causes a person to lose touch with reality. Throughout the movie, Nina shows signs of visual, auditory, and tactile hallucinations. She sees her paintings mocking her, scratches her skin, and sees herself transform into a Black Swan. She also shows signs of persecutory delusions, anxiety, and […]

The Unfair Portrayal of Women’s Body Image

For decades women’s body image being unfairly portrayed. On every platform of social media there is a propaganda of idealized picture of women’s body image and beauty. Many women today are dissatisfied with their body and its obvious result of the culture we live in, the culture that constantly imposing on us the standards of feminine beauty as a required attribute. As a young girls women learn that if they want to be attractive and attention worthy, they would have […]

Negative Effects of Body Image on International Students

Introduction Pick up a magazine. Turn on the television. Watch a movie. We are flooded with messages and images advise us that weight, body shape, outer look, and dressing make the person. Success seems to be directly connected to waist size, shape, and fashion label. The cultural significance of the physical seems to be so ubiquitous that other definitions are difficult to differentiate. For many individuals, especially women and international students the matter of question for beauty is extremely personal […]

Body Image in Modern Society

Body Image can be defined as how one mentally perceives their own body. It has taken a title in which depicts the importance of a majority of our modern society. An individual’s body image becomes affected when they too closely relate their unique bodies to their own personal happiness and, in some cases, their own identity. People take such great measures in order to alter their appearance without themselves even knowing what they are exactly doing or what is going […]

Fashion Industry and it’s Affect on Body Image

The fashion industry has always been an influential establishment since the 1900’s and prior. There is no denying the impact fashion has on the fast trending world, as many different ages participate to stay up to date with what’s in and what is considered last season. In the early 1900’s the S-shaped figure was what was strived for with big, lavish clothing (Bowman,2017). Women wore corsets and bustles just to achieve such figure. Fast forward to the fifties when knee […]

Important Element of Culture is the Media

An important element in human culture is the media. There are over 1.4 billion television sets in the world today. According to the National Centre For Eating Disorders, about 95% of households have access to TV sets and are stick to the television for an average of 4 hours per day. By the end of the 20th century, 50% of women and 60% of men read a newspaper daily, and approximately 50% of all girl read a ladies’ magazine every […]

Running Head : what is Bulimia Nervosa?

Abstract Bulimia nervosa is an eating disorder that commonly is associated with young girls. Bulimia is the act of eating a large amount of food and quickly getting rid of the calories to prevent any weight gain. The two types of bulimia are the purging type and the non-purging type. This eating disorder is difficult to spot in people because the sufferer can hide signs unlike anorexia. People that are suspected to be suffering from this disorder should consult with […]

Cultural Artifacts and how they Affect Women and Men’s Body Image

A culture can be described as a certain way of thinking, judging, feeling and acting over a period of time becoming part and parcel of a people or a society. A certain culture can be classified as a family one, organizational culture, traditional culture, popular culture and many others (Narayan 177). For instance, since the 1980s, blue-chip companies and mega corporations have entrenched a certain code of conduct or performance amongst their circles. Management consultants and theorists have popularized and […]

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• v.5(1); 2019 Jan

Care experiences of young people with eating disorders and their parents: qualitative study

Oana mitrofan.

Academic Clinical Lecturer in Child and Adolescent Psychiatry, University of Exeter College of Medicine and Health, University of Exeter, UK

Hristina Petkova

Health Economist, King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK

Astrid Janssens

Senior Research Fellow, University of Exeter College of Medicine and Health, University of Exeter, UK

Jonathan Kelly

Policy Officer, Beat, UK

Eve Edwards

Research Officer, Beat, UK

Dasha Nicholls

Reader in Child Psychiatry, Imperial College London, UK

Fiona McNicholas

Professor of Child and Adolescent Psychiatry, School of Medicine, University College Dublin, Ireland

Consultant Child and Adolescent Psychiatrist, Child and Adolescent Eating Disorders Service, South London and Maudsley NHS Trust, UK

Ivan Eisler

Professor of Family Psychology and Family Therapy, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK

Tamsin Ford

Professor of Child and Adolescent Psychiatry, University of Exeter College of Medicine and Health, University of Exeter, UK

Sarah Byford

Professor of Health Economics, King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK

Associated Data

For supplementary material accompanying this paper visit http://dx.doi.org/10.1192/bjo.2018.78.

