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Session 1

Professionals – What is disordered eating?

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WELCOME
TO MODULE 3

Welcome to Module 3! In this module we will explore disordered eating, what might be causing these difficulties, and provide you with information and strategies that we hope will help you in your journey.

Learn about disordered eating

Manage expectations

Learn self-worth

Download Sessions once complete

Brought to you by

East London
NHS Foundation
Trust

NELFT NHS Foundation Trust

True or False?

Do you think these statements are true or false

Question:

Dieting is one of the most common
forms of disordered eating

I think this is...

Question:

Avoiding a type of food or food group is part of normal eating

I think this is...

Question:

People who regularly display dieting behaviours are more likely to develop an eating disorder than those who don’t

I think this is...

Question:

People with disordered eating can often feel isolated from their peers

I think this is...

Question:

Disordered eating is not linked to poor mental health

I think this is...

Question:

It is not possible to change disordered eating behaviours

I think this is...

What is disordered eating?

Disordered Eating is a phrase used to describe a range of irregular eating behaviours that do not warrant a diagnosis of a specific eating disorder. However, the behaviours can still be of concern, and the disordered eating can sometimes make a person more likely to develop an eating disorder.

Eating disorders, such as anorexia nervosa and bulimia nervosa are diagnosed according to specific and narrow criteria. This excludes a majority of people suffering with disordered eating.

Disordered eating may still require attention and appropriate action. This is because there is a risk that disordered eating patterns may become more problematic and put individuals at risk of serious health problems.

Disordered Eating vs Eating Disorder

The most significant difference between an eating
disorder and disordered eating is in the severity and the frequency of the symptoms which impacts on whether or not a person's symptoms and experiences align with the criteria defined by the American Psychiatric Association and the World Health Organisation.

Disordered eating that does not meet criteria for an eating disorder diagnosis may still require attention and appropriate action as they may become more problematic eating disorders and put individuals at risk of serious health problems.

The term "disordered eating" is a descriptive phrase, not a diagnosis. People who experience disordered eating, whether diagnosed with an Eating Disorder or not, often have poor emotional awareness and have limited access to emotion regulation strategies. Disordered eating can become one way to help regulate and manage difficult emotions.

How does growing and developing effect your eating?

It is not uncommon to notice changes in young people's eating habits as they approach and navigate teenage years. There are a number of things that would be considered normal aspects of adolescence that may influence their eating behaviours.

You might notice that healthy eating habits may become less common, e.g. often skipping breakfast, avoiding eating meals with the family etc.

Teenagers can be influenced by their peers, while navigating friendships and developing a sense of belonging, which is all crucial in their social development. With this brings aspects of social eating, which may influence their preferences and patterns of eating.

Their increased independence may also be reflected in food choices that
they make.

Adolescence also brings about puberty, significant physiological growth and changes in brain development. This may also influence changes in appetite and eating behaviours, likely an increased appetite.

During adolescent years, growth and brain development increases significantly. In order to support these changes in the body, teenagers will often need more sleep, and social influences (education, work, social life, home life etc) may also effect sleep and wake times. This in turn can impact eating patterns.

signs and symptoms of disordered eating

Frequent dieting, anxiety associated
with specific food or meal skipping

Chronic weight
fluctuations

A feeling of loss of
control around food, including
compulsive eating habit

Preoccupation with food, weight
and body image that negatively
impacts quality of life

Rigid rituals and routines
surroundings food and exercise

Using exercise, food restriction, fasting or
purging to "make up for bad foods" consumed

Feelings of guilt and shame
associated with eating

Influence of social media
on disordered eating

Pictures of
aesthetically
presented food

Videos of people
looking slim and
toned advising you
on what to eat

“what I eat in a day” –
which ends up being restrictive and
unattainable

“how I lost X amount
of weight”

“follow me on my
OMAD
(one meal a day)
journey”

Diet Cycle

Dieting is one of the main risk factors for
developing an eating disorder (source – nedc.com.au)

At least 75% of individuals who start a diet will eventually regain the weight that they had lost

Diet Cycle

Try this for yourself! Make notes in the boxes below

Is there a link between disordered eating and emotions?

Emotions are the feelings we get as we interact with ourselves and the world. We experience them as sensations in our bodies and changes in our thoughts. Emotions tell us when we have found something good, safe or fun, and they alert us to danger and things we should avoid or protect ourselves from. In short, they help guide our responses and reactions to people, situations and ourselves.

But dealing with emotions can be difficult. We need to be shown how to recognise and respond to our emotions (this usually happens when we’re very young), and we need to be in an environment that is accepting of them. For instance, feeling sadness or anger can be unpleasant. If we don’t recognise these emotions, or if we are in a situation that doesn’t encourage or allow us to express them, we might struggle to know how to respond to them and end up feeling confused or overwhelmed. Sometimes this is referred to as ‘emotional dysregulation’ or ‘struggling with emotion regulation’.

If this happens too often, we can end up turning to less helpful ways of coping with our emotions, like self harm, compulsive checking, or under or over-eating.

The link between emotions and eating

You might find yourself controlling food and eating as a way to manage emotions that are difficult to understand or to respond to. Patterns of controlling food or eating can then become hard to give up and other areas of your life might start to suffer as a result.

Using food and eating as a way of soothing or trying to get rid of emotions is very common. We all do it from time to time – just think about the last time you had a bad day and someone suggested a cup of tea and a biscuit!

Controlling food and eating may feel like it protects you from the effects of unpleasant memories or experiences by dampening or even getting rid of unwanted emotions.

Perhaps you have noticed this within yourself. Write some notes in the section below...

Emotional Eating

1

You might find that when you are experiencing strong emotions you respond in different ways, including in the way you eat

2

This can become a habit as a
way of coping with stressful
moments or strong
emotions

3

Some people eat less when
upset or distressed

4

Others may use food to cope with these feelings, which might look like eating more or even binge eating

5

Although this feels as if it might help in the moment, the benefits are not long lasting. You might end up feeling worse in the long term sometimes experiencing feelings of guilt and shame

Acknowledgments - Module 3: What is disordered eating?

Module 3:

  • Dr Nadia Daer – Clinical Psychologist NELFT (London) Eating Disorder Service
  • Dr Katie Quayle – Clinical Psychologist NELFT (London) Eating Disorder Service
  • Dr Salma Suri (module lead) – Consultant Child and Adolescent Psychiatrist NELFT (London) Eating Disorder Service

Emotion-Focussed Family Therapy (EFFT) material used with permission from the International Institute for Emotion-Focussed Family Therapy https://www.mentalhealthfoundations.ca - Adele Lafrance, Natasha Files, Sheila Paluzzi and Jennifer Danby.

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