Eating Disorders 

Getting treatment for eating disorders can take time when seeking NHS care. Budgets are tight and the threshold for admission: high. Often, there is a lack of local provision and clients often find themselves having to travel hundreds of miles for treatment. There can also be long waiting times for admission which can significantly impact the person for whom their eating disorder is having a real impact on their life.  

As with addiction, eating disorders don’t happen overnight and it can be months, even years, before the person asks for help or loved ones notice the signs and start the conversation. GP’s do their best, but their input is limited in monitoring and referral. Admission to a psychiatric unit should be avoided as these units cannot provide the right environment for someone with an eating disorder.  

Up until recently, specialist eating disorder treatment within a private setting has been very cost prohibitive and only accessible to those with health insurance or very deep pockets. Now, there are several addiction rehab centres that are using existing facilities, with the appropriately qualified and experienced clinicians and therapists, to provide a lower cost alternative. The costs are lower that other offerings because the infrastructure is already in place.   

Providing evidence based, safe and effective treatment for those with an eating disorder is a complex process involving a multi-disciplinary approach with an array of treatments. It is not as simple as providing someone with food and standing over them while they eat. Indeed, there is a phenomenon within the field of eating disorders of those who “eat their way out” meaning they will adhere to the programme, in so much as dietary intake, simply to achieve discharge and then undo the work at home by returning to their restrictive eating habits.  

Unlike some private hospitals and NHS units, we do not provide “locked units”. This means that clients are free to leave, if they wish, though there are parameters to alert people to someone’s discharge based on risk.  

Here at find me a rehab, we are recognised as a rehab referral specialist UK. As well as providing help to anyone seeking alcohol and drug treatment, we also provide home detox services UK. 

There are many different types of eating disorder: it is not just about anorexia and bulimia. While there are similarities when treating different diagnosis, treatment plans are tailored to the individual and make use of the specialist treatments in line with client need. All clients are welcomed into a group therapy process and, depending on the treatment plan, may be provided with different forms of talking therapies and adjunctive therapies such as mindfulness. Nutritional guidance can also be an important part of the process as with family therapy.  

The first step is to speak, in total confidence, with our clinician who has direct experience, as a staff grade, within numerous private eating disorder residential services. They will be able to give you free and impartial advice. When selecting a centre, it will be necessary to obtain a medical summary from your GP. While it is always advisable that to inform your GP, if you prefer you can ask for a summary without divulging as to why, though we would strongly discourage this. A medical summary ensures that the receiving centre can make an accurate assessment and offer the right help. There may be circumstances where it would not be safe to offer admission. Diagnosing an eating disorder requires the input of several professionals: doctors, therapists, state registered dieticians, etc.  A comprehensive assessment of the client’s physical health, psychological state and history of the presenting eating disorder is essential to provide the right treatment plan.  

This is a disorder that affects up to 600,000 people across the UK and thus it affects more people than anorexia and bulimia. The lack of public awareness stifles information sharing and fuels misconceptions. Unlike those with Bulimia who will try and compensate after a binge with vomiting and laxatives, those with binge eating disorder encounter extreme periods of guilt and shame: This merely perpetuates the cycle leading to another episode.

As with addiction, there is no single cause, rather that there will be a whole range of factors leading to a diagnosis. Psychological trauma, cultural issues, family history and biochemical are just some of the possible pre-emptive factors. Identifying the cause, which is part of the treatment process, is crucial. Stress, anxiety and boredom can be powerful driving forces in an eating disorder.

Sadly, as with physical addiction to substances and alcohol, BED can adversely affect someone’s health. It can lead to type 2 diabetes, heart disease, sleep problems, digestive difficulties and insomnia.

It is very common, indeed, for someone with BED to also have significant anxiety and depression running alongside chronic issues with self-esteem. This can perpetuate a repeating cycle which is why therapy is a pathway to breaking that cycle.

