Tuesday 23 January 2018

Therapy is key to overcoming eating disorders

A willingness to engage with therapy is vital in overcoming eating disorders. Photo: Getty Images.
A willingness to engage with therapy is vital in overcoming eating disorders. Photo: Getty Images.
Eilish O'Regan

Eilish O'Regan

A message of hope and a belief in full recovery is essential to encourage people with eating disorders to come forward early for treatment, according to GP, Dr Sinead O'Dea.

She pointed out that eating disorders such as anorexia and bulimia "although complex and multifactorial, are very treatable and the earlier they are detected the better the outcomes".

"Full recovery is possible, even in those presenting late and having had a protracted course, once there is a willingness to engage with therapy, and a commitment to persevere in the recovery process."

Dr O'Dea said young people who diet moderately are six times more likely to develop an eating disorder, and those who diet severely have 18 times the risk.

"GPs are uniquely placed to recognise early onset eating disorders, offer initial intervention as well as co-ordinating and monitoring treatment."

The most effective tool is the GP being aware of the possibility of an eating disorder, she wrote in 'The Forum' – the journal of the Irish College of General Practitioners.

"This involves extreme sensitivity in the consultation. I would ask simple questions such as: 'Any concerns about nutrition? Any worries about weight?'

"The answers can provide clues. If there is a suspicion, then the recommendation is further enquiry in an empathic, non-judgmental manner."

Dr O'Dea said: "Whether there is weight gain or loss, it's neither good nor bad. We spend too much time equating weight loss with being good and the converse if overweight – feeding a negative mindset.

"I encourage patients to come to their own conclusion, empowering them to take responsibility for respecting their body. This is a gradual process."

Along with food and weight-related issues, other symptoms to be aware of include excessive exercise, low mood, fatigue, food intolerances, social withdrawal, dizziness, headaches, nausea, bloating, constipation, dental infections, skin conditions, recurrent sore throats and hair loss.

"Those engaging in excessive exercise may present with injuries or stress fractures. Some may also go down the road of body altering through excessive use of sunbeds or plastic surgery."

Dr O'Dea said often the information comes from the worried relative, typically the mother, concerned about dietary changes, a focus on weight, insisting on different meals to the family and increasing social withdrawal.

"This may be accompanied by an indifferent patient, denying any issue and insisting that mother is over-anxious. This can be challenging for the GP.

"The key is to take on board the mother's concerns, establish the patient's trust and monitor closely, taking every opportunity to educate the patient on the consequences of poor nutrition," added Dr O'Dea.

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