Great. Good morning, everyone, and thanks ever so much for joining us.
For the latest in our mental wellness sessions, which are hosted by the Department of Experimental Psychology here in Oxford.
So my name, Kathy Creswell, and I'm really delighted to be chairing this session today on understanding and managing eating disorders.
We just wanted to remind you before we get started that this series, as I said, is hosted by the Department of Experimental Psychology.
So you can find all our previous talks on the experimental psychology YouTube channel and on our Web page.
So so far, we've had talks on managing stress and anxiety, on depression and low mood and on sleep problems.
And we've got some other exciting events coming up shortly on coping with trauma and also overcoming mistrust and paranoia.
So please do keep an eye out for those. As you know, this session is going to be running for 45 minutes.
We deliberately do 45 minutes in the hope that you'll have 15 minutes break before whatever you're doing next kicks in.
So because some of these sessions can raise difficult issues for people, we'd really encourage you to use that time to step away.
Give yourself a bit of a break.
And also, we also want to highlight that if there are any issues raised for you, then please do reach out to others, to friends,
to your GP, for example, to charities, and we'll be signposting some useful resources as we go on through the talk.
But without further ado, let's move on to the talk itself. And I'm delighted to introduce you to Dr Rebecca Murphy,
who is a senior research clinician here in the university in the Department of Psychiatry
and also an honorary clinical psychologist in Oxford Health NHS Foundation Trust.
So over to you, Rebecca, and thanks so much for joining us.
Thank you very much, Kathy. I'm just going to share my screen with you.
So I'm delighted to be here today to talk to you about eating disorders.
And I'd like to thank the organisers of the talk from experimental psychology
for inviting me here to present as part of their series of mental health talks.
I'm based at the Centre for Research on Eating Disorders at the University of Oxford and.
Let's begin by thinking about what eating disorders are.
So eating disorders have been defined as medical illnesses marked by severe disturbances in eating.
Or disturbances of behaviour intended to control white and these disturbances calls somebody considerable distress,
and I have a clear and negative effect on someone's health and other areas of one's life, such as relationships and work.
And conventionally, eating disorders have been divided into different diagnostic types,
and these include anorexia nervosa, where somebody is a severely low weight and is restricting their food intake.
Believe me, if I saw where somebody has episodes of losing control of their eating and eating an unusually large amount of food and then
tries to compensate for these episodes or counteract the effects of binge eating by strict dieting or self-induced vomiting,
laxative, misuse, there's binge eating disorder where people also have the frequent and highly distressing episodes of losing control of one's eating.
But without the compensatory behaviours such as strict dieting or vomiting.
And then importantly, there are also other types of eating disorders where people still have a significant and impairing eating disorder.
But the features just don't map exactly on to the other categories.
However, for people familiar with a range of people with eating disorders.
Well, it's actually quite striking is how much different eating disorders have in common rather than their differences.
And this, in fact, is what has led researchers to develop a TRONS diagnostic theory of understanding eating disorders.
So what are the common features of eating disorders?
Well, I'd like to start with what's arguably a central feature for many eating disorders,
and it's something we might not have thought a lot about, but it's to do with how we judge ourselves as a person.
And if we're meeting our personal standards in the areas of life we value, we tend to feel reasonably good about ourselves.
If not, we feel bad. And what's notable in people with eating disorders is that often they judge themselves largely
or even exclusively in terms of eating shape and weight and their ability to control them.
And this is not the same as what might be described as more sort of normative body dissatisfaction,
which can affect many people in societies with particular body ideals.
This is really quite different. And this is exemplified in this quote here where somebody says, I feel so disgusted with myself as a person.
When I fail to stick to my diet or my weight goes up, I lose all hope for the future.
So in terms of other common features of eating disorders, in addition to this sort of self-worth, being dependent on eating weight and shape.
People often have the associated extreme concern about their eating and their weight and their body,
accompanied by a kind of intense scrutiny and checking of one's body and weight or possibly avoidance.
Somebody may lose weight or gain weight as a result of the eating disorder.
But often people's weight is in the sort of normal range. There's often strict dieting and preoccupation with food.
