The Importance of Expert Knowledge and Safeguarding in Treating Eating Disorders
Written by Angelique da Silva, Tutor Post Qualifying Diploma in Eating Disorders
Eating disorders are a significant mental health issue in the UK, affecting individuals of all ages, genders, and backgrounds. According to the charity Beat, around 1.25 million people in the UK are living with an eating disorder. These conditions, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are complex and often life-threatening. Effective treatment and support require expert knowledge and stringent safeguarding procedures to ensure the safety and well-being of those affected. It is crucial to understand the various types of eating disorders to ensure that important aspects are not overlooked when working with an individual who does not present in a stereotypical manner.
Expert knowledge is crucial when dealing with eating disorders due to the complexity of these conditions. Eating disorders often have deep psychological roots, involving issues such as control, self-esteem, and body image which can stem from early childhood. Therefore, professionals working with individuals suffering from these conditions need a thorough understanding of the psychological, physical, and emotional aspects involved. This knowledge allows therapists and counsellors to create comprehensive and personalised treatment plans that address the unique needs of each individual.
Treating eating disorders can include a diverse array of therapeutic approaches, each tailored to address the specific needs and underlying issues of the individual. Cognitive Behavioural Therapy-Enhanced (CBT-E) is a widely used treatment, focusing on changing the unhealthy thought patterns and behaviours associated with eating disorders. It is an intensive, time-limited approach that helps individuals understand the connections between their thoughts, feelings, and behaviours related to food and body image. Interpersonal Psychotherapy (IPT) targets the interpersonal relationships and social functioning of individuals, helping them to identify and resolve issues in their relationships that may contribute to the development or maintenance of their eating disorder. Family-Based Therapy (FBT), particularly effective for adolescents, involves the family in the treatment process, empowering parents to take an active role in restoring their child's healthy eating patterns and supporting their recovery.
Dialectical Behaviour Therapy (DBT) is another effective approach, especially for individuals with co-occurring conditions such as borderline personality disorder. DBT teaches skills to manage emotional distress and improve interpersonal effectiveness. Acceptance and Commitment Therapy (ACT) focuses on helping individuals accept their thoughts and feelings rather than fighting or feeling guilty about them. It encourages commitment to actions that align with their values, which can be crucial for long-term recovery from eating disorders.
Psychodynamic psychotherapy delves into the unconscious processes and early life experiences that shape an individual’s behaviours and attitudes toward food and body image. This approach explores how unresolved conflicts and traumas from childhood can contribute to the development of an eating disorder. By understanding and working through these early experiences, individuals can gain insight into their current behaviours and develop healthier ways of coping and relating to others. This form of therapy provides a deep, introspective route to recovery, addressing the root causes of the disorder and fostering long-lasting change.
In addition to therapy, medical monitoring is often necessary. Eating disorders can cause severe physical health issues, including electrolyte imbalances, heart problems, and gastrointestinal complications. Regular medical check-ups are essential to monitor these potential health issues and ensure that clients are physically stable. This medical oversight must be integrated into the treatment plan, requiring coordination between mental health professionals and medical doctors.
Safeguarding procedures are equally important when working with eating disorders or suspected eating disorders. These procedures protect individuals from harm and ensure that they receive appropriate care. Safeguarding involves the therapist or counsellor recognising the signs of an eating disorder in the therapy room, which can include dramatic weight loss, puffiness of face, yellowing of skin, scratches on knuckles, preoccupation with food, and withdrawal from social activities. It is also important to be aware of the less obvious signs, such as disclosure of mood swings, excessive exercise, and frequent trips to the bathroom after meals, which may indicate purging behaviours.
When a professional suspects that someone may have an eating disorder, it is essential to follow a clear protocol. This typically involves conducting a thorough assessment to determine the severity of the disorder and any immediate health risks. If there is any indication of severe health issues, such as dangerously low weight or severe malnutrition, immediate medical intervention may be necessary.
Confidentiality is a key aspect of safeguarding, but it must be balanced with the need to protect individuals from harm. Professionals must be clear about the limits of confidentiality, where possible in the very first session, especially when dealing with minors or individuals who are at significant risk. In cases where an individual’s life is at risk, it may be necessary to break confidentiality to ensure they receive the necessary medical care and support. This decision should always be made with the individual’s best interests in mind and, whenever possible, with their involvement and consent.
Another crucial element of safeguarding is creating a supportive and non-judgemental environment. Individuals with eating disorders often experience feelings of control, shame or guilt, which can be exacerbated by judgemental attitudes. Professionals must approach clients with empathy and understanding, validating their experiences and creating a safe space where they feel comfortable discussing their struggles. This supportive environment is essential for building trust and encouraging individuals to engage in the therapeutic process.
It is also important to involve family members and loved ones in the treatment process whenever appropriate. Eating disorders can have a significant impact on families, and involving them in treatment can provide additional support for the individual and help them to understand the nature of the disorder. Family-based therapy or appropriate reading material can be particularly effective for adolescents and young adults with eating disorders, helping to restore healthy family dynamics and improve communication.
The treatment of eating disorders in the UK requires a multifaceted approach that combines expert knowledge with rigorous safeguarding procedures. The complexity and severity of these conditions necessitate a thorough understanding of their psychological and physical aspects, as well as a coordinated approach involving various healthcare professionals. Safeguarding is crucial to protect individuals from harm and ensure they receive the appropriate care and support. By prioritising expertise and safeguarding, professionals can help individuals with eating disorders on their journey towards recovery, promoting healthier and more fulfilling lives.
Expert training in eating disorders is crucial now more than ever.
By Angelique da Silva
Tutor Post Qualifying Diploma in Eating Disorders
Written July 2024