All clients take part in group therapy, which includes both a morning meeting (to review the evening before and plan for the day) and an evening meeting, to work through any issues that arose during the day. Group therapy allows others to support the client. While everyone’s experience of an eating disorder is different, there are similarities. Often, therapy staff are in recovery themselves so can offer a unique experience.  Depending on the care plan drawn up, one (or more) of the following therapies may be on the client’s treatment plan:  

Therapy can follow a single or eclectic model and may well include aspects of cognitive and dialectical behavioural therapies. These are aimed at helping the client understand triggers and avoid them as well as learning new strategies. Role play is often used.  

Should it be needed, an on-site doctor will assess and prescribe medication alongside input from a state registered dietician.

This is one of the strongest links in the chain and it is essential to maintain a healthy recovery. All centres offer a minimum of a weekly group session (in person or virtual). Many also have a telephone support service for previous residents.

This is where someone’s desire to eat a balanced diet goes to extremes. The person dealing with this condition will spend inordinate amounts of time sourcing ingredients and/or selecting prepared foods. Orthorexia is not, ordinarily, concerned with a distorted body image of restricting calorific value in food but is mainly focused on the purity of the food.

Aside from obsessional pre-occupation with the purity of food, someone suffering from this condition may restrict some food groups. The non-availability of the sought-after products/ingredients can cause the person extreme stress and anxiety. It can also damage relationships as the person can start to judge others and proselytise. Alternatively, some sufferers may socially isolate so they do not have to face situations where their requirements cannot be met. On a physical level, severe restriction of certain foods can have a significant impact on someone’s physical health. Not only can it cause a loss in bone density, a lowering of immune function, but it can also render someone infertile.  

Current research suggests that there will be multiple factors at play, including social and cultural influences as well as underlying personality traits. Embedded psychological issues, namely obsessive and compulsive behaviours, can also be a strong driving force. Currently, there is little evidence of genetic pre-disposition relating to orthorexia.  

To provide a safe and effective treatment plan, a thorough multi-disciplinary team assessment will be required, including medical, therapy and dietician. GP information will be required. This can be obtained from a GP surgery without disclosing as to why, though we discourage this.  

As with all rehab centre programmes, all clients are welcomed into a group therapy process. To augment this, and to address client specific issues, individual sessions are provided, sometimes around a dialectical/cognitive model. Family therapy can be an essential part of the recovery process as well as sessions with a dietician to identify positive food choices.  

A very common disorder, Bulimia nervosa, typically follows a pattern of binge eating and then behaviours to try and reverse the effects of the binge: taking laxatives, making yourself sick, exercising, etc. It is not uncommon for someone with bulimia to become very adept at hiding the signs and symptoms due to their feelings of shame and self-loathing. As with anorexia, there are significant psychological aspects to Bulimia. Often the sufferer will have a significantly distorted image of their own body despite their physical appearance. The associated guilt and shame that is very often present in Bulimia can perpetuate the disorder and put the person in a cycle they find impossible to break. Depression and anxiety can also be factors. 

The effects on someone’s physical health, from Bulimia, can be very significant. Some of them are visible to others, such as dental decay, skin appearance and hair loss. Others are invisible yet critical, including electrolyte and hormonal imbalances. Serious cases can lead to severe gastrointestinal complications and damage to the oesophagus. There is, also, very often, damage to gums and frequent dental infections.  

Sadly, left untreated, those with Bulimia can sometimes develop ideas of self-harm and suicide due to the turmoil of coping with the disorder.  

As with other eating disorders, there will be many factors at play: Some will be biological, some due to the everyday stresses of life while others societal influence. 

Getting a diagnosis is not like going to the doctor with tonsilitis. It requires assessment from a group of professionals, including doctors, therapists and dieticians. A family assessment can also be an important element of reaching a diagnosis and forming a treatment plan.   

Eating disorders take time to form and it may be years before someone has the courage to face up to their issues and seek treatment. As such, eating disorders are complex and require a multitude of therapeutic approaches to achieve meaningful recovery.    

This is the mainstay of effective treatment and recovery. While everyone’s experience will be different, they are also many similarities. The therapists leading the group may well be in recovery themselves. Groups provide a warm, receptive, accepting environment that is safe and therapeutic.  

