The importance of early intervention for eating disorders.

Eating Disorders are preventable illnesses with early and appropriate intervention. With that being said, many are still dying from eating disorders every year.

I started Nyxie’s Nook in early 2019 in a bid to not only document my recovery but to highlight the key issues regarding eating disorders. I’ve since made it my business to learn everything I can about recovery, early intervention, and ongoing support for eating disorders.

It’s important to note at this stage that while I have lived experience of anorexia and bulimia nervosa, I am not an expert. I’ve had no medical training and I am not a therapist. Please bear this in mind when reading. If you’re in need of help, contact your general practitioner or local eating disorder charity for the appropriate advice.

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Why is early intervention for eating disorders so important?

As with many illnesses, early intervention and detection play a key role in recovery. Research has shown that taking quick action improves not only the likelihood of recovery but reduces long-term symptoms. All of this combined can reduce the occurrence of relapse and improve the overall quality of life. There has also been evidence that when teenagers with anorexia nervosa are given family-based treatment promptly (within the first three years of the illness), they have a much greater chance of lasting recovery (1).

Through adequate early intervention, medical issues presented by eating disorders can be addressed and dealt with quickly. It also allows the person experiencing the disorder to begin work on healing the mental impacts. This progress is arguably the most difficult to overcome, and therefore takes time and a significant amount of effort. Much like an addiction, kicking an eating disorder for good is more difficult the longer it’s present in the brain. But, if the individual begins treatment early enough, it allows them to work on eliminating behaviors, addresses comorbid conditions, and helps them develop a relapse prevention plan (2).

Eating disorders are preventable illnesses!

There’s no doubt in my mind that eating disorders are entirely preventable when the right tools are in place. There are a variety of methods that can be used to provide training to medical professionals, and those who work closely with key groups. Training for general practitioners, counselors, therapists, teachers, lecturers, etc is particularly important. It’s thought that early intervention starts with prevention. This means that education and screening are at the forefront of stopping the onset of eating disorders. 

Beat’s National Officer for Northern Ireland, Nicola Armstrong has this to say about early intervention.

‘Eating disorders are serious mental illnesses that impact around 37,500 people in Northern Ireland. We know that the sooner somebody with an eating disorder accesses quality treatment, the higher their chances of making a full and sustained recovery. That’s why it’s so important that our healthcare system is equipped to identify eating disorder behaviours quickly and that services are available to anybody who needs it, regardless of how long the person has been unwell. 

‘At Beat, we would encourage the Northern Ireland Executive to fund quality eating disorder training and staffing for healthcare professionals, so that they have the tools that they need to spot the signs of eating disorders quickly and signpost patients to support. We have also been campaigning for the 10 year Mental Health Strategy to secure its full amount of funding from the Northern Ireland Executive, which is crucial for improving eating disorder care across the nation.’ 

What barriers prevent successful early intervention?

One of the main barriers to early intervention is the focus on weight rather than the symptoms of the illness. Unless your physical weight is within a dangerously low category, help is often denied. Even if mental and physical health is at risk. Anorexia is often what comes to mind when you think of an eating disorder. However, there are a variety of other illnesses under the umbrella that are flying under the radar. These often receive little to no treatment, leaving sufferers without support indefinitely. Phoebe works on a psychiatric ward and has personal experience with an eating disorder.

“Part of why a lot of people get denied treatment is on the basis of weight.” she states, “Since working on an acute psychiatric ward, it’s become even more obvious to me how absurd it is to measure someone’s mental illness on weight or physical observations. Someone could be highly distressed and disabled by their eating disorder. But if their blood sugar and pressure are okay, they’re dismissed. Meanwhile, we don’t measure the severity of someone’s schizophrenia or major depressive disorder by their physical observations.”

Alongside weight stigma, there are many other barriers in the way of early intervention such as the following.

• There is a severe lack of funding for eating disorder research and treatment. This applies across the UK, with Northern Ireland being among one of the lowest regions for available funding.
• Partially due to funding is the lack of resources available.That includes treatment facilities, therapists, groups etc.
• As well as weight stigma, there is also a stigma surrounding eating disorders in regards to gender, race, socio-economic background and age.

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Lived experience with early intervention.

Thank you to all those who have lent their experience to this article. Everyone has a different experience with treatment, some good, others not so much. The purpose of this is to highlight the experiences of others and their thoughts on early intervention. Please be kind when commenting and bear in mind that experience with treatment is individual to everyone.

My personal experience with inadequate early intervention. 

As someone who has suffered from anorexia for years, I can clearly see the impact that inadequate treatment has had. While I received treatment as a teenager, their methods were, in my opinion, poor. Firstly, I had to travel forty minutes from home for a simple one-hour appointment. I missed important classes, events, and time with friends who, at the time, were my lifeline. The guidance and support given to my parents was non-existent. It’s no surprise that they were unsure how to handle my illness!

In the grand scheme of things, I can understand that this isn’t the worst-case scenario. I was very lucky to have any intervention, no matter how awful it was. Many from my home country have had to travel across seas for even the most basic of treatment. I was certainly one of the lucky ones in that regard. However, the level of treatment received was basic, to say the least. It was primitive, clearly generic, and carried out as quickly as possible. The key goal from day one was weight gain in order to complete discharge, even if that meant you were still mentally unwell.

Adam’s Experience.

I feel had we been given support when my family and I first reached out for help, we wouldn’t have suffered for so long. It would have also potentially prevented the physical complications I’ve since experienced. I’ve also had various hospital admissions and operations, all caused by me being so unwell. Not to mention the trauma we’ve had to endure. Early intervention isn’t just about increasing chances of recovery. It’s about preventing years of suffering, physical, emotional, social, and financial complications.

Phoebe’s experience.

I wasn’t able to access “early intervention” when in a relapse despite having been hospitalized with anorexia a couple of years earlier. As the tale so classically goes, once they decided I needed treatment I didn’t want it and ended up in a worse state than ever before. It’s no wonder that people presenting with an eating disorder for the first time get turned away if someone with an established diagnosis can’t get help!

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Helplines & Charities.

If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, 365 days a year on 0808 801 0434, nihelp@beateatingdisorders.org.uk or www.beateatingdisorders.org.uk.

If you are based in Northern Ireland and want to help ensure that eating disorder support is available for all, you can take part in the public consultation on the draft budget for the next three years.

You can also get in touch with the Eating Disorder Association for Northern Ireland on 028 9023 5959. Or you can send them an email using this form. I volunteer with this charity and while we are small, our impact is mighty!

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References to early intervention research.

1. Lock, Agras, Bryson, & Kraemer, 2005; Loeb et al., 2007; Russell, George, Dare, & Eisler, 1987; Treasure & Russell, 2011.
2. https://www.nationaleatingdisorders.org/treatment