Your L&D Newsletter Issue 4

Happy Friday. You have made it through the week and now the weekend is yours to enjoy!!

This week we are going to look at restrictive Eating Disorders (ED) the signs someone has one and a look at the phases of a restrictive ED. So what is an ED? An ED is a serious but treatable mental and physical illness that can affect people of all genders, religions, weights, ethnicities, sexual orientations and body shape. In the United Kingdom it is estimated that 1.25- 3.4 million people have an ED with approximately 25% being male (Priory UK).

While no one knows for sure what causes eating disorders, a growing consensus suggests that it is a range of biological, psychological, and sociocultural factors. Watch this video for more info: YouTube - What are eating disorders and what impact do they have on the body.

Lets rephrase this. Someone has problem eating if their eating behaviour, or attitudes about food and weight are taking pleasure out of their life. People with ED typically worry a lot about their weight and about the food they are eating (or trying not to eat). They probably have an eating disorder if some of the following is happening:

• Excessive concern and preoccupation about calories or fears of weight gain
• Eating habits that seem abnormal
• There is a lot of shame and guilt around eating
• You think they are too thin, but they don’t think there is a problem
• They vomit to avoid gaining weight or use laxatives
• Their weight is fluctuating a lot
• There are a lot of foods they strictly avoid to control their weight, and they may express feeling like a terrible person if they eat any of these foods
• They have unmanageable cravings for certain types of food that they think you should not be eating
• Exercise is something they are driven to do; they would feel fat or like a bad person if you missed an exercise routine even if injured or unwell
• They are depressed and irritable
• They pretend that you have eaten to get people off their back.

See here for more on this: NEDA - Eating Disorder Signs & Symptoms.

Phases of a restrictive ED

It is thought that there are different stages to a restrictive ED. Recovery is non linear and ongoing. Stages are thought to be:

• Stage 1: I am not so bad, I am certainly not ill leave me alone
• Stage 2: I think I have a problem but I can manage it on my own, its not so bad it will go away on its own
• Stage 3: I know I’m ill but I don’t care, you can’t make me eat and neither can I so leave me alone
• Stage 4: Turning point- recovery is possible
• Stage 5: maintenance/relapse.

See here for more information on these: NEDA - Stages of Recovery and National Centre for Eating Disorders - Phases of Restrictive Eating Disorders.

What an Eating Disorder is not

It can be tempting to regard an eating disorder as vanity, weak willpower, attention seeking behaviour or even “just a phase”. ED’s are none of these. An ED are complex mental-health problems which begin very simply, with a wish to be a little thinner and more attractive. They morph over time into something more sinister. Having said this, many people with ED’s are not “mentally ill”, they are often high-functioning, sensitive, intelligent people. Many live normal lives, have normal relationships and do not have any other emotional problems.

Why do people get an ED?

There is no simple explanation and there has been a lot of research into the causes of eating disorders. We know that we cannot simply blame the culture, fashion magazines, family relationships, early traumatic experiences, or abuse or buried psychological problems like depression or anxiety. Eating disorders arise from a combination of personal, family, physical or genetic factors as well as life experiences that may cause someone to be both emotionally vulnerable and sensitive about their weight and shape. Dieting has a role to play in the development of an eating disorder, in fact in most sufferers the eating disorder grew out of dieting behavior. It is hard to “tease out” the relative contribution of many of these factors. You may often hear it said that the root of eating disorders is low self esteem and certainly for people with eating disorders, their weight plays a very important role in their opinions about themselves prior to the onset of an eating problem. People who do not develop eating problems may be concerned about their weight but there are other domains in life that influence their self-esteem; these act as a protective buffer. Eating disorders are coping behaviors, which provide the person with an outlet for displacement of feelings, which really relate to other areas of life being out of control.

Looking at people who have eating disorders, several things have been noted that they have in common:

• Feelings of powerlessness, or worthlessness
• They are terribly sensitive to imagined rejection or abandonment
• Most have poor assertion skills and find it hard to manage relationships healthfully
• They may have perfectionist attitudes, and find it hard to measure up to their own high standards for themselves, but would not necessarily apply those standards to other people
• They are not good emotional problem-solvers, and tend to avoid life’s difficult situations
• Find it hard to say “no” or ask for what they want in life, may be “people pleasers” or go out of their way to be nice, may have moments of aggression when things get on top of them
• They may lack confidence in managing relationships in a way that serves their needs rather than those of other people

Those with and ED will also display deceptive behaviours to hide their ED:

"I sprinkle some cereal in a bowl, and put a bit of milk in, and put the spoon in and stir it around. Then I leave it on the side and my mum will think I have had my breakfast. Sometimes I shake the crumbs out of the toaster and leave it on a plate. They think I had a snack. I do 100 sit-ups in my room because they won’t let me exercise. 5 times a day. More if they got me to have an extra bite. I hate myself".

