It is estimated that around 1.25 million people in the UK have an eating disorder. One of the most common eating disorders in the UK is Binge Eating Disorder, and it’s often linked with obesity. According to recent data, 50% of people who are morbidly obese may also be suffering from BED.
Obesity
- Defined by a metric
- Someone who is significantly overweight
- May be linked to a consequence of an eating disorder
Eating Disorders
- A mental health condition
- Can occur at any weight
- People with Binge Eating Disorder can be obese too
The link between eating disorders and obesity means that people who require weight management services can often be suffering from BED. Considering this, weight management services need to accommodate for the treatment of BED.
Patients receiving help from weight management services may need to be supported in losing weight and overcoming the eating disorder they suffer from. We heard from Jess Griffiths, Clinical Lead at Beat, on how to include emotional support in weight management services to improve outcomes for patients.[2]
Eating Disorders are Mental Illnesses
It needs to be remembered that eating disorders are mental illnesses. The disorder is tied in with the psychology of eating in general and this needs to be remembered in treatment plans. The treatment plan for BED often involves ordered eating meaning it is unlikely the patient will see any weight loss when they start the weight management programme.[3]
Emotions and Weight Loss
People suffering from BED have both physical hunger and emotional hunger. This can sometimes be wrongly viewed as emotional overeating, which everyone experiences. Emotional overeating is an eating behaviour and BED is an eating disorder. The difference between the two is the frequency, nature and emotional aspects of the binges. People who emotionally overeat can also be overweight.
Weight Management Treatments
Emotional health and physical health are not two completely separate entities. Both of these can impact on one another and affect a person’s overall perception of themselves. This is why a more holistic approach should be considered with weight management solutions. An approach that includes both physical and emotional aspects is more likely to help a person achieve recovery.
Involving holistic care in weight management solutions should engage with the psychology behind eating. It helps develop an understanding of a patient’s behaviours and how they use food to cope with emotions.
It also supports treatment for BED patients as the CBT treatment and self-help prescribed to them involves eating at regular intervals and does not often help them lose weight quickly. By considering emotions and psychology in the treatment, you support the patient in their recovery, highlighting emotional strengths rather than physical weaknesses.
Holistic Care in Weight Management Services
Holistic care should engage both mental and physical health, creating a dual approach within the weight management service to help the patient understand their eating behaviours.
Practitioners should avoid negatively framing food and the individual by saying things are ‘bad’. Using this sort of language can impact a person’s self-esteem and hurt their chances of recovery. In a similar way to language try to celebrate a patient’s strengths and successes. Focusing on their strengths helps build up a patient’s self-esteem. Both of these aspects of treatment take careful consideration of the patient’s emotional health.
Another way to engage more directly with the emotional connections associated with food is with the use of a food diary. Emotions need to be worked through and a food diary helps a patient do this.
Food Diaries
Food diaries work to help patients understand how to directly handle difficult emotions and identify why they are feeling hungry. Is their hunger for emotional reasons or a physical need?
If they are looking for food to fulfil an emotional need then the diary can help identify if the food has become their only way of dealing with emotions. If so, those emotions can be worked through as part of the treatment. Working through these emotions helps them decide whether or not to eat when they are feeling emotionally distressed, instead of acting as they might have done in the past.
A good way to do this is by getting the patient to engage with feelings of hunger in the diary using the BLAST technique: Are they?
- Bored
- Lonely
- Angry
- Stressed
- Tired
Identifying the specific emotion helps a person understand why they are feeling hungry and if that hunger is due to an overwhelming emotion. By coming up with tools for dealing with each of these emotions, the patient can understand the reason for their hunger and decide whether or not they want to eat. This helps them recover mentally as well as physically.
Conclusions
Appropriate training is needed for healthcare professionals on eating disorders so they can provide better support for patients. This involves taking an emotional history in regards to their relationship with food as this could be beneficial in deciding the best treatment. Good psychological interventions need to be in place alongside weight management services to ensure patients recover both physically and mentally.
[1] BEAT, How Many People in the UK Have an Eating Disorder?, (2021)
[2] Jess Griffiths, Clinical Lead Beat, (2021)
[3]NHS, Binge Eating Disorder Treatment, (2020)
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