Eating disorders

Eating Disorders

Safeguarding conferences for Birmingham schools

Dr Newman Leung, PhD, CPsychol, AFBPsS

Consultant Clinical Psychologist

Birmingham & Solihull Mental Health NHS Foundation Trust

Honorary Lecturer

University of Birmingham

Honorary Visiting Fellow

University of Loughborough Research Centre into Eating Disorders

An Eating Disorder is

• A serious psychological / emotional

disorder (formally classified as a
psychiatric

illness),

which

has

significant medical and psychological
consequences

• Anorexia nervosa has the highest

mortality rate amongst psychiatric
illnesses

Types of Eating Disorders

• Anorexia Nervosa

• Bulimia Nervosa

• Binge Eating Disorder

Anorexia

• Restriction of energy intake relative to

requirements, leading to a significant low body
weight

• Intense fear of weight gain, or persistent

behaviour that interferes with weight gain

• Body image disturbance
• Self-evaluation based on weight/shape

Bulimia

• Recurrent episodes of binge eating (once a

week for 3 months on average)

• Recurrent use of purging behaviour (e.g.,

self-induced vomiting, laxatives, diuretics)
and compensatory behaviour (e.g., extreme
dieting, exercises)

• Sense of lack of control over eating
• Self evaluation based on body shape/weight

Binge Eating

• Recurrent episodes of binge eating (once a

week for 3 months on average)

• Sense of lack of control over eating
• Marked distress associated with binge eating
• Absence or infrequent use of inappropriate

compensatory behaviour

Common psychological risk factors

• Personality traits

– Interpersonal

hypersensitivity

–

naturally

shy,

reserved and tends to “take things to heart”

– Perfectionism – highly self-driven and tends to set

unrelenting standards (usually associated with a
strong fear of failure)

– Emotional inhibition – tendency to suppress feelings

rather than talking about them

– Low self-esteem

• History of traumatic experience

Common social risk factors

• Media influence

– Portrayal of the thin body ideal

• Consistent glorification of slimness

– Images of celebrities in popular magazines
– Social media, e.g., “hot or not” site

• Early “sexualisation” of children

– Trends in fashion
– Beauty pageants for children

Common social risk factors

• Peer pressure

– Focus

in

physical

appearance

(e.g.,

competing to be the slimmest)

– Competition

in

academic

performance,

sporting achievements, etc.

– Intense pressure to conform to certain

behaviour (e.g., dieting)

An eating disorder is

about emotions

and not about food

Identifying early signs of ED

• Change in character

– Being more quiet and isolated
– Reduction in level of interest
– Decrease in performance

• Change in eating behaviour

– Eating very little
– Stop eating with peers or in public
– Go to toilet after meals

Identifying early signs of ED

• Mood changes

– Low mood and tearfulness
– Anxiety and irritability

• Physical changes

– Tiredness and fatigue
– Lack of concentration

• Social changes

– Isolated and withdrawn

If you know someone with an eating disorder

(or disordered eating)…

• Offer support

– Don‟t focus on food
– Encourage to talk about what really bothers

them

• Provide “pointers”

– B-eat website (https://www.b-eat.co.uk)
– Self-help materials

• Encourage to seek professional help