Perspectives of young people with eating disorders and their parents on helpful aspects of care should be incorporated into evidence-based practice and service design, but data are limited.

To explore patient and parent perspectives on positive and negative aspects of care for young people with eating disorders.

Six online focus groups with 19 young people aged 16–25 years with existing or past eating disorders and 11 parents.

Thematic analysis identified three key themes: the need to (a) shift from a weight-focused to a more holistic, individualised and consistent care approach, with a better balance in targeting psychological and physical problems from an early stage; (b) improve professionals' knowledge and attitude towards patients and their families at all levels of care from primary to ‘truly specialist’; (c) enhance peer and family support.

Conclusions

Young people and parents identified an array of limitations in approaches to care for young people with eating disorders and raised the need for change, particularly a move away from a primarily weight-focused treatment and a stronger emphasis on psychological needs and individualised care.

Declaration of interest

Eating disorders are serious conditions of increasing prevalence among young people. 1 In the UK, out-patient treatment 2 was historically delivered in generic child and adolescent mental health services (CAMHS) or highly specialised eating disorder services, with significant regional variation in provision. 3 Although there is growing evidence about the efficacy of particular treatments, 2 our knowledge about the impact of different clinical settings on treatment outcomes is limited. Studies suggested that specialist service provision may lead to better case identification, greater consistency of care and be more cost-effective, 4 – 7 but the data are limited. In England, there has been recent investment in specialist community eating disorder services for young people in all regions, 8 the impact of which is unknown. These developments are contemporaneous with increasing emphasis on patient-led recovery approaches to eating disorders as well as patient and carer participation in service design, for which data on patient and carer perspectives are important.

Qualitative research can facilitate a better understanding of what patients perceive as optimum care. 9 In the field of eating disorders such understanding mostly comes from qualitative studies in adults, with research on adolescents' perspectives of treatment and recovery more recently emerging. Previously identified themes highlighted the role of family, peers and professionals, family therapy, the in-patient setting, emphasis on physical versus psychological aspects and conceptualisation of recovery among adolescents with anorexia nervosa. 10 Most previous qualitative research has focused on anorexia nervosa rather than broader eating disorder diagnoses. 11 However, current service provision does not typically provide distinctive care pathways or services for different types of eating disorders. Research also focused on experiences of specific treatment settings, particularly in-patient care and parallel exploration of young people's and parents' perspectives is limited. Greater satisfaction with treatment and more positive experiences of family therapy have been reported by parents compared with adolescents with anorexia nervosa. 12 Our study aimed to explore young people's and parents' experiences of care for eating disorders, both positive and negative, across various treatment settings and the ways care could be improved by using thematic analysis. We hypothesised that, despite the ego-syntonic features often encountered in eating disorders, young people want good care towards recovery, and their views would be similar to those of parents on what constitutes good healthcare.

Participants

A purposive, non-probability sampling method was used to identify individuals who were likely to have experience of a range of different eating disorder service provisions. Young people aged 16–25 years who had an ongoing or past eating disorder and had contact with healthcare services in relation to their eating disorder, and parents of young people in the same situation, were recruited through Beat using an online advertisement. Beat is the UK national eating disorder charity, which has supported extensive research in this field by facilitating recruitment ( http://www.beateatingdisorders.org.uk ). Attention was drawn to the advertisement via Beat's email database and its Facebook and Twitter profiles. Responders to the study advertisement were provided with further information about the study via email. Recruitment continued until saturation of themes was reached (i.e. the point at which no new ideas emerge from additional data collection). 13 All participants gave written consent to take part via email. Ethical approval was granted by the University of Exeter Medical School Research Ethics Committee (REC REF Apr15/B/062).

