1. Understanding Eating Disorders Fiona Flynn 29 April 2015

2. What we will talk about… My background What are eating disorders? Signs and Symptoms of eating disorders Effects of eating disorders. Why people develop eating disorders? Self esteem. Body Image. How people get better? Bodywhys support services What to do if I am worried about my child?

3. What are the main types of eating disorders? Anorexia Bulimia Binge eating disorder

4. Why do people get eating disorders? Eating disorders are not primarily about food Eating disorders are a coping mechanism An unconscious way of coping with/avoiding difficult feelings or situations Sometimes by controlling food and weight a person may feel more in control of his/her life

5. About eating disorders.. True or False? It only happens to girls It’s just a teenage thing It’s a lifestyle choice People with eating disorders are just looking for attention You never fully recover!!

6. Potential effects on the body Poor circulation – feeling cold all the time Feeling tired all the time Dry flaky skin Constipation and abdominal pain Poor concentration Withdraw socially Sore throat Swollen glands Decay of tooth enamel Damage to bodily organs Osteoporosis - “brittle bones” My experience

7. Signs and Symptoms Weight loss/gain Evidence of low self-image Pre-occupation with weight and body shape Pre-occupation with food, and in particular with preparing food for others, that they themselves won't eat Excessive exercising Withdrawal from regular activities and social situations Frequent trips to bathroom after meals (perhaps with sound of water running) Unusual food rituals Constant dieting, even when thin Taking laxatives or diet pills Making excuses to get out of eating Avoiding social situations that involve food Eating alone, at night, or in secret Hoarding high-calorie food

8. Why do people develop eating disorders? There are as many reasons why people develop eating disorders, as there are people with eating disorders… There is NO single cause.........

9. Some common factors: Low self esteem, unhealthy body-image Perfectionist tendencies Family difficulties/ problems in relationships Emotional factors Pressure from fashion, media Bereavement or loss Dieting

10. People with healthy self-esteem tend to... Believe in themselves Feel that they can do the things they want when they put in the effort Recognise their strengths Know what they like and don’t like Are able to communicate effectively Learn how to handle difficulties NOBODY FEELS GOOD ALL THE TIME

11. Sometimes when we’re not feeling great we… Doubt themselves Focus on the bad stuff Dwell on personal weaknesses Compare themselves to others and feel we’re not good enough Go along with things… no matter how uncomfortable they feel

12. How to give your self esteem a boost.. Hang out with supportive people who don’t put you down or make fun of you…. Do things YOU enjoy Think about what you have learnt about yourself when you achieve something or when you have setbacks. The way we think… Accept that NO ONE gets it right all the time and that no one is happy all the time.

13. Self Talk It can be a good idea to keep a diary of all the nice things people say or compliments people give you to look at when you don’t feel great about yourself

14. Body Image What is body image? What influences our image of ourselves? Do we feel pressure to look a certain way? Where does this come from?

15. The Media Make up Lighting Airbrushing

16. Some strategies for increasing positive body image: Emphasise the fact that body image is only one part of who we are.. Set a good example Focus on talents and doing things they enjoy Talk about airbrushing and the fact that the images in magazines are NOT REAL Encourage them to be individual – and not to try to live up to the media or peer pressure Healthy diet and exercise

17. How do people get better? Eating disorders have many different aspects: - Emotional - Physical - Psychological -Behavioural Getting better means having each aspect addressed!

18. How do people get better? Above all they need lots of support and understanding from those around them

19. Treatment & Support Options Family Doctor/ G.P. Counselling or psychotherapy Nutritionist/ Dietician Psychiatric treatment Inpatient/ Outpatient programmes Support Services – Bodywhys:helpline, support groups, online support

20. What to do if you’re concerned your child may have an issue: Read all you can about eating disorders Look for support groups that can give you more information Speak to your family doctor if you have specific medical concerns If you know of someone else who has been through this experience, speak with them and ask their advice – its important to have support for yourself too

21. Distinguishing between an eating disorder and ‘normal disordered eating’ Some questions you can ask yourself: Is your child’s behaviour having an impact beyond meal times? Is their behaviour impacting on their personality, or on the rest of their day-to-day life? Does your child see food as a source of energy and nutrition, or is some other value being attached? How does your child react to mealtimes? Is there an overly emotional response?

22. When speaking to your child: Do be honest Do speak from your own perspective (e.g. “I’m worried about how you’ve been feeling lately…”) Do remember that your child may feel extremely vulnerable Do be prepared for denial, resistance, false reassurances Do speak in specifics: mention behaviours you have noticed, and explain why you are concerned about those behaviours Do remember to listen as well as speaking – balancing your concerns with their responses is important at this stage Do encourage them to speak as openly as possible Don't ask for immediate changes in behaviour Don't make accusations Don’t demand that they ‘just eat’ or ‘just stop’. This is too much to ask of them in the early stages.

23. When speaking to your child.. It is particularly important in the context of your relationship with your child that they see your anger as being directed at the eating disorder and not at them. Ways of making this distinction: Avoid labelling your child e.g. describe your child as 'having' or 'being affected by' an eating disorder, as opposed to 'being anorexic' Be clear that you are not assigning blame to your child

24. If your child does not want to seek help In this scenario it is important to be able to negotiate: Focus on specific issues which you are concerned about; this may be a behaviour, or a physical symptom that you have observed. Explain that you need them to address these issues with you and with your doctor Reassure your child that you are not asking them to change their behaviours today. It is vital that your child feels they can trust you – so if you make an agreement with them around attending a GP or similar, you need to stick to it. It is also important that they trust any Doctors/Counsellors they may be dealing with

25. Within the family Accept that it is not your fault. If you have other children, share what you know about eating disorders and supporting a person towards recovery with them. Encourage them to express their range of feelings about what is happening to their brother / sister and to their family. Try not to let the needs of the child with the eating disorder overshadow the needs of siblings. Be aware that the distress of siblings can be very acute and is often hidden so as not to burden parents. Aim to be as consistent as possible in your approach. Self care - Talking to someone (a trusted friend, a helpline volunteer, a professional care giver) will help to reassure you and put things back into perspective.

26. A final note Set a good example… Eat healthily and avoid dieting or making negative statements about your own body or your eating habits. Focus on building self esteem and positive body image Learn about eating disorders Listen without lecturing Take care of yourself…

27. Bodywhys services LoCall Helpline 1890 200 444 Support groups in Dublin, Carlow, Galway Support email alex@bodywhys.iealex@bodywhys.ie Online support group - BodywhysConnect Website at www.bodywhys.iewww.bodywhys.ie Text ‘support’ to 53305 for details

28. Questions? Thank you