Are rates of Eating Disorders on the up?
Writer Stuart Large shares insights from an interview with Dr Zadeh, consultant psychiatrist at South West London and St George's Mental Health Trust
Have you been to a supermarket since coronavirus became an unwelcome visitor in town? Well unless you’re part of the 7% who were already doing their grocery shopping online – of which I’m not I hasten to add – or someone has been doing it for you then the answer to that question is, yes. Whilst I found the experience stressful combined with what I would term an atmosphere of self-perpetuating anxiety, we (the general public) appear to have got over the hump. In fact it’s to the credit of food manufacturers and retailers that things seem to be almost back to pre-pandemic levels.
After writing my article on OCD during the pandemic, I became interested in the impact of the health crisis on other mental health conditions. So consider if you will, for a moment, food shopping at this time with an eating disorder. Dependent on how the condition manifests itself, you may feel guilt for depriving others from food when it’s in short supply, suffer extreme anxiety at the prospect of not being able to follow your highly specific food itinerary in controlled amounts (not too much, not too little) or worse still, the supermarket not having the ‘safe’ foods your condition is demanding.
What is an eating disorder?
Well it’s a complicated landscape and prevalence rates are difficult to gauge. Many people think first of anorexia, but this actually accounts for only 8% of cases. According to research carried out in 2015(1), the other types are avoidant/restrictive food intake disorder (ARFID) 5%, binge eating disorder 22%, bulimia 19%, and other specified feeding or eating disorder (OSFED) 47%.
What about scale? According to BEAT, the leading UK charity, there are currently 1.25 million people suffering with an Eating Disorder in the UK, of which 1 in 4 are male. Additional research (2), points to a more concerning upward trend showing a 7% increase annually.
I recently spoke to Dr Ewa Zadeh (consultant psychiatrist at South West London and St George’s Mental Health NHS Trust) to better understand the complexity of the condition and how the current pandemic might be affecting those that suffer with disordered eating.
I wanted to know if there had been an increase in referrals since the crisis took hold. “We haven’t had the full data yet, but we have seen a drop,” Dr Zadeh tells me. “The reasons for this are patients’ fear of entering a hospital where Covid-19 is treated and also a belief of being undeserving of help. That’s the emotional component of the condition“. Could this be a lull before the storm I ask her? “We need more time to predict, but my fear is we will see a spike in demand once the restrictions are relaxed. This will produce new referrals as well as symptoms worsening for existing patients".
What exactly is meant by 'safe' foods? “These are foods that promote physical and emotional stability and are tried and tested for recovery,” she explains. “Such is the anxiety associated to food shopping, it can throw someone into an avoidance behaviour to be faced with finding a different item, even down to the consumer brand“.
As with other mental health difficulties, eating disorders often occur comorbidily with other conditions. “I would say close to 100% of inpatients would have been diagnosed with anxiety or depression,” and this becomes more complex within different age groups, Dr Zadeh explains. “We are seeing in recent cases it’s quite common to have OCD, body dissatisfaction or perfectionism running alongside“. In the younger age group around 50% of cases present with body dissatisfaction or social anxiety. Dr Zadeh also goes on to say secondary conditions are often diagnosed as pro-morbid (after the initial diagnosis is made).
So a complex problem surely needs specialist and tailored treatment. If this is affecting you or you may be a family member affected, where do you go to seek help?
For the younger cohort, Dr Zadeh strongly endorses the school or college mental health advocate as the first port of call. They can provide confidential guidance for someone who could be suffering with feelings of shame and not knowing where to begin.
Of course the first step should be contacting your local GP, this may not be something that suits everyone so, in that case you can get advice from the BEAT helpline which offers support and guidance on how to approach the referral process. There are also therapists and counsellors who specialise in eating disorders; you can find some of them here.