Data collection

Participants completed a baseline questionnaire covering demographic information, details of healthcare services used in relation to their eating disorder, or, in the case of parent participants, those of their child's eating disorder. Focus groups for young people and parents were facilitated separately. In order to provide a balance of experience of different service provision in each group (out-patient and in-patient, generic and specialist, child and adult services), we drew on the baseline questionnaire data on type of healthcare services they had used for eating disorders to allocate participants, as much as possible, given the response rate and participant availability. Each of the four online focus groups with young people included a mixture of younger and older participants (i.e. below and above the mean age for the sample), also of mixed diagnosis and treatment status (except for one group where by chance all participants had anorexia nervosa and were no longer receiving treatment). Each parental group included a participating father; one group included parents of a child with anorexia nervosa and mixed treatment status, and the second group included parents reporting more than one diagnostic category and whose children were no longer in treatment for their eating disorders.

Each focus group was convened as a synchronous ‘chatroom’ for a maximum of seven individuals in the Chat Blazer software ( www.chatblazer.com ). Each participant was provided with a unique, non-identifying username and password. Participants had no access to others' personal information except for their chosen usernames. Each group was run by an experienced Beat moderator and a group facilitator from the research team. The facilitator led the group by introducing the topics of the semi-structured guide, which included open questions and prompts. The topics were identified through a review of the existing literature. 10 , 14 , 15 and from the authors' clinical experience and covered the following areas: overall experience of services including accessibility, flexibility, medical assistance, professional encounters, key professional qualities/skills, individual and family support and important treatments; helpful aspects of care; unhelpful aspects of care, potential changes to these and desired impact of change; views on specialist services versus generic CAMHS; views on community versus in-patient services; views on age division within services and experience of adult services; and suggestions for service improvement (see Supplementary Material, available at https://doi.org/10.1192/bjo.2018.78 ).

The moderator was responsible for setting the ‘ground rules’, monitoring for any sensitive issues and rejecting any unsuitable comments prior to them being shared. Each participant typed their answers, which, after being approved by the moderator, were displayed on screen for others to read and respond to. Each group had a chat supervisor (member of the research team) who provided support to distressed participants through private online communication (separate closed chatroom). This included the recommendation to contact a healthcare professional such as their general practitioner (GP) (the research team did not have participants' consent to make contact directly on their behalf) and signposting to other support services (only one participant required this). Each group lasted between 60 and 90 min. All participants were invited to comment on the transcript of the group they participated in and on a summary of findings.

Data analysis

Focus group transcripts were generated automatically by participants' typed responses (mean word count 6043, s.d. = 1351.8, range 3587–7258 words). All transcripts were analysed in NVivo software ( http://www.qsrinternational.com/nvivo/nvivo-products ) using thematic analysis. 16 This involved a detailed reading and re-reading of the transcripts, identifying and labelling codes in each transcript, arranging the codes into themes and summarising the themes. This process was carried out iteratively with the team of researchers moving back and forth between transcripts and emerging themes. In order to address potential preconceptions of the main rater, three transcripts of two groups with young people and one with parents were independently coded and extracted themes were subsequently compared and discussed until full agreement on final themes was reached.

Characteristics of the young people who participated in the study are described in Table 1 . A total of 19 females aged 16–25 years (mean age 20.7, s.d. = 3.3) took part in four online focus groups. Only one participant was from an ethnic minority. Nearly two-thirds had or were recovering from anorexia nervosa and the remainder had or were recovering from bulimia nervosa, ‘other/atypical eating disorders’ or a combination of these. Mean illness duration was 6 years (s.d. = 3.6, range 15 months to 13 years).