Using various models, clients can learn new skills and ways of thinking with a therapist: on a one-to-one basis. Role plays often plays an important part of this process.  

Since the early days of eating disorder treatment, the value of family therapy cannot be underestimated. One, vital, aspect of this is educating family members on how to support someone on discharge.  

Those with eating disorders often have very fixed ideas on foods nutritional value and become overly concerned about food groups. Working, on a one-to-one basis, with a dietitian is an important part of challenging these ideas, in a safe and supportive way

A debilitating condition that affects up to one in sixty people across the UK. Every year, thousands of people are admitted for treatment. Like all eating disorders, it is complicated and developed on a long period of time. Someone with anorexia will have overriding concerns about their body image, despite their physical appearance, and will do, almost anything, not to take in calories as they are terrified about gaining weight. Someone with anorexia, despite being skeletal, will look in the mirror and see themselves as overweight. It affects both men and women.  

As someone with anorexia will usually be significantly underweight, they are at serious risk of malnutrition. This leads to a damaged immune system. Organ damage and a loss in bone density is also a common factor with Anorexia as are low blood pressure and hormonal changes. Women with Anorexia may well find their periods stop and they cannot conceive.  

Poor nutrition damages mental health and wellbeing while, at the same time, it is common for someone with Anorexia to experience anxiety and depression. Sometimes there are also aspects of obsessional behaviour involved, also. Severe malnutrition will, inevitably, lead to problems with completing everyday tasks, especially retaining information. The illness will place great strain on someone’s ability to function at work, school and impinge on relationships. Often, someone with Anorexia, will withdraw from interacting with others leading to significant isolation.  

Aside from being significantly underweight, it is common for someone to try and compensate with very baggy clothing. Often, they will insist on long sleeved garments as the arms are usually in someone’s field of vision. They may experience constant episodes of fatigue, falling over and see their hair fall out, their nails become brittle and their skin becoming very dry.  

Family mealtimes with someone who has Anorexia can be a battlefield. They may make excuses not to attend, make excessive demands regarding portion sizes and ingredients and may try and offset the calorific value by vigorously exercising after eating. It is not uncommon for someone with Anorexia to become incredibly knowledgeable about calorific values of different foods. They may cook and prepare food for the family but avoid eating it themselves.

As with all eating disorders, there are multiple contributory factors, including:  

• Genetics and hormonal deficiencies: a family history can make someone predisposed to Anorexia.  

• Pressure from others: There are higher rates in boarding schools, dance schools, though peer pressure, alone, is unlikely to lead to a diagnosis. 

• Response to trauma: Anorexic thought patterns can be a coping mechanism for trauma. 

• Lack of control over life stresses: By controlling food intake, someone with Anorexia feels a sense of control that they otherwise wouldn’t when life stressors become overwhelming.  

• Sense of achievement or need to conform: Someone wanting to compete in sports at the highest levels may well develop anorexic thought patterns. Simultaneously, losing weight can give a sense of achievement where they feel unrecognised in other areas of life.  

Determining if someone has Anorexia is a complex and in-depth process using information and assessments, not just from doctors, but from therapists, dieticians as well as biochemical tests (blood and urine). This then provides for a comprehensive treatment plan that will be effective, realistic and safe.  

If you need a rehab referral specialist UK, home detox services UK or simply want to find me a rehab: Call or email.  

After a comprehensive, multi-disciplinary, assessment the client will be welcomed into a rehab centre and taken into a group therapy process. These are a safe environment where others with eating disorders, led by a therapist, discuss, challenge, support, laugh, cry and discuss. The therapist is, more than likely, in recovery themselves.  

This could be on a cognitive or dialectical basis and may also include role play. These sessions are tailored to the individual and look at examining and challenging thoughts while learning different approaches and coping tools.

A mainstay of eating disorder recovery. Not only will family therapy explore/repair disharmonious relationships in the family circle, it also helps family members support the person with anorexia in a positive, non-threatening manner.

