Managing Eating Disorders In Your Clients








Screening Questions for Identifying Eating Disorders




If you suspect your client may have an Eating Disorder, initiate the conversation with simple, non-judgmental questions about their eating habits and weight concerns. For example, ask, 'Do you ever worry about your food intake or weight?' or 'Have you ever struggled with overeating?' If the answer is affirmative, it's advisable to delve deeper. Two key questions - 'Are you content with your eating habits?' and 'Do you ever eat secretly?' - have proven effective in pointing towards Bulimia Nervosa. A negative response to the first and a positive to the second signal a potential case of Bulimia Nervosa, warranting more detailed assessment.


SCOFF Questionnaire


The SCOFF reliably identifies people who are likely to have an Eating Disorder. The SCOFF five-question screening tool: S – Do you make yourself Sick because you feel uncomfortably full? C – Do you worry you have lost Control over how much you eat? O – Have you recently lost more than One stone (6.35kgs) in a three-month period? F – Do you believe yourself to be Fat when others say you are too thin? F – Would you say Food dominates your life? One point for every ‘yes’ and a score of ≥ 2 indicates further questioning is warranted.


We recommend that the SCOFF be administered as part of a routine intake assessment. It is important to remember that you cannot tell someone has an Eating Disorder just by looking at them. Eating Disorders do not discriminate and can affect any body.

If you are a healthcare professional looking for assistance in managing clients with Eating Disorders, please do not hesitate to reach out to us.



Effective Communication Strategies When a Client Discloses an Eating Disorder



  • When a client reveals they are experiencing an Eating Disorder, it's crucial to handle the situation with empathy and understanding. 
  • Recognise the courage it takes for them to share such private information and the feelings of shame and loneliness they might be experiencing. 
  • Validate their experiences as they narrate them, and understand that you might be one of the first to learn about their symptoms.
  • Acknowledge that these symptoms can often feel uncontrollable, contributing to a deep sense of despair and helplessness. 
  • Inform them about the negative impacts of an Eating Disorder and the available treatment options in a supportive, non-threatening manner. 
  • Encourage them to seek specialist help if needed.
  • Reassure the client about the effectiveness of treatment, and make it clear that support will continue even after symptom resolution. This reassurance is essential to help them understand that they won't be left alone once their symptoms improve.
  • Avoid commenting on their appearance, whether positive or negative, and steer clear of power dynamics, instead fostering a cooperative relationship through a non-coercive approach. 
  • Reiterate that these struggles are common, and many have successfully recovered. 
  • Encourage them to openly discuss any underlying issues, as well as their eating habits, in future appointments.

A client is opening up to a health professional that she is experiencing a type of eating disorder

If you are a general practitioner, your role in managing Eating Disorders is critical. We've compiled the latest recommendations for GP care of Eating Disorders in Australia - a set of invaluable resources tailored to enhance your practice.

 

Whether you wish to discuss a specific case or make a referral, our team is here to support you. Click here to access our resources or contact us directly. 




We are happy to accept referrals from any of your clients who may have developed Eating Disorders, if this is outside your scope of practice. Similarly, if you would like supervision around Eating Disorder treatment, we have a highly-experienced team available and offer supervision to help you upskill in treating eating concerns. Don't hesitate to reach out to us for this collaborative approach to managing Eating Disorders.





How Can We Help?




Hand of an individual experiencing eating disorder reaching for hope of recovery

At BodyMatters Australasia, we have a special interest in providing treatment for disorders associated with eating, dieting, body image, and problematic exercise behaviours. Our highly experienced team is committed to delivering industry-leading, best practice treatments. If you have a client who are experiencing an Eating Disorder, body image problems, or unhealthy exercise habits, we can help (click here to learn more). We provide a full range of services that are suited to each person's needs. Our goal is to help people have better relationships with food and exercise and, in the long run, to improve their general health. Your help can make a big difference in how well this recovery goes.



Understanding the Different Types of Eating Disorders and Their Characteristics




Eating Disorders, a combination of mental and physical illnesses, lead to serious disturbances in eating habits and body weight regulation. Here are some common types of Eating Disorders:


BINGE EATING DISORDER (BED)

BED is the most common Eating Disorder and is characterised by regular episodes of excessive, uncontrollable eating, often leading to discomfort and distress. Unlike other Eating Disorders, it does not involve compensatory behaviors. Individuals may eat quickly, even when they're not hungry, and these episodes can cause feelings of guilt or embarrassment.