Information about the young people who participated

CAMHS, child and adolescent mental health services; AMHS, adult mental health services; CYP-EDS, child and adolescent (specialist) eating disorder services; AEDS, adult (specialist) eating disorder services; CBT, cognitive–behavioural therapy.

Eleven parents took part in two online focus groups. Most were mothers ( n  = 9), none were from an ethnic minority and the majority had a daughter ( n  = 9) rather than a son ( n  = 2) with an eating disorder, mostly anorexia nervosa. One participant reported a combination of anorexia nervosa and binge-eating disorder ( Table 2 ). Mean age of their child at the point of diagnosis was 14.7 years (s.d. = 2.1, range 11–17). Mean duration of their child's illness was 5 years (s.d. = 4.1, range 12 months to 15 years). As a result of the anonymity assured by our protocol, we were not able to establish the overlap between the young people and parent samples (although three participants disclosed this).

Information about the parents who participated

CAMHS, Child and Adolescent Mental Health Services; CYP-EDS, Child and Adolescent (Specialist) Eating Disorder Services; AEDS, Adult (Specialist) Eating Disorder Services; AMHS, Adult Mental Health Services.

Most young people had used a mixture of healthcare services. Use of private healthcare was scarce (young people 16%, n  = 3; parents 18%, n  = 2). For both samples, nearly two-thirds of young people were no longer in treatment (young people 63%, n  = 12; parents 64%, n  = 7).

Three main themes emerged from participating young people's and parents' accounts of their experiences of care. Each main theme and its subthemes are discussed in turn and illustrated by participants' first-hand quotations. The source of each quotation is indicated by the participant's study ID number (YP ,young person; PA, parent). Three secondary themes and supporting quotes are presented in Table 3 .

Secondary themes

A&E, accident and emergency department; CAMHS, child and adolescent mental health services; GP, general practitioner.

Early, holistic, individualised and consistent care

All participants' accounts (young people and parents) suggest an imbalance between physical and psychological aspects of care. Most participants described good experiences of the care addressing physical health needs, but reported that there was too much focus on patient's weight while neglecting psychological aspects and more personalised, life-long skills.

Early intervention

Participants viewed referral to services and admission for treatment as largely dictated by the patient's weight, setting a threshold that appeared to promote weight loss as a means of accessing support. Delaying intervention as the patient was ‘not ill enough’ was seen as likely to hinder recovery, as opposed to early consideration of relevant emotional and behavioural symptoms:

‘…specialist services are simply brought in too late. They're supposed to catch you, but often you have to fall quite a way to get there.’ (YP9)

‘One of the main challenges is getting help early enough. There is too much attention paid to weight loss and not enough to the behaviour patterns and so they are dangerously low in weight before you get referred…It is the strange behaviour around food and rituals that indicate a problem. They may not be dangerously low in weight at this stage but far more retrievable.’ (PA9)

‘Seeing the whole person’

Most participants experienced professional help as being targeted towards reaching a ‘minimum healthy weight’ with limited psychological input. This often led to deterioration and relapse as their underlying difficulties of how to ‘deal with emotion and lack of control’ persisted. They advocated a holistic approach aiming towards ‘recovery in body and mind’:

‘I recovered physically and got back to a healthy weight, but then with that recovery comes a huge psychological struggle and thus high risk of relapse, which certainly wasn't addressed at the time…’ (YP3)

‘Really what you need is someone who sees the whole person – the link between the medical and psychological condition and treats both together.’ (PA1)

Many young people described upsetting sessions that revolved around ‘the number on the scale’ and frequent weighing ‘like a pig at the fair’, while their thoughts and emotions were ‘brushed off’. One recalled:

‘…I was feeling really positive about my recovery after reading a book about someone who had recovered and “seeing the light” a bit but when I arrived at my session, stepped on the scales and had lost weight the whole session turned to be about food. I never even got to mention the book and how it made me feel.’ (YP6)

