Information Leaflet for Carers
Derbyshire Eating Disorders Service
Derbyshire Healthcare NHS Foundation Trust
Derbyshire Eating Disorders Service
Floor 2, North Mill, Bridgefoot, Belper,
Derbyshire, DE56 1YD
Living with an eating disorder, particularly anorexia, can be very stressful. You
have to deal with difficult behaviour, stigma and shame, anger, guilt, feelings
of failure, self blame and fear. Living with an eating disorder can put a strain
on relationships and on family.
Carers need both emotional and practical support from their network of
family and friends and also from professionals – their GP, Derbyshire Eating
Disorders Service and voluntary agencies.
This leaflet aims to provide the carers of people with an eating disorder, with
practical information and support. This information can help carers identify
an eating disorder, and recognise some of the physical and psychological
symptoms of anorexia and the best strategies to help.
Common features of eating disorders
An eating disorder is a serious illness that affects the physical and
psychological health of the sufferer. Food may be used in a way to control or
block out difficult thoughts and feelings. Stress, depression, sadness and low
self-esteem may be too painful to bear and for some people the behaviour
associated with an eating disorder seems to help.
Eating disorders do not usually result from a single cause. They are more
likely to be caused by a complicated mix of factors such as traumatic
experiences, unpleasant emotions, unrealistic expectations and perfectionism.
For many sufferers it may appear to give them back a degree of control over
their lives but the longer the illness persists the more likely it is that the eating
disorder will be in control.
Some of the physical and psychological signs of anorexia nervosa are:
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extreme weight loss
constipation indicated by abdominal pains
bloated stomach, puffy face and ankles
fine downy hair all over the body
in female sufferers, periods stop or onset is delayed
poor circulation and always feeling cold dry rough or discoloured skin
intense fear of gaining weight
obsessive eating in what others are eating
distorted perception of body shape and weight
denial there is a problem.
Strategies for supporting someone with an eating disorder
A good way to begin to support someone you suspect has an eating disorder
is to seek expert advice from a healthcare professional. This would normally
be their GP; who can make a diagnosis, offer treatment or initiate a referral
to secondary health services if required. In Derbyshire this would entail a
referral to the Community Mental Health Team (CMHT), or if the sufferer is
under the age of 18 they would be referred to Child and Adolescent Mental
Health Services (CAMHS). A more indepth assessment would be carried out
and a decision made about the best course of action. In some cases a referral
is made to Derbyshire Eating Disorders Services (see the referral criteria
leaflet). When this has happened you will feel more supported, you will be
given the opportunity to ask questions and become more informed about
eating disorders. There are several telephone contact numbers on the back of
this booklet where you can receive further information and support from.
As a carer it is important for you to seek support for yourself. This could
be through family or friends. It’s about looking after everyone’s health
as well as taking care of the person with the eating disorder. Good
communication between yourself, your partner, other family members and
health professionals is imperative. Eating disorders do need to be challenged;
however eating disorders make the sufferer feel in control and able to cope
with life so any apparent threat to the disorder may make them defensive.
Confidentiality is important within the Eating Disorders Service; we are not
able to disclose personal information without the clients consent. We are
happy to listen to your concerns and offer advice and in some cases to act,
however the client would be informed of the call. We can also offer the
opportunity for you to attend an appointment if the person with the eating
disorder gives their consent.
Some physical and psychological signs of bulimia nervosa
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frequent fluctuations in weight in some sufferers
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sore throat, tooth decay and bad breath caused by vomiting
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swollen salivary glands making the face more rounded
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poor skin condition and possible hair loss
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increased risk of heart problems and problems with other internal
organs
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uncontrollable urges to eat vast amounts of food
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distorted perception of body weight and shape
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anxiety, depression, low self-esteem, shame and guilt
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bingeing, followed by vomiting or use of laxatives to prevent weight gain
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disappearing to the toilet during or after meals to regurgitate food just eaten
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periods of fasting
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food disappearing unexpectedly or being secretly hoarded
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vast amounts of money being spent on food.
The above list is not exhaustive. Sufferers from eating disorders may present
with all of the above signs or only a couple. It is important to recognise that
each person has individual features of their own.
The four stages of an eating disorder
Professionals have identified four key stages in the sufferer’s attitude towards
their eating disorder. The following gives a brief explanation of these stages.
Pre-contemplation:
At this stage sufferers are ‘in denial’. They have no thoughts about change,
and are dependent on their eating disorder, which is seen as a solution to
their problems, offering many rewards and very few, if any, in their mind,
unpleasant consequences. They are ’in denial’.
Contemplation:
At this stage sufferers are in two minds about their eating disorder. They can
see how damaging it is but they can also see many rewards in maintaining it;
the prospect of life without the eating disorder is daunting. These opposing
attitudes make the sufferer very confused about what they want.
Determination and action:
At this stage sufferers believe that life would be better without their eating
disorder. They are motivated to change, and begin working seriously towards
recovery.
Maintenance:
After change has been made, sufferers have to cope with maintaining
recovery; they have to manage the demands and frustrations of life without
their old coping mechanism. This fourth stage is extremely challenging.
Sufferers who learn positive alternative coping strategies during treatment
and receive long term support will have a good chance of maintaining
recovery, but are still likely to struggle at times of stress and many relapse
into their old eating pattern.
You may have already identified the stage the person you are caring for is
in. Perhaps they seem to be between a stage, which is common. Frequently
sufferers may go through these stages several times before they can fully
recover from their eating disorder and it is important to accept this so you
can be ready to support them.
Useful contacts
beat0845 634 1414
www.b-eat.co.uk
First Steps, Derby
01332 367571
www.firststepsderby.co.uk
First Steps Hyped (12-25 years)
01332 367571
Image, Chesterfield 07511 617813
Amber Valley Mutual Support Group
07890 804507
Crossroads Caring for Carers:
• Derby, South Derbyshire & Erewash 01332 344448
• Derbyshire North East
01246 557541
• Derbyshire Dales01629 812664
Information on the following can be obtained from www.direct.gov.uk.
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Caring & Support Services
Money Matters
Caring for a Disabled Child
Health & Taking a Break
Carers & Employment
Parentline Plus0808 800 2222
The Princess Royal Trust for Carers
0844 800 4361
www.youngcarers.net
Contact
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