Recovery

Recovery is possible, however staying ill is much easier than recovering. There are many reasons for this. Unhelpful comments from other "you look so much better, you were so thin" can be interpreted by the person as "you are fat", for example. Re-feeding releases a flood of emotions which have been blocked by starvation. The recovering anorexic may not feel happier for quite some time; they are angry, confused and overwhelmed by emotional experiences which they are unable to describe or manage. Sometimes an ED can manifest into different a ED... Anorexia may become bulimia or orthorexia (where the person will only eat extremely healthily. Orthorexia is less accessible to therapy because it is not viewed as a problem unless it has serious effects on life and relationships with other people. It is a form of eating that helps a person with coping issues be in control by avoiding food groups like carbs or animal products. Orthorexic behaviour can become obsessive. They say that these foods make them ill or that they have a mission to save the planet. Research is clear: although many people with eating disorders claim to have food allergy or IBS, they probably do not.

Who is affected by an ED?

Useful articles and references

• Anorexia Nervosa - National Centre for Eating Disorders - All About Anorexia Nervosa
• Bulimia Nervosa - National Centre for Eating Disorders - About Bulimia Nervosa
• Orthorexia - National Centre for Eating Disorders - Orthorexia
• The affects of undereating - National Centre for Eating Disorders - The Effects Of Under-Eating
• All about ED - Beat Eating Disorders - Learn about eating disorders and HealthyPlace - All Eating Disorders Articles
• Body image and ED - NEDA - Body Image
• Professional training courses - National Centre for Eating Disorders - Professional Training Courses

A quick round up of some safeguarding related stories that may interest you and help inform your practice.

If you have any suggestions for articles to be published in this newsletter then email bisp@bury.gov.uk.

The Culture, Media and Sport Committee has published a report on the use of connected technology looking at the risks and harms, including data and privacy concerns and technology-facilitated abuse. The report finds that tech abuse is becoming increasingly common. It considers the role of connected devices in broadening and exacerbating patterns of domestic abuse. In relation to children, it also explores connected toys and data collection; smart speakers and online safety; and connected technology in schools. See: Connected technology: MPs call on Government to tackle growing problem of tech-enabled domestic abuse.

Father who beat his teenage daughter with a metal bar and left her unconscious in a horrific attack outside her school has avoided jail. See: Manchester Evening News - 'Monster' dad left daughter, 15, unconscious after battering her with a metal bar and BITING her outside school.

Fitness trackers, home security systems and baby monitors are among the devices that MPs warn are enabling the growing issue of tech-enabled domestic abuse.

The Culture, Media and Sport Committee says there are on average nine such "smart" products in UK homes. It found they were being used to "monitor, harass, coerce and control" victims by collecting recordings and images. See: BBC - Baby monitors and smart speakers enabling abuse, say MPs.

Online Safety Experts have received reports of an anonymous chat website being accessed by children and young people. This platform actively encourages users to chat with strangers. Testing has found that this platform is not appropriate for children and young people, largely due to the dangerous nature of the content found. See: INEQE - Emerald chat safeguarding update.

A children's home in south Manchester where a child snuck out in the early hours of the morning and came back drunk has been shut down just two months after opening. See: Manchester Evening News - Children's home where kid snuck out in early hours to go drinking is shut down.

A man from Salford has been jailed for 12 years for grooming and raping a 12-year-old girl. he court heard Harte met the youngster via social media platforms, and obtained indecent images of her. He would also then regularly meet her in Broughton Park, where he would film her on his mobile phone. See: ITV - Salford man jailed for 12 years for grooming and raping a 12-year-old girl.

Gambling related harms training - The training will be held at he Mosses Centre in Bury. The training is 10am to 12pm. The room is booked for 9.30am, feel free to arrive from this time. Tea and coffee will be provided. If you have already booked onto the training you should have received an email please accept or decline the invite.

You can view the bank of webinars focused on topics like ‘How Kooth and Qwell can support neurodiverse and SEND users’ here: Information webinars on Vimeo. There are 38 videos including webinars for parents/carers, for professionals and for children and young people. You can also view their new short film around men’s Mental Health ‘Breaking the Stigma’ which you can then use with young people (age 17+) and adults to raise awareness and get men talking about mental health. View the video here: Breaking the Stigma.