The interplay between a weight-driven approach to treatment and the ‘competitive nature’ of eating disorders could create a vicious cycle. One participant felt she was ‘taken more seriously’ the lower her weight was, which ‘fed the illness itself’ as her eating disorder would see this as being ‘successful’. Another felt she needed to make herself worse to ensure support:

‘I spoke to my psychiatrist once I got to a healthy weight and she said there isn't much they can do if I'm not ill which really upset me…Just focus more on the emotional side…I still don't really know how to get better. I wish she hadn't said there was nothing she could do because I wasn't ill physically because that makes you think you need to make yourself ill to get help which shouldn't be the case!’ (YP14)

Young people talked about the complex nature of their condition that ‘consumes every single aspect’ of their lives. They felt that treatment should address ‘how to live long term’ and ways of ‘keeping the eating disorder at bay’:

‘…anorexics think about their condition every second of the day…even in my dreams I still have the condition…Recovery shouldn't be just meal times and weight focused.’ (YP12)

Some parents highlighted the absence of the recovery topic in professional contacts and their struggles to find ‘actual evidence that people could recover’. For others, the recovery message was conveyed in unhelpful ways:

‘Our initial treatment didn't promise “recovery” but…they did…stress that full recovery was possible…It just seemed that they sort of blamed the parents before 18 and the patient after 18 if that didn't happen!’ (PA10)

Individualised approach

Many participants experienced a ‘one size fits all’ approach, where professionals were ‘treating the condition not the person’ and evidence-based interventions were applied with ‘little understanding of individuals recovering differently’. They recommended a more personalised approach that would help them find their ‘own positive reasons to recover’:

‘I disagree with the homogeneity of treatment methods. Where I am at the moment, they are very good at tailoring recovery to the individuals' needs…my therapist…has a way of putting my recovery in my hands.’ (YP1)

Consistency and continuity

Several participants experienced frequent, disruptive changes in professionals and ‘re-telling the same story’ at each new clinical encounter:

‘…building up relationships with individual counsellors, etc. takes time, and having to cut and change as the services chop and change has been quite unsettling.’ (YP17)

A key issue was the gap in treatment provision when young people made the transition from child and adolescent to adult services, which often triggered clinical deterioration:

‘CAMHS gave up on me when I was about 17 and 2 months and I couldn't start adult treatment until 18 – that gap was when I made the biggest decline.’ (YP6)

This transition takes place ‘right in the middle of the struggle years’ and the disconnection between services was described as an ‘artificial divide’. Suggested alternatives were changing the age boundary to 25 years, a flexible approach ‘dictated by needs rather than age’ or an ‘integrated 8–80 specialist eating disorder team’.

Knowledge of eating disorders at all levels of care

A salient issue in both young people' and parents' accounts concerned the insufficient knowledge of the nature and clinical management of eating disorders among various professionals working across all levels of care.

Knowledge at primary care level

Primary care practitioners have a gatekeeping role, crucial for early identification and referral. Although willing to help, they often lacked knowledge in the identification of eating disorders and when and where to refer:

‘The general opinion of the GP when I first visited was to go away for a month and come back if there was still a problem. For an eating disorder, I think this is very poor considering how much weight you can lose in a month…’ (YP17)

‘If I were to express any misgivings, it will be about the time it took to get a referral from her GP to CAMHS…there is a huge variety of awareness on eating disorders among GPs, some of the responses given to my daughter were appalling and wouldn't even have registered with the Ladybird book on eating disorders.’ (PA8)

‘True’ specialist services

Many participants experienced ‘an extreme lack of experience and knowledge in eating disorders’ among various professionals working in general hospitals, emergency services, generic mental health and more specialist eating disorder services:

‘…the NHS mental health service I was with had seemed to take people who had jobs as counsellors, physios, dieticians…they thought that they would be helpful but because they are not specialists it made it ten times worse.’ (YP5)

‘…you get referred for “more specialist” advice to someone who knows a LOT less about the subject than the nurses doing the referring.’ (PA10)

