Community: The Social

Eating disorders

Psychotherapist Andrea Scherzer joins us to answer your questions on asking for help, therapy and other issues surrounding getting support for eating disorders.


Andrea: Hello everyone, thanks for coming, feel free to ask me questions :)

daisychaindream: I'm going to be watching for a while, I'm a bit unsure what to ask.

Andrea: This is a always a sensitive issue so it's understandable if you're scared to say something. The best thing you can do is have a go and don't forget it's all anonymous and we understand.

feelinglow: I sometimes skip meals, have I got an eating disorder? :/ I feel really stupid for that question too.

Andrea: First of all, don't ever feel stupid asking for help. It's the first port of call for getting better. Skipping meals doesn't necessarily mean an eating disorder but can I ask why you think you're skipping meals at the moment?

feelinglow: I don't have any motivation; don't want to eat anything, it's depression mostly.

Andrea: OK feelinglow, it's not necessarily about food then, it's much more about feelings and moods by the sounds of it. Do you have someone that you can talk to?

feelinglow: I've just started CBT today.

Andrea: Good for you, that's a really great start for you and do give it a couple of sessions to get into the swing of things.

feelinglow: It's better than nothing I guess.

Andrea: Opening up to people around you can really help - sharing as much as you feel comfortable with and making use of your friends too.

feelinglow: Thanks Andrea :)

Helen - TheSite mod: Ok, well we'll move on to the next question as it's about CBT and I'm sure feelinglow will find it helpful too.

daisychaindream: My question is around CBT as a treatment for eating disorders. After 10 years of treatment this is the only thing I've held off trying and I'm apprehensive. I wonder if, after all this time, recovery is even possible?

Andrea: The first thing to say daisy is yes it is, but changing habits is a hard thing to do. CBT is about changing thought processes and behaviours and can be very challenging but it's more than possible and I've seen it work successfully many times.

Helen - TheSite mod: Hope that helps daisy, let us know if you have any follow-up?

daisychaindream: That does help, thank you.

Andrea: Hi to those who have just joined :)

HannahMarie: OK well, I've been bullied a lot and it's like I have this word 'fat' just always stuck on the brain. I either just don't feel hungry or I feel sick. When I do eat I feel guilty and I've been skipping meals. The thought of eating, of putting on weight , scares me :-/ I get really low and it's just comfort eat, comfort eat. The next thing I'm feeling guilty again. I make myself sick and then I get mad at myself and self harm. It's really a cycle. I also can't really eat in front of people.

Andrea: Hi Hannah, I'm really pleased that you've come along tonight, you're not alone. Does anyone know about how you've been feeling?

HannahMarie: Nah, no-one.

Andrea: Do you think there's anyone you could talk to in your family or amongst your friends perhaps?

HannahMarie: Nah, my family aren't much of a family and my friends just joke about that kind of stuff.

Andrea: OK Hannah, it sounds like it's really hard for you to be going through all of this and that you're family aren't an option to talk to at the moment but there are some options if you're willing to try and talk to people.

HannahMarie: Yeah, I just get scared about being judged by people, the "you're too fat to have an ED" thing, that's what I think they'll say.

sequinsplease: You can be any size whatsoever and have disordered eating habits.

"CBT is about changing thought processes and behaviours and can be very challenging but it's more than possible and I've seen it work successfully many times."

Andrea: Please try not to worry about people judging you, we certainly aren't here and we want to help you be healthy and happy and to figure out how best to get there. Would you like some advice on how to eat healthily for you and your family too? If so let us know and we can post some info.

HannahMarie: Yes please.

Andrea: Helen is going to add in some links for you that you should find useful :)

HannahMarie: Thank you.

Helen - TheSite mod: We've got a whole section here on about healthy eating that you can check out. The BBC also has a good section on healthy eating and staying active.

Claire: TheSite has everything!

Andrea: It's also worth thinking about going to your GP as a first step to getting some advice. You can tell them as much as you feel comfortable with and they can refer you for further support.

HannahMarie: Thanks.

Andrea: I hope that's helped. I think we have some questions waiting but do come back if you have any more to ask.

Helen - TheSite mod: Ok, thanks Andrea. We'll go to Karen's question next.

Karen: What do you think the threshold should be for being able to access specialist Eating Disorder services through the NHS and how does this compare to the reality? Is it acceptable for Eating Disorders to be managed by CMHT staff with no specialism in them?

Andrea: Hi Karen, that's a really valid question. I've been in the NHS for 16 years and I can't answer that question easily. The threshold for who gets treatment and who doesn't is a really fine line and unfortunately it comes down to money sometimes.

In my opinion anybody with an Eating Disorder deserves specialist treatment and I think everyone should have access to the same treatments - that's not always how it works in reality though. Unfortunately different areas end up with different treatments.

Karen: I'm currently struggling to get more expert support. My psychotherapist with CMHT has little advice for me but there is no talk of referral elsewhere. I feel that I'm being left to get worse because my BMI isn't low enough.

Andrea: Try to remember that it's not personal, your BMI is as important as anyone's.

Karen: I know, I'm just concerned for the state of my body; it's been a long time. Is it possible to be heavier than you look? I mean, to look underweight and to restrict intake but to still have a relatively healthy weight. In other words, to have an eating disorder in the psychological sense?

Andrea: Yes, eating disorders are psychological, they're complex but they're predominantly psychological. It's certainly possible to have a relatively healthy weight and still have an eating disorder, it's a state of mind.

Karen: And is it right that having an Eating Disorder long-term can really affect metabolism etc?

Andrea: Yes that's right, when you starve you tell your body one thing and then when you eat you tell your body something else and it becomes confused. As a result your metabolism also becomes confused.

Karen: Thanks Andrea, I'm going to use this info to hopefully get better help, thank you x

Andrea: No problem, good luck with everything.

Karen: Thank you.

Randomgirl: I have mental health problems. In 2008 I had anorexia and my weight was dangerously low. Then in 2009 I started taking anti-psychotics and started putting weight on as a result. In weight terms I'm now almost double what I was then and I hate it. Today I was mistaken for being pregnant (by a midwife!) as I carry it all up front. I still have the anorexic head though but the big fat bloater body that I imagined I had before. Have you got any advice?

Andrea: There are certainly anti-psychotics that make people gain weight, they can make you hungrier than normal. Anti-depressants don't tend to have the same effect. I'm really sorry to hear you've had this experience; the best thing to do is to talk about what's going on for you, either through your GP or someone else. It may be that you could change your medication for example. Once you manage to come off the anti-psychotics hopefully you will notice a change and can focus on things like exercise to help you feel better.

Andrea: Unfortunately that's all we have time for tonight. Thanks for all your questions, hope to see you again soon :)

Helen - TheSite mod: Thanks for coming everyone. Don't forget that you can ask a question anytime via askTheSite where you'll be put in touch with expert advisors and receive a response within three working days.


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