Eating disorders such as anorexia nervosa and bulimia are no longer straight forward with treatment needing to be adapted from the recommended NICE (National Institute of Clinical Excellence, 2020) of family based therapy.

Since the pandemic Child and Adolescent Mental Health Services (CAMHS) patients are more complex with additional co-morbidities such gender questioning, autism, emotional dysregulation and self-harm. To put this into context; a recent statistic is that the percentage of children and young people admitted to hospital with eating disorders has increased by 35% in the last year (Naylor, 2022). In the previous year there was a 128% increase of young people starting treatment within the NHS inpatient or community services, which was an increase by two thirds compared to the previous year (Naylor, 2022). This is substantial and concerning evidence and research.

However, general CAMHS services are stretched and under-resourced in managing eating disorders and disordered eating; therefore they will often be referred to the eating disorders team- putting further pressure on resources.

Local eating disorder charities have put on training for general professionals on how to recognise disordered eating.

Eating disorders are where someone is concerned about their body shape and is striving to lose weight either by restriction, purging or other ways such as excessive exercise. More patients are being referred in late 2022 and 2023 who need an urgent assessment and may end up needing hospital admission, this may be due to difficulty getting a GP appointment for a referral, the manipulation of the eating disorder where by parents won’t pick up symptoms straight away of an eating disorder.

Disordered eating can be a variety of reasons such as anxiety induced nausea (so someone doesn’t eat), it can also be a significant way of controlling emotions or trauma of any kind.

It can be difficult to unpick the root cause of food & fluid restriction; emotion v body shape concerns.

This is done by a thorough assessment with different discipline clinicians looking at everything from the mother’s pregnancy to up to date eating concerns.

Our team is lucky to have a wide range of professions within our team and a home treatment team who help patients in their homes to avoid admission to hospital by providing meal support for example:

I also work with a great nurse who has struggled herself with an eating disorder, Bea (Adult Nurse)

“Eating disorders have played a part in my personal life as aged 16 I was diagnosed with anorexia nervosa and underwent intensive community treatment within CAMHS and into adulthood, so this further inspired me. This led me to pursue a career in nursing and once I had gained some general nursing experience, the opportunity arose to join the CAMHS Eating Disorder Team. I was recruited into an Eating Disorder Nurse role within a new service; the Home Intensive Treatment Team. This new service was set up due to the increasing number of complex eating disorder presentations and increased acuity at the time of referral; leading to an increased number of hospital admissions.

Eating disorders are by nature very complex, however using my own experience to support others through a really dark period of their life, I feel enables young people to feel less alone, and encourages young people to work towards a life beyond the eating disorder. Life with an eating disorder can feel desperate, hopeless and at times, not worth it. I often describe the recovery journey as “a long old slog” (that’s the technical term), because that’s how it feels; it often feels like walking through treacle. In the depths of the eating disorder, for young people to see the reality of “the other side”, I feel is important. Whilst maintaining the professional boundary, I share small parts of my
personal experience with some young people under our service, usually the slightly older ones, and more often than not, it appears a weight is visibly lifted from their shoulders, because someone *really* gets it.”

We are both happy to discuss this blog further with any interested professionals as this is a great passion of ours.

Reference:
National institute of Clinical Excellence, 2020, Eating disorders in children and young people,
Naylor, H 2022, The London centre for Eating Disorders