Professionals who ‘know their stuff about eating disorders’ and have ‘real hands-on experience of eating disorders’ were ‘invaluable’. These skills were not necessarily linked to service type: specialist eating disorder services were seen as beneficial as long as they were ‘truly specialist not just in name only’:

‘We reacted best to people who had experience of eating disorders, who calmly said yes, we will help you get out of this.’ (PA4)

Professionals' knowledge appears key in avoiding inconsistent or incorrect information being given to families. Several participants recalled feeling ‘bewildered’ and having to make ‘the first move in every direction’. Many participants highlighted the need for early psychoeducation including clear information about standard and crisis care:

‘I think giving families information around the causes of eating disorders and also how to act/miss a crisis. How to talk about things and strategies to plan for stressful times.’ (YP16)

‘There is no clear route to treatment in the early weeks. CAMHS was unable/unwilling to lay out the possible treatment pathways, so every family would start the long education process right from scratch.’ (PA4)

Professionals’ attitude

Many participants described professionals who were ‘far too judgemental’ and made ‘devaluing’ comments, that hindered help-seeking and therapeutic engagement. They sometimes felt openly criticised for ‘misbehaving’, ‘making a fuss’ and ‘choosing a career’ of having an eating disorder. Parents felt blamed for their child's condition and their ‘inappropriate use of resources’ when seeking help:

‘… personal treatment can make a big impact…Even just sort of a helping hand to doctors to sometimes be a bit more sensitive with the stuff they say, for instance comments regarding “superficial self-harm” or that a weight loss/weight gain isn't “serious” just ways of phrasing stuff that can be quite triggering.’ (YP18)

‘I do think that many clinicians (not necessarily eating disorder specialists, we haven't had this from them) genuinely believe that parents cause eating disorders.’ (PA10)

Professionals' attitude was linked to their misunderstanding of eating disorders, inexperience, focus on patient's weight and tendency to compare the patient to others with a similar condition or to healthy individuals:

‘…when eating snacks my psychiatrist would talk non-stop about the calories and how she was eating more than me and had already finished hers…not helpful!’ (YP9)

Peer and family support

Talking to someone with a similar experience seemed vital as it gave participants a better understanding of eating disorders, motivation and hope:

‘I did like all the people that were trying to help me, they did their best. I just didn't feel like they ever completely got me. In fact the people who did make me feel that way were often people that had experienced an eating disorder as well.’ (YP2)

‘A lot of support has come from recovered anorexics telling her the struggle to recover is worth it and to keep going. They have helped her through some of her blackest days.’ (PA9)

Peer support was often unavailable locally, contributing to a sense of isolation:

‘It's funny they tell you about the amount of people suffering with it but I didn't know anyone.’ (YP13)

Parents described a similar need for talking to others with related experience:

‘I couldn't have got through without being able to discuss the worst aspects with another mum who'd been through it. Some things you can only talk about with others who've experienced it.’ (PA1)

Many participants highlighted the need for young people and parent support groups and respite care. Support for family members would relieve some of the burden so that ‘in turn they can support the patient’:

‘I think allowing my family to breathe and have a break away from me, maybe a chance to meet others supporting patients would have been helpful…Especially for my brothers.’ (YP17) ‘We had no family support…The professionals only offer care for a short time. Remember the families support the sufferer the rest of the week. Also it impacts on the whole family.’ (PA9)

Participants' experiences of type, availability and quality of care were mixed. Positive experiences often concerned care addressing physical health needs, alongside sporadic reports of treatment tailored to individual needs, consistency from keyworkers, a good therapeutic relationship, contact with eating disorder specialists and peer support. Common negative experiences, however, suggest a raft of limitations with service provision and the need for change. It is clear that some participants were not offered or accessing an evidence-based psychological intervention. Identification and clinical management appeared dominated by a young person's weight, linked in some cases to professionals' understanding of eating disorders and service thresholds for referral and treatment. Clinical practice thus seemed to contradict the advice some professionals gave to participating young people to stop thinking about diet and weight.