While people with anorexia often have an encyclopaedic knowledge of calories, they often have very distorted views on differing food groups. Sessions with a dietician can help to challenge strongly held thoughts. Also, when someone has restricted their food intake for a significant time, it is essential to avoid re-feeding syndrome which occurs when someone who has not been eating starts to take calories on-board.  

As important as any other aspect of the treatment plan. This starts from admission and all centres offer a minimum of a year with a weekly therapy group for those who have completed residential treatment.

There are several lesser-known eating disorders that are becoming more prevalent with more people seeking treatment at rehab centres. While they may well be lesser known, this does not denude the impact they have on the individual and their family, loved ones and friends.  

Whereas those with anorexia and bulimia are pre-occupied with either gaining weight, body shape: or both, those experiencing ARFID are concerned with avoiding foods due to their texture, smell or colour. Their avoidance will result in extreme anxiety while the avoidance of certain foods can have a very significant impact on the persons health. While it is more commonly found in young people and school age children, adults can also experience ARFID. Current research has discovered three different types of ARFID:

• Avoidant: Where the person has a total lack of interest in food. This can be a diagnostic challenge as the person experiencing it may be wholly unaware

• Conditioned: This is usually triggered by a traumatic experience such as choking while eating a particular food or when someone was ill after eating something.

• Sensory-sensitive: A total aversion of certain coloured food, the smell of certain foods and/or their texture. The resulting anxiety can be extreme.

Someone with this condition is likely to present with heightened stress reactions when presented with certain foods. They may well self-exclude from family and social gatherings or choose not to eat lunch with colleagues in the staff room. They may well have thinning hair, brittle nails and dry skin. Digestive and gastrointestinal issues are also common. They may become obsessed with dietary supplements.  

As with all eating disorders, there are several different causational factors.

Biological: When someone, with an eating disorder, has a family member who experiences the same problem this is known as genetic predisposition.

Deep-seated personality traits: When an individual has ingrained thoughts about certain the textures of some foods, their colour, consistency and taste there is a higher likelihood the person may develop ARFID. Such difficulties make eating out or eating food prepared by others incredibly difficult and anxiety provoking.

Where someone is raised in a family where there are extreme practices around food, be that excluding food groups or unusual family dynamics around food, this could be a springboard to ARFID.  To cope with very stressful family situations, especially where the parenting style is overly controlling and/or where there is a lot of very high expressed emotion, the instances of ARFID increase.  

During a child’s early years, as humans move from milk to solids, some children develop a fear of new foods that are introduced. This fear can vary significantly impact on the child’s nutrition and physical development as they may only eat a very small variety of food groups. There have been cases of children who will only eat baked beans or crisps, even just chicken nuggets! 

This relates to those who develop an aversion to a food/FoodGroup because of an uncomfortable experience on a previous occasion. This could be a digestive issue, an intolerance or a perceived allergy.

Children who are penalised, by their parents, for not eating a particular food or who are coerced into eating something can be left with a deep fear of those items and will actively avoid them.

People with Autism often feel safer when constrained within routine which can manifest in an obsession with limited food choices, especially colour, texture and keeping foods of different colours, separate on a plate.

One of the main elements of ARFID is anxiety and it can be to a level where someone cannot eat, or at the very least, try a new food.

Obsessional compulsive disorder/ADHD: It is not uncommon for those with OCD and/or ADHD to develop ARFID. For those with OCD, their fears are usually around food hygiene and how food is prepared and thus they are unlikely to eat food prepared by others and will go to extreme lengths to prepare food for themselves or, simply, not eat.

This is not uncommon and falls under the umbrella of Unspecified Food or eating disorder (UFED). If someone has a problem with food but does not meet the diagnostic criteria of the recognised eating disorders this requires a thoughtfully put together treatment plan. Simply dismissing the person, because their issues with food do not “fit the mould” of a diagnosis only perpetuates that person’s difficulties. Not everyone who binge eats then tries to compensate with laxatives and exercise, for example. Those with UFED may find it very difficult (if at all) to get treatment from NHS services because they don’t meet NICE guidelines.