There may be vomiting, which is self-induced, or laxative misuse.
And under exercising and people might have occasions where they lose control of their eating.
I need to an unusually large amount of food and each individual with an eating disorder may not have all of these features.
So we just want to launch a poll now. And this is entirely anonymous.
Would you be able to indicate if you or someone you know has experienced an eating disorder?
I'm just going to. That was quite interesting.
So clearly, the very large majority of you are very familiar either yourselves or because of knowing someone else,
and this really isn't surprising because eating disorders are relatively common with estimates of around sort of one point two to five million people.
But also studies have found that actually one in five women and one in eight men scream positively for a possible eating disorder as well.
So that doesn't surprise me. That overwhelmingly sort of high response.
So. Just moving on.
I want to have a little bit of a think about common eating disorder myths.
So one myth that is very common is that eating disorders only happen to kind of young, white, thin, heterosexual, affluent women.
And whilst it is true that many young women do experience eating disorders,
eating disorders can affect anyone of any gender weight sized age, race, ethnicity, sexual orientation, socioeconomic status or culture.
Another unhelpful myth is that people choose to have an eating disorder.
In reality, many factors contribute to somebody having an eating disorder.
Nobody chooses to have one. They're not a phase or a means of getting attention.
And in fact, people often hide the fact that they have an eating disorder.
A third myth is that families cause eating disorders, whereas actually people with eating disorders come from all kinds of families.
And families are not to blame.
It is the case that sometimes families do develop problems as a result of the difficulties of having a family member with an eating disorder.
But in most cases, family families are a really helpful resource in terms of helping people get better.
Another myth is that you can't recover from an eating disorder,
whereas actually most people who receive one of the recommended evidence based treatments for eating disorders do get better.
And there is always hope, no matter how long the eating problem has been going on.
So we're going to launch another poll now.
I'd like to know if you have ever felt uncertain of what to do to help yourself or someone else with an eating disorder.
So I think that's well, that come up now. Great.
So, yeah, so I can just see. We've got about 90 percent view.
It's varying a little bit saying that you have been.
So I think I'm going to move on now to have a little think with you about.
Let me just share the results. There we go. See, you can see that 80 percent to me.
So let's have a think about what you can do in that situation, how to get help for an eating disorder.
So involving your GP is the safest and usually the most helpful step for getting help with an eating disorder.
If you're a student at university, then they may be able to help, too.
I don't want to just make a few points about this process.
Firstly, it's normal to be in two minds about seeking help, and that's for a variety of reasons.
So in some cases, some aspects of the eating disorder might be valued,
or you have maybe a sense of stigma or shame around disclosing that you have an eating problem or doubts about whether you deserve help.
And a specialist in eating disorders will be familiar with that and can really help you to make an informed sort of choice about change.
So I would say don't let that put you off going to your GP and starting that process.
Secondly, try to make an appointment as soon as possible, because really intervening early gives you the best chance of recovery.
You may wish to make a sort of double or longer appointment with your GP so you can have a bit more time to discuss these difficult matters.
And if your GP suspects that you have an eating disorder,
the recommendation is for the GP to refer you on to a community with specialist eating disorder service.
And it's useful to think in advance about your different areas of concern and the impact that it's
having on your life so that you can be sure to really express that when you go for your appointment.
Often times it's helpful to have a list to hand, and you may want to ask someone supportive to go with you.
There are times where it's particularly urgent or more pressing to go to a GP, and these include if you've sort of feeling very distressed.
Lots of areas of your life are being affected. The problem's getting worse or has been ongoing or dramatic weight loss or being a low weight.
And please don't give up. If you feel like your problem hasn't been understood, it may be worth going to see another GP.
And what do you do if you're in that situation where you want to try and help someone else with an eating disorder?
So this is advice for people who have a friend or a family member with an eating disorder.
So firstly, it's helpful to try and have a kind of supportive approach and listen to
somebodies concerns without really focussing everything on eating right in shape.
And it's best to take a sort of concerned and interesting's intrusted stance because people
can be sort of feel criticised or uncomfortable about somebody else trying to take control.