Participating young people and parents' negative experiences are consistent with the findings of an cross-national (USA, UK) survey in adults with eating disorders highlighting the limited availability and inequity in geographical distribution of services, lack of knowledge of eating disorders among GPs, limited access to care unless severely underweight and long waiting lists in the UK sample. 14 Qualitative exploration among adult patients portrays recovery from eating disorders as a wider phenomenon that goes beyond weight restoration. 17 Suggested strategies to address control issues and ambivalence towards treatment in adult patients include consideration of wider psychological issues and a sensitive approach, linked to specialist expertise. 18 Similarly, issues around priority given to physical over psychological recovery, lack of individualised care and need for sensitivity from healthcare staff were noted in a number of qualitative studies of adolescents' experiences of in-patient treatment (as well as out-patient treatment in one study) for anorexia nervosa. 19 – 24 Both a positive and a negative impact of peers on adolescents' recovery from anorexia nervosa in an in-patient context has been described. 12 , 19 , 20 , 24 , 25 It is worth noting that almost all of these studies were published more than 10 years ago. Qualitative explorations of parents' experiences of their child's care for eating disorder, also dating back 10 years or more for most studies, highlighted the importance of personalised intervention 26 and specialist knowledge in eating disorders. 12 , 27 Peer support for parents has been supported in the literature, sometimes reported as one of the most helpful aspect of care. 27 , 28

The main contributions of our study stem from bringing together the combined experiences of young people and parents of treatment in multiple services, and the emerging emphasis on psychological aspects of eating disorders from very early stages and having appropriately trained professionals working across a wide range of services rather than a single specialist service. Qualitative investigations into the meaning of anorexia nervosa to adolescent and adult patients support psychodynamic and cognitive theories of its connection with the development of individuals' own identity and control systems, with a subsequent impact on their help-seeking behaviour and treatment outcome. 29

Furthermore, a recent qualitative synthesis into the perspective of recovered adult patients suggested four dimensions of psychological well-being – positive relationships with others, self-acceptance, autonomy and personal growth – and self-adaptability/resilience as fundamental criteria for eating disorder recovery in addition to symptom remission. 30 In a study using a multidimensional recovery model, adults with eating disorders placed more emphasis on the combined psychological, emotional and social functioning and evaluation of one's own appearance criteria compared with clinicians. 31 In line with these findings from the adult literature, our study highlights two important aspects in addressing the psychological well-being criteria for recovery and the development of a ‘healthy’ identity in young people with eating disorders, according to both patients and parents: an earlier consideration of psychological aspects of these conditions that should start at identification in primary care and referral to specialist treatment, as well as enhanced professionals' knowledge of eating disorders and attitude towards patients and families across all levels of care.

Eating disorder services for children and adolescents in England have received a significant investment, and are undergoing major restructuring, 8 which should address many of these concerns, in particular timely access to psychological interventions independent of weight status. Our findings support the importance of these changes to improve the quality of patient and parent experience, regardless of the cost-effectiveness arguments. However, these standards are not yet applicable to adult eating disorder services, which remain patchy and underresourced. Eating disorder services in Wales are currently subject to a major review for which this study provides timely evidence.

Gaps in health professionals' ability to recognise and treat eating disorders and the negative attitude that some express towards individuals with eating disorders have been previously highlighted as more prevalent compared with other mental or physical illnesses. 32 , 33 Our findings are in line with a recently published report highlighting the poor experience of mental health services often encountered by children and young people in the UK. 34 Others have reported short comings in service provision and suggested strategies for a more consistent and smooth transition to adult mental health services, tailored to the young person's needs and taking into account other simultaneous life changes. 35 , 36

Strengths and limitations

This study recruited a national sample of young people and parents not bound by setting or treatment group. It used synchronous online discussion (i.e. all focus group members temporally co-present) that has recognised similarity to a traditional, face-to-face focus group, 37 but has the advantage of providing an anonymous online environment. This has previously been identified as preferable by young people when discussing sensitive topics because of its private and less judgemental nature. 38 The young people's age range ensured access to experiences of both child/adolescent and adult services as well as the transition.