Unlike conditions that are underpinned by a digestive disorder or more complex gastrointestinal complications, some people will regurgitate their food, and this can become an ingrained habitual element of mealtimes. Some people will repeatedly chew, then re-swallow food whereas others will chronically regurgitate without any associated nausea or discomfort.  

Secondary symptoms from rumination disorder  

As the person experiencing this is not benefitting from the nutritional value of the food it is not uncommon for them to experience weight loss, vitamin deficiency, gastrointestinal difficulties, dental decay (stomach acid erodes enamel) and chronic bad breath.  

As with other eating disorders, there will be several factors at play:  

• High expressed emotion within the family unit

• Absence of stimulating play in infancy and childhood

• Medical emergency (food poisoning, appendicitis)

• Underlying mental health condition

• Neurodiversity 

The mainstay of all eating disorders is group therapy. While everyone’s experience is different, and those in the group may have differing diagnosis, there are shared experiences, and the support of peers can be immeasurable. The therapist leading the group will usually be in recovery themselves. Individual therapy, either CBT or DBT or an eclectic approach, may well form part of the treatment plan as can family therapy and mindfulness.  

While not, yet a recognised condition by the NHS or the wider medical establishment, night eating disorder affects people who consume large amounts of food during the night, often gorging and binging. Either the person only eats at night due to stress or heightened expressed emotion at home or because they wake up, during the night, with a desire to eat. This can lead to thoughts of shame and guilt from repeating these behaviours.  

As with all eating disorders, treatment revolves around a group therapy process. All rehab centres run with group therapy at the very core of recovery. While not everyone in the group will have the same diagnosis or experiences, all benefit from shared support. Individual and family therapy also forms part of the recovery process as can art therapy. There is a growing body of evidence that shows additional recovery tools, such as mindfulness, can also be effective.

While the majority of those getting into recovery with an eating disorder are dealing with food issues, Pica is distinct: It is the consumption, often obsessively, of items that have no nutritional value such as ice, newspaper, soil, etc. Sadly, some items can be hazardous such as metal or even plastic or glass. While more common in women who are pregnant and young children, it is not confined to those groups. The consumption of non-food items presents specific gastrointestinal problems as well as damage to the mouth and teeth. Nutritional deficiency is common and there is a significantly heightened risk of parasitic infection which can be very dangerous.  

Those experiencing non-food obsession can develop heightened anxiety and, in extremis, suicidal thoughts. It can cause very significant barriers in relationships and prevent someone going to work or studies.  

Pregnancy cravings: It is not uncommon for pregnant women to develop uncontrollable desires for non-food items.  

Underlying mental illness: Pica can be a common, yet distressing, feature of obsessional compulsive disorder and major mental illness such as Schizophrenia.  

Vitamin/mineral deficiency: Just as PICA can cause a nutritional deficiency, a lack of certain nutrients, especially zinc or iron, can cause PICA.  

Neurodiversity: Those with autism can often experience PICA.  

A multi-disciplinary approach helps to formulate a diagnosis and to formulate an effective, safe treatment plan, it is usual for blood tests and a referral to a gastroenterologist to assess any emerging health conditions. A check up with a dentist is also recommended. There are psychological screening tools that are used in the diagnostic process and a level of observation, from a healthcare professional, may also be indicated in reaching a diagnosis.  

Building around a nucleus of group therapy in a rehab centre, someone with PICA can really benefit from both family and individual therapy (CBT/DBT/eclectic) as well as other evidence-based treatments including:  

• Art therapy 

• Mindfulness 

• Music therapy 

• Meditation  

Aftercare is, as with all those attending rehab: Essential. All rehab centres offer a minimum of a weekly support group (either in person or virtually) for at least a year, post discharge. Many offer telephone support and clients can usually continue individual therapy, for an additional fee.  

Apart from providing home detox services UK, here at Find me a rehab act as a recognised rehab referral specialist UK.