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Eating Disorders Awareness Week (EDAW 2023 27 February - 5 March) is an opportunity to focus our attention on eating disorders, extending awareness through conversations and education. In this blog our Senior Clinical Advisor Dr Fiona Pienaar highlights the complexity of eating disorders and the importance of seeking help, along with how we’re providing a crucial means of connection to people experiencing eating disorders through our Shout text service.

A clinical lens on eating disorders

Eating disorders are described by the NHS as ‘a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.”

Eating disorders can affect anyone, but teenagers aged between 13 and 17 are mostly affected. According to the charity BEAT, it’s estimated that around 1.25 million people in the UK have an eating disorder. Around 25% of them are male.

The most common eating disorders are: Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). There are also Other Specified Feeding and Eating Disorders (OSFED).

During a recent Royal Society of Medicine event, ‘Eating disorders: Advances in science and treatment’, experts reported on the seemingly inexorable rise in eating disorders hospital admissions, particularly Anorexia Nervosa, which they noted was very hard to treat. The complexity of eating disorders was highlighted, specifically social, genetic and psychological risk factors. The presenters also drew attention to the increase in referrals, hypothesising that this could be attributed to greater awareness of eating disorders and improved service availability.

Eating disorders are associated with both psychiatric (depression, anxiety, self-harm - most common) and physical comorbidities (cardiovascular, reproductive health, musculoskeletal, gastro-intestinal). One of the great psychiatrists and neuroscientists of our times, Professor Karl Deisseroth (Stanford University), declared that he had ‘found no greater mystery than eating disorders, anywhere in psychiatry or medicine. None greater in all of biology’. He also noted that ‘though no drug can cure these two diseases (AN and BN), words can reach them as one human being reaches another.’ (Connections: The new science of emotions, Deisseroth, Penguin, 2022, pgs 161 and 163).

Young Black girl texting on phone

The importance of connection through conversation in helping Shout texters with eating disorders

Indeed, through our text support service, Shout, we utilise the power of words, albeit the ‘written word’, to connect with texters struggling with issues such as eating challenges or body image, helping to guide them to a state of calm and empowering them to take their next steps to seeking further help, whether that’s by talking to a family member or a professional such as their GP.

Since Shout launched in May 2019, volunteers for the service have taken more than 60,000 conversations with around 20,000 texters about eating disorders or body image issues. Every day, around 4% of all conversations mention eating disorders or body image, with most of these conversations taking place between 6pm and 10pm. The majority of texters who brought up these topics were female (83%), with 6% male, 3.5% transgender and around 8% who identified as non-binary. In conversations that focused on these two topics, texters were also more likely to talk about anxiety, depression and self-harm.

In terms of the age of texters who discuss these issues, it was those who were aged 13 and under who were most likely to contact Shout to discuss eating and body image (7% of all conversations), followed by 14-17 year olds (6%).

Of the texters who contacted Shout for support about eating disorders and body image, 90% have rated the service as helpful; the majority of the comments we received reflect the kindness and the non-judgemental attitude Shout Volunteers offer texters. Taking the time to listen to the stories people bring and acknowledging the often enormous challenges they are facing, and reflecting their courage in reaching out for support.

Complex as eating disorders are, sometimes all it needs to support someone in the moment and move things forward a little, is a conversation.

We have a number of resources available if you are looking to support a family member, friend or colleague that you may be concerned about or indeed, if you’re looking for information or support for yourself:

At Mental Health Innovations we offer a number of services including consultancy, training and partnerships to help support people with their mental health and wellbeing. Find out more about how we’re working to support people across a range of mental health issues through the services we provide.

“I genuinely cannot thank you enough. I haven’t opened up about my eating disorder before. Now I’m going to talk to someone who can get me some help.”

Shout texter