NH Explore 7815 Ken Yeow Overview WHAT are they WHY do they happen HOW can people be helped WHAT Main types ANOREXIA NERVOSA AN BULIMIA NERVOSA BN AN with BN symptoms Atypical ANBN ID: 408299
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Slide1
EATING DISORDERS
NH Explore 7/8/15
Ken
YeowSlide2
Overview
WHAT
are they?
WHY
do they happen?
HOW
can people be helped?Slide3
WHATSlide4
Main types
ANOREXIA NERVOSA (AN)
BULIMIA NERVOSA (BN)
AN with BN symptoms
Atypical AN/BNSlide5
Core features
Weight
BMI; trend
Eating
Under; over
Behaviours
Vomiting; laxatives; exercise etc.
Thinking/feeling
Fear; self-evaluation; distortion; preoccupation etc.
Complications
Acute; chronic (periods, bones etc.)Slide6
Estimated frequency
Inc.
/10
5
pop./yr
Prev.
/10
5
pop.
NI
New cases/yr
NI
Existing cases
AN
4-10
10-30
68-170
170-510
BN
10-30
50-150
170-510
850-2550
Atypical
‘At
least
as
many’
TOTAL
28-80
120-360
476-1360
2040-6120Slide7
WHYSlide8
Quote
‘It’s not about food,
it’s about feelings’
(and much more...
self-esteem, identity, control etc.)Slide9
One Model For Understanding
Early experience
Emotional
problems
Attempted
solution
Solution becomes a
problemSlide10
It serves a purpose
What is being AVOIDED?
Negative emotions; frightening change; family disruption etc.
What is being GAINED?
Control, safety/security; attention, regard; self-esteem, value; achievement, specialness; anxiety relief, mood lift etc.
What is being EXPRESSED?
Anger/frustration, guilt, self-hatred (self-punishment) etc.Slide11
HOWSlide12
Principles of helping
Engagement/motivation
Risk assessment/management
Nutritional restoration
Psychological therapy
Medication sometimes
Functional/occupational recovery
Support for/from family/friendsSlide13
1) Engagement/motivation
Curious
Compassionate
ContainingSlide14
2) Risk assessment/management
Physical, psychiatric, social
Point in time and trends
Multidisciplinary team (including patient and family/friends)Slide15
3) Nutritional restoration
Essential priority
Individualised approach
‘Food as medicine’Slide16
4) Psychological therapy
Symptoms/causes
Structure, focus, timing
Supervision, reflectionSlide17
5) Medication sometimes
Helpful in BN
Symptomatic treatment in AN
For co-occurring psychiatric conditionsSlide18
6) Functional/occupational recovery
‘Getting a life’
Basic living needs/skills
Structured, purposeful activitySlide19
7) Support for/from family/friends
Young person vs. adult
Working together against the illness
Communication, communication, communicationSlide20
How you can help
Mild-moderate BN
‘Guided self-help’ (‘Overcoming’ books)
Encourage to see GP for physical monitoring and ?medication
Severe BN and AN
Usually referred, via GP (collaboration, advocacy)
General support
Friendship, ‘normality’, distraction, spiritual help, encourage treatment engagement etc.Slide21
From a Christian perspective
Christians not immune!
Avoid superficial/overly spiritual answers
Real answers to deeper questions
Self-esteem, identity, control etc.Slide22
We have good news!
Personal Freedom:
How The Gospel Can Be Good For Your Mental Health
(www.amazon.co.uk)Slide23
Divine resources
The Word of God (truth)
The Spirit of God (power)
The people of God (community)Slide24
Other resources
See handout