The gender imbalance and preponderance of anorexia nervosa are a likely effect of the means of recruitment and self-reported diagnosis, although it is consistent with anorexia nervosa being the dominant presentation of eating disorders to CAMHS services. The recruitment and data collection methods limited participation to consenting older young people and also meant that individuals with easier access to and familiarity with internet use were more likely to participate. Findings may therefore not pertain to all young people with eating disorders and their carers, particularly younger children, males and those from ethnic minorities, and may not generalise to non-UK healthcare settings. Methodological issues around gender and ethnicity imbalance in this field have been previously reported. 19 , 20 , 23

Our recruitment may have skewed the perspective towards negative experiences. Most participating young people were over 18 years of age at the time of the study, had relatively long illness durations and experienced treatment in multiple services, often in-patient or day services, with likely poor initial response to treatment. More than half of them were no longer receiving treatment at the time of the study. Although potentially allowing for more reflective accounts, our sample characteristics may explain the differences between our findings and those of Roots et al , 12 which were more positive, particularly regarding specialist services. Their study included adolescents with an average duration of illness of just over 1 year, thus perhaps better representing the patient population in child/adolescent services with relatively short illness duration, good response to out-patient treatment and no need of in-patient care or transfer to adult services. The two studies thus provide different, complementary perspectives on treatment experiences and suggest the likelihood of more positive experiences if receiving early, specialist intervention. Our findings do echo other similar studies and, rather than the experiences of a dissatisfied minority, they replicate and add to the existing evidence of shortcomings and needed changes in care provision for young people with eating disorders.

Implications

There was a strong consensus that treatment should not just focus on weight but also address psychological and relational aspects from an early stage. An individualised treatment approach that addresses physical and psychological recovery in parallel, from an individual's first contact with health services throughout their therapeutic journey, is more likely to lead to full recovery and minimise the risk of relapse. Carefully planned peer support for young people, as well as support for parents and siblings would be highly beneficial. Although such changes in care provision may be challenging for many overstretched services, they seem essential in the long term by preventing delayed intervention and longer illness duration, both well recognised predictors of poor clinical outcome. 39

The role of professionals' knowledge of eating disorders and treatment pathways was perceived as crucial at all levels of care, from primary to ‘truly specialist’. Specialty training, such as general practice and core psychiatry training should provide more opportunities to enhance eating disorder knowledge and understanding of patient and family experience of eating disorders among junior doctors. This should particularly target misconceptions around weight loss as a sole or primary factor in the referral and treatment process.

Improving professionals' knowledge at all levels is clearly key to achieving early diagnosis and intervention, 40 but equally important is to ensure that treatments have a better balance between the necessary focus on restoring nutrition and physical health and psychological well-being. In England, this has been extensively highlighted in the literature and recently brought forward by the new commissioning guidance for children and young people with eating disorders 8 and advocacy efforts to increase awareness among GPs of the clinical, particularly psychological, indicators of eating disorders and importance of early referral for specialist assessment. However, these efforts will only be effective where specialist services exist and have the capacity to respond. Further research is needed to assess the potential positive impact of these initiatives. The historical nature of retrospective accounts means that some of the issues raised here may have already been addressed in national guidance and service provision. Nonetheless, qualitative data supporting these changes adds impetus to these priorities.

Acknowledgements

We would like to thank all participating young people and parents, Beat, Adrienne Rennie, Amanda Woodrow, Caroline Kalorkoti (Beat Ambassadors), Leoni Randall, Susan Howson and Barbara Barrett who assisted with data collection and manuscript preparation. Work was carried out at the University of Exeter Medical School.

O.M. was supported by a NIHR Academic Clinical Lectureship.

Supplementary material