ANOREXIA NERVOSA

This disorder is characterised by an intense fear of gaining weight and a distorted body image that leads to self-imposed starvation and excessive weight loss. People with Anorexia Nervosa may see themselves as overweight, even when they are underweight, leading them to restrict calories or exercise excessively.

BULIMIA NERVOSA

This disorder involves periods of excessive eating followed by compensatory behaviors such as self-induced vomiting, use of laxatives, fasting, or over-exercising. Individuals with Bulimia Nervosa often maintain a normal weight, making the disorder less visible than Anorexia.

AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID) Formerly known as "Selective Eating Disorder," ARFID involves limitations in the amount and/or types of food consumed, but unlike Anorexia Nervosa, it doesn't involve any distress about body shape or size, or fears of fatness. 



These disorders can lead to serious health problems if not recognised and treated appropriately. It's important to understand the specific characteristics of each to ensure proper diagnosis and treatment.



Understanding the Complexity of Eating Disorders and the Role of General Practitioners and Health Professionals




Eating Disorders result from a complicated mix of biological, psychological, and social factors. They encompass developmental concerns, familial and relationship influences, significant life events, innate biological tendencies or genetic predispositions, and cultural norms. There's no single, easy-to-find cause of eating disorders like Anorexia Nervosa and Bulimia Nervosa.  The risk factors can be grouped into predisposing, precipitating, and perpetuating elements. Predisposing factors are inherent individual attributes or environmental influences such as a perfectionistic personality, high ambition, exposure to a conflict-free family environment, or societal pressures related to gender roles and physical appearance.  Precipitating factors often involve significant life stages like adolescence, personal crises (e.g., loss or grief), illnesses, or personal disappointments. Perpetuating factors are those that maintain the disorder, such as strict dieting, binge eating, harmful weight control behaviors, and distorted thinking patterns, often centered around excessive worry about weight and shape and typically accompanied by enduring low self-esteem. General practitioners and health professionals play a pivotal role in understanding the complexity of Eating Disorders. They are often the first point of contact for individuals struggling with these conditions, making their ability to recognise and appropriately respond to symptoms crucial. By developing a deep understanding of the multi-faceted nature of Eating Disorders - including their psychological, physical, and social implications - they can facilitate early detection, provide timely interventions, and navigate clients towards necessary specialist care. In essence, the insight and intervention of healthcare professionals can significantly impact the trajectory of an individual's recovery journey, underscoring the importance of their role in managing these complex disorders.
If you wish to make a referral



Key Indicators and Common Symptoms of Eating Disorders




Eating Disorders are very complex and symptoms in individuals vary. Some symptoms that commonly appear that health professionals should be aware of include:



  • Weight patterns include vague psychological concerns about weight, recent considerable weight loss or volatility, or requests for weight loss support. Normal weight suggests Bulimia Nervosa, but significant weight loss suggests Anorexia Nervosa.
  • Note any eating patterns such as restrictive diet, vegetarianism, calorie tracking, and overeating and purging. Excessive exercise, remorse over missed workouts, preferring physical activity over transportation, and exercising despite pain or illness are also warning flags.
  • Self-harm, abuse of appetite suppressant, laxative, or diuretic misuse, and substance abuse can suggest a problem. Starvation or nutritional restriction can cause weariness, cold intolerance, gastrointestinal difficulties, and physical deterioration. 

  • Psychologically, psychiatric referrals, a family history of psychological or weight disorders, perfectionism, hopelessness, or big life upheavals may indicate an Eating Disorder. Look for a past history of Eating Disorders, sexual abuse, depression, anxiety, or self-harm.
  • Family dynamics including confused personal identities, conflict-avoiding or chaotic households, or a relative with an Eating Disorder can also be indicators. 
  • Denying diets or weight reduction activities and downplaying their severity is common. Watch for Anorexia or Bulimia in people who lose weight quickly or are underweight.
  • Inconsistent menstruation, late puberty, or infertility in females may suggest an Eating Disorder. 


Families often report progressive behavior changes, reduced food choices, mealtime absences, longer toilet visits, too much exercise, social withdrawal, and weight loss.



Eating Disorders have one of the highest mortality rates of any mental illness.


~1 million

Australians are living with an Eating Disorder, that is 4% of the population  
~450
people across Australia are estimated to die from Anorexia Nervosa every year

~90
people across Australia with Anorexia Nervosa are expected to die from suicide each year
~200
people across Australia are expected to die from Bulimia Nervosa every year
Source: Inside Out Institute for Eating Disorders




to learn more about us



today for more information