'Fat talk' is causing eating disorders in our young people
'FAT talk', 'college stress' and 'social media' are triggering eating disorders in young adults, say leading experts at Ireland's only purpose-built residential house for victims of eating disorders.
In an interview with the Sunday Independent, Dr Maire McLoughlin, the clinical director of Lois Bridges Eating Disorder Treatment Centre, stressed that eating disorders including anorexia, bulimia and obesity are a mental health issue and that triggers are "constantly changing".
"Perfectionism, low self esteem, trauma and high anxiety levels are common themes in the eating disorder narrative and whenever western culture is introduced we see a rise," said Dr McLoughlin, who has worked with over 300 adult residential patients since Lois Bridges opened in 2010.
Speaking before their weekly team meeting at the luxurious treatment centre in Sutton, north Dublin, Dr McLoughlin said the disease is "potentially fatal" if it's not identified, diagnosed or treated. There are currently six residential patients, 12 day patients and a large number of out patients, from all over the country, seeking treatment at Lois Bridges.
"Our patients require ongoing risk assessments at a medical, psychiatry and dietetic level by our multidisciplinary team. . . ultimately we still do not know what causes this complex illness," Dr McLoughlin said.
However, based on their own findings, a number of informative trends have been revealed over the years.
Clinical psychologist Zuzanna Gajowiec, who runs a module called 'Body Image', believes it is becoming increasingly impossible to shield young people from an "emphasis on appearance that is embedded in our culture".
During her daily therapy sessions with the patients at Lois Bridges, who stay for between 8-12 weeks, she has become aware that "fat talk" is "seriously damaging" to young minds and can "potentially spark" bad food habits.
"There is more fat talk and phrasing about how we look in our jeans or asking people if they've lost weight or if they've been working out. . . everything is centred around body image and fat talk is everywhere," she said.
In her role, Ms Gajowiec attempts to break down "the perfectionist trait" common to many men and women who have eating disorders and teaches them that "it's OK to fail sometimes".
"It starts so early, even from a Disney movie, children see the portrait of beauty in a man or a woman. There is so much emphasis on the physical side and it stays with us from an early age," she said, adding that the reasons people struggle with "body image" have changed dramatically.
"Years ago, media was less important. Knowing how to pose for a picture was only something models or professional photographers needed to know but now teenagers know a specific way to pose for a selfie, the angles that will make them look thinner and that is scary," said Ms Gajowiec, who is also concerned about the rates of young people researching how to pose online.
During the day, bedroom doors are locked at Lois Bridges and at meal times bathroom doors are locked too. Although their "vulnerable patients" are allowed to use laptops, iPads and smartphones, their time online is monitored. Their families are hugely involved in the whole process and they can call home at any time.
The patients spend their time in the large bright communal area, in group therapy sessions or in individual consultations.
Dietician Harriette Lynch said: "You have to really look at how depleted they are when they come in but our main priority is to help them beat their eating disorder."
So far, 50pc of their patients benefit from an evidence-based cognitive behavioural therapy approach. This involves structured, individualised meal planning and dietary changes as well as psychotherapy, diary keeping and regular weighing.
Although they are currently working with adult patients aged from 18-45 years, operations manager Lilly Molloy said the disease affects each client differently.
"Based on our experience, anorexia or binging are more common at a younger age and it would be bulimia or obesity at an older age."
However, they've also found dual diagnosis such as depression and anxiety as well as the eating disorder is more common in older age groups.
Depending on the time of the year, the rate of calls from worried families and parents go up and down too.
"Christmas is huge because there is much more pressure on people, and families are very scared. Their daughters and sons are in university at the moment and they are petrified about the child coming home from Christmas and possibly not eating at the table and there can be a lot of tensions," said Ms Molloy.
The team's routine visits to family homes has also revealed that the disappearance of family mealtime can help hide an eating disorders.
"We go out and we look at your house and we look at how you and your family work together and, increasingly, what we are seeing is that open-plan living is splitting up at the family and nobody is sitting at the kitchen table eating their food," she said.
According to their research over the years, the treatment centre has found that the college years can play a "crucial role" in the development of an eating disorder. "If it hasn't been nipped in fifth or sixth year, if it hasn't been identified, it will manifest in college because you are the smallest fish there and you're lost and that is a recurrent theme," Ms Molloy added.
Last summer the Lois Bridges centre was filled with male and female Leaving Cert students trying to learn coping mechanisms to prepare them for first semester.
A few weeks ago, Ms Molloy said they had a young girl from a northern county who was "completely overwhelmed" when she started at Trinity College Dublin. "She didn't know where to sit, she thought everyone was looking at her and she didn't know how to fit in and it's adding extra pressure and the eating disorder intensifies."
To date, Lois Bridges, who works very closely with Trinity College Dublin, have had residents from many top universities including University College Dublin and Dublin City University.
"In college if your problem hasn't been stopped or aided, it really intensifies; young people become incredibly lost and appearance is huge."
When asked why she believes there are more reports of eating disorders in Ireland, Ms Molloy added: "There is a huge amount of more media coverage and there is increased awareness, but at the minute the girls here constantly refer to Snapchat, Instagram, Tinder and a lot more websites that are encouraging people to look thin and they fall down that trap."
According to their research, early warning indications are seen in digital technologies, bullying at school and cyber bullying.
"The desire to be thin is out there and it's hugely accessible and we would see young people as young as eight years of age starting it off," she said.
Although the expert believes there is "more general acceptance with regards to mental health", they believe more education is needed to acknowledge eating disorders as a mental health issue.
However, they're encouraged by in the increase in males who are reaching out for treatment.
"Nationwide, the figures are one in 10 but from our own research, we see one in seven men," Ms Molloy added. "Men are definitely coming forward, they see that it's OK to say they have a problem, before they thought it had to be a lady who wanted to look like a model, but that is a complete myth."