A leading psychiatrist specialising in the treatment of eating disorders says they should not be seen exclusively as a “teenage issue” and that other key life stages, including menopause, can trigger anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders.
Consultant Psychiatrist Dr Lorna Richards, based at the addictions and eating disorders centre at Priory’s Life Works Hospital in Woking, Surrey says: “We know that eating disorders often develop as a means of coping, and any life-stage change can be a potential trigger.
“The stage leading up to menopause in a woman’s life, known as the perimenopause, is a time of immense physical and hormonal change. It often coincides with other milestones such as adult children leaving home, marital breakdown, illness or the challenges of looking after ageing parents. Inevitably, a new identity is also emerging.
“This cumulative psychological burden can be overwhelming and what may have been a mild eating difficulty can transform into a full-blown eating disorder. This can provide a feeling of being in control or at least a sense of purpose in pursuing that control when the body feels under threat from an unstable environment. It can be the known component during an unpredictable and turbulent time.”
Experts at Priory’s Life Works Hospital have developed a new programme for eating disorders tailored to individual patients. It provides all treatments recommended in the National Institute for Health and Care Excellence (NICE) guidelines and is suitable for adults with any type of eating disorder.
In June 2012 the International Journal of Eating Disorders published the results of a seminal study on the prevalence of eating disorders in midlife and beyond.
Lead study author Cynthia Bulik, Ph.D., director of the Center of Excellence for Eating Disorders at the University of North Carolina, Chapel Hill, found that 13 per cent of American women of 50 or older experienced symptoms of an eating disorder; 60 per cent reported that their concerns about weight and shape negatively affected their lives; and 70 per cent were trying to lose weight.
Dr Richards says: “Eating disorders are severe mental disorders with a complex array of risk factors specific to each person. We cannot treat people with a ‘one size fits all’ approach and the more we can understand someone’s unique condition and what has contributed to the development of the illness, the greater the chance of a full recovery.
“I also have little doubt that social media is currently playing a part in the increase we are seeing in body dissatisfaction, low self-esteem, identity confusion and a need for constant validation, which in turn are all risk factors for developing eating disorders.
“There’s nowhere to hide from the social media that pervades younger people’s lives. There is limited space for quietly and privately developing oneself in terms of appearance, friendships and interests. The relentless scrutiny that young people are under is unprecedented and we need to understand its impact in the context of treatment strategies.
“The important message to convey – which dovetails with the excellent work of charities during Eating Disorders Awareness Week – is that these conditions do not discriminate, and they should not be kept secret or stigmatised. Seeking help as soon as possible, whatever your age or gender, is vital to ensure that specialist treatment is accessed during the early stages of illness when treatment can be most effective.”
The evidence-based programmes at Life Works target all aspects of an eating disorder, providing individuals with the practical and psychological tools they need to begin the road to recovery. Family and carer interventions are seen as integral to the approach of the service.
Patients are supported by a team of specialist staff, including nurses, therapists, dieticians, consultant psychiatrists and a nutritionist. There are a range of psychological therapies such as CBT (Cognitive Behavioural Therapy), DBT (Dialectical Behaviour Therapy), MANTRA (Maudsley Anorexia Nervosa Treatment for Adults) and the innovative CRT (Cognitive Remediation Therapy) which focuses on the neurobiological aspects of anorexia nervosa.
Additional approaches are used including dance movement psychotherapy and enabling patients to learn from the experiences of others in their recovery. The service also provides support and practical interventions for meal-planning, shopping and cooking.
Life Works is located in a Grade Two listed Georgian manor house. It is an 18-bedded facility and in addition to the in-patient programme, a full range of treatments are available for day-patients and out-patients. Assisting people during the transition home following treatment is particularly important.
Steve Clarke, Clinical and Therapy Services Manager at Priory’s Life Works Hospital said: “Our treatment plans give our clients the best possible support to make their recovery as effective and as smooth as possible.”