An NHS dietitian’s advice for Eating Disorder Awareness Week

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Written by Alex Bell – Senior Specialist Paediatric Dietitian – East London Foundation Trust NHS

Why did you become a dietitian?

I grew up playing competitive sport to a high level and so learning about nutritious foods and how they can support my overall health, but also fuel my performance was important.

In school my favourite and best subjects were science and health. It was therefore, a natural decision for me to choose a career that involved both nutrition and health.

What was your route into this career?

I had an interesting path to becoming a Dietitian. At 18yrs old, I left Australia (my home country) to play tennis in America. It was there that I completed my BSc in nutrition on a sports scholarship.

In the USA, budding Dietitians complete an additional year after their Bachelor as a full time intern. In this role, you experience all areas of nutrition (inpatient, outpatient, community, children, adults and food service). This variety gave me a good idea of the fields of nutrition that I enjoyed, but also the fields I didn’t enjoy, with my preference being early intervention and community settings rather than inpatient settings.

After my time in America, I moved to the UK where I completed my Masters in Sport and exercise nutrition and transferred my Registration as a Dietitian. My Master research lead to my first role in the NHS in weight management for children and adolescents. This role was in a mental health trust and so I was fortunate to be asked to do some mental health hospital work alongside weight management. I really enjoyed working with mental health and the impact that a Dietitian can have to support in improving physical and mental health. From this role, I focused on building my experience in Paediatrics and also in mental health. This inevitably lead me to seeing the many struggles young people have with their nutrition whilst their bodies are developing and changing. I love helping and supporting those struggling in the community with their dietary behaviours and body image through my current eating disorders role.

How do you help your patients and what does your role cover?

I support young people by assessing current nutritional intake and providing strategies to achieve optimal nutrition. I work closely with my team to educate against misinformation including food groups, ‘normal eating’, diets, metabolism and energy needs of the body. This at times can include working together to troubleshoot barriers to changing dietary patterns and challenging of feared foods.  My role can include tough conversations around the risks of continued poor nutrition to the body at which point individual meal plans are sometimes introduced to provide a support framework for young people and families in re-establishing adequate intake.

What’s your advice to someone who is struggling with disordered eating? 

1. You are not alone! Whilst disordered eating and thoughts around food and body image can often be associated with feelings of guilt and shame and isolation, allow those closest to you to be your support network. Speaking to someone you trust can bring you an ally and a cheerleader to support and motivate you when improving your intake or changing your behaviours seems most difficult.
2. Take a social media spring clean. If you are finding that your news feeds are constantly showing images that make you feel worse about yourself or increase restrictions and rules within your eating habits, it is time to take a moment to filter these accounts out and unfollow them. Instead aim to follow accounts that make you feel better, whether that be body positive accounts or accounts about cute animals or travel destinations.
3. Reject diet culture within your peer group. I often hear comments such as ‘it’s my cheat day’, ‘oh I shouldn’t eat this, it’s bad for me’, ‘I feel fat’… Where possible steer conversations away from foods that are being eaten, comments on weight, comments on clothing. The regular commentary and comparisons on foods and body image feeds into a culture that accepts dieting behaviours and disordered eating habits as ‘normal. Consider if your peer group is helping or hindering your ability to have a healthy relationship with food and your body.
4. Seek help. Early intervention and support for disordered eating has better outcomes for recovery and prevents further decline of behaviours to a clinically diagnosable eating disorder.

What is your message for Eating Disorders Awareness Week?

This Eating Disorders Awareness week, the NHS and ELFT are launching the Be Body Positive website which aims to support young people, carers and professionals with topics around body image, nutrition behaviours and fussy eating habits.

This year’s Eating Disorders Awareness Week theme is eating disorders in men. BEAT Eating Disorders estimate that 1 in 4 people with eating disorders are men, yet many don’t seek support, similarly there is often a stigma that men don’t get eating disorders, which can limit their willingness to seek support or recognise any issues with their eating behaviour or body image. If you are a man struggling with your eating habits or your body, you are not alone. Reach out to those who care for you, reach out to health professionals, take a look at the Be Body Positive website, or give an anonymous call to BEAT helpline and get support.