Support for people with eating disorders

New guidelines for clinicians in Scotland

Doctors in Scotland are to be given new guidelines to support the treatment and care of patients with eating disorders.

Produced by the Scottish Intercollegiate Guidelines Network (SIGN) the guidance will focus on the unique cultural and geographical make up of Scotland, which includes remote and rural parts of the country where there may be not be specialist treatment. It will also give clinicians more advice on supporting patients with medical complications associated with anorexia nervosa.

In 2017/18, 536 people across Scotland were treated for an eating disorder diagnosis and the guidance will also include a version for patients and carers.

The announcement marks the start of Eating Disorders Awareness Week 2019, a campaign organised by national eating disorders charity Beat. The theme for this year’s week is tackling discrimination, and breaking down the stereotypes associated with eating disorders.

Clare Haughey, Minister for Mental Health said: “It is vital that patients across Scotland have the best possible support available and I welcome the eating disorder guidance SIGN is creating which will give clinicians in Scotland more specific advice.

“Our ambitious 10 year Mental Health Strategy, backed by investment of £150 million over the next five years, sets out clearly how we can improve early intervention, and ensure better access to services, including specific actions to support people with eating disorders

“Eating disorders do not discriminate – anyone can be affected by them and we are committed to raising awareness across Scotland.”

Sara Twaddle, Director of Evidence with Healthcare Improvement Scotland, of which SIGN is a part, said: “Studies tell us that eating disorders in teenage girls may be as high as 12% and that male eating disorders are increasingly being recognised.

“Moreover, professional and public bodies representing people with eating disorders tell us that there’s a need for a guideline on diagnosis and treatment that is specific to the needs of Scotland.

“The guideline will be for healthcare professionals, and there will be a version for patients and carers also. We believe that the guidelines will support access to CAMHS services and will complement the work Healthcare Improvement Scotland is providing to support this. Our intention is that the guideline improves the care that people receive, and improves service provision and outcomes across all of Scotland.”

The new Scotland specific guidance will also include the Royal College of Psychiatrists’ Management of Really Sick Patients with Anorexia Nervosa (MARSIPAN) Guidelines which focus on the medical complications associated with anorexia nervosa and associated management.

The Scottish Government’s approach to mental health from 2017 to 2027 – a 10 year vision.

Beat is the UK’s eating disorder charity and the first national charity for people with eating disorders.

Stereotypes about who gets an eating disorder are preventing BAME, LGBT+ and people from less affluent backgrounds from seeking and getting medical treatment, according to research published today for Eating Disorders Awareness Week by the UK’s eating disorder charity Beat. The charity says this delay could make it harder for individuals from these groups to recover.

A YouGov poll commissioned by Beat found that nearly 4 in 10 (39%) of people believed eating disorders were more common amongst white people than other ethnicities. Yet clinical research has found that the illnesses are just as common or even more common among BAME people than white people.

This widespread misconception means that eating disorders among BAME people often go unrecognised. Ballari, 25, suffered from anorexia and bulimia and said that her mixed race South Asian ethnicity played a large role in her illness. She said “My father spent a lot of time learning you do not need to be a white, privileged teenage girl to have an eating disorder.” Ballari added “the harsh reality is eating disorders do not discriminate”.

Beat’s research found that BAME people feel less confident in seeking help from a health professional for an eating disorder than white people, with just over half (52%) of BAME respondents saying they would feel confident doing so compared to almost two-thirds (64%) of white British* respondents.

Priyesh, who suffered from bulimia, said he faced “two strong stereotypes: that being male and from a BAME background, I would not be affected by an eating disorder. People like myself are not confident in seeking help for eating disorders because this is something not talked about in our communities.” Priyesh added, “We should be encouraging everyone regardless of race or gender to feel comfortable in seeking help should they need it and speak openly.

Similarly, Beat’s research found that nearly 30% of respondents believed less affluent people were less likely to develop eating disorders than affluent people, when in fact eating disorders occur at similar rates across all levels of income and education. Kate, 22, said that in her working class background “there was an element of disbelief” about her eating disorder. “Someone like me shouldn’t have an eating disorder, because it wasn’t common in such an environment. It wasn’t something I felt my school had had to deal with before so aside from a therapist I saw once a week or fortnight there was no support put in place to keep me on track or even to help my family.”

While LGBT+ people are at significantly higher risk of eating disorders, Beat’s research found that 37% of lesbian, gay or bisexual respondents said they would not feel confident seeking help, compared to 24% of straight people. Andy, 37, said that when he tried to explain the fact that he had binge eating disorder, he found people “thought gay men were all muscle or thin. I wanted people to understand, but they didn’t take my illness seriously. It took years to explain that I wasn’t just greedy and my problems were emotional.

More adults suffer from eating disorders than young people but with 60% of respondents to Beat’s survey saying they believed the illnesses predominantly affect young people, older sufferers often go unnoticed. Lee, 44, has struggled with bulimia and other mental health issues since her twenties. Now, she says she can “go out for a meal with my family, but other days are still so hard. I am with a new partner and she is very supportive, but most folks don’t get it. There’s definitely a stereotype, that it’s young women who get eating disorders, when anyone, of any age or gender, and from any walk of life can get one.

During Eating Disorder Awareness Week, Beat is campaigning against stereotypes and is highlighting the stories of those who are not normally associated with eating disorders. Beat’s Chief Executive Andrew Radford said “It is sadly not surprising that stereotypes about who gets an eating disorder are so widespread, but it is very worrying that those misconceptions are preventing people from seeking help. This means that BAME, LGBT and poorer people will get iller before they start treatment and find their recovery is harder.

“Eating disorders are serious mental illnesses that affect people of all ages, genders, and backgrounds. We have to challenge the stereotypes and raise awareness so that everyone who needs help can get it quickly.”

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davepickering

Edinburgh reporter and photographer