And because mealtimes can be highly stressful. It's best to try to have conversations away from me at all times.
And it is helpful to try and learn more about eating disorders so that you can support someone else.
That doesn't mean you have to be their therapist.
And probably those more detailed discussions about shape and why actually are best left to professionals.
And it's important to look after your own needs as well.
And the final point is it's really important to how to make somebodies life about things other than food and wine.
So you could suggest that you sort of engage in social activities or hobbies together.
Really show interest in that person as a whole. You know,
aside from what's happening with their eating weight in shape and try to just avoid lengthy discussions about things like dieting and shape or why,
even if it's about someone else. So what treatments are available?
Well, the National Institute for Health and Care Excellence have reviewed the research on treatments,
and they've concluded that basically there will be different types of treatment depending on the eating disorder you have.
But there are all types of talking therapy or a guided self-help programme.
So you can see one of the treatments that's common across the eating disorders is a cognitive behavioural therapy,
which is a specialist treatment for eating disorders.
If you have believe in AVOs, sell or binge eating disorder, you may be working through a self-help programme with some guidance.
And there are other treatments as well that are recommended for anorexia nervosa.
And so there are different pathways to treatment. And if you don't have one of these disorders,
what NICE recommends is that you receive the treatment that's closest to the particular eating problem that you have.
So even if you don't quite meet the threshold for anorexia nervosa, if you have similar difficulties,
you'd be more likely to get the anorexia nervosa treatment in terms of other sources of help and support.
I really want to highlight Bayt, too, on the National Eating Disorder charity,
and they provide a lot of help and support for people with eating disorders.
If you were to go on to their Web site and you also have the option of a sort of search
box where you can specify your location and you'll be told about an eating disorder,
services, NHS and private and other sources of help in your area.
There are other useful resources as well.
I mentioned about the nice guidelines. So I think it's worth taking a look at those if you want to find out more about the recommended treatments.
There are other initiatives.
So, for example, by South London and mostly they have a campaign and an end to a sort of overall approach for early intervention.
And our our research group, in collaboration with colleagues in Italy,
have developed a sort of specialist Web site to provide information about CBT, the treatment for eating disorders.
And then, of course, there's this important issue of what to do if you've already been to your GP, but you're waiting to get more help.
So first of all, I'd say do keep in touch with your GP or the service that you've been referred to and update them.
If there's any sort of changes, you may want to consider self-help books for you or the people that are supporting you.
And there's there's a book here I mentioned which is suitable for people with eating disorders and a book for carers of people with eating disorders.
We're currently researching a digital a digital self-help programme.
If you're unable to find NHS treatment and you're in a position to help to pay for it, I know that many people on there are private alternatives.
And you can have a look on the beat website or some of the professional bodies which regulate therapists.
The other thing to think about is whether there are things in your environment which might be helpful or unhelpful during that waiting process.
And that includes your kind of social media environment.
So often it's helpful to try and unfollow any accounts which promote a sort of thin body ideal or kind of very strict diets,
and instead to try and follow campaigns which talk about how we can value ourselves in different ways aside from our eating and our bodies,
such as the one that Jamala Jamail is running. So I'm aware that this talk might have been difficult for some of you,
either if you're experiencing an eating disorder yourself or have people close to you all.
And so I suggest is at the end, once we've had the discussion that you take a moment to just readjust to going
back into your daily life and engage in some kind of helpful coping activity,
such as listening to a piece of calming music or speaking to a friend.
But I've also put here the contact details for B as well.
Thank you. All right. Thank you very much indeed, Rebecca, I'm sure that was very useful for everybody listening.
And thanks to everyone for sending in well, everyone who sent in questions prior to this week,
we're not obviously able to go through all the questions,
but we've tried to organise them in a way that will allow us to address many of the concerns or questions or comments that were raised.
So as we go into that, I'd like you introduce.
I'd like to introduce you to our panel members, Dr. Robin Murphy, associate professor here in the Department of Experimental Psychology,
and also Dr. Debbie Walla Walla, who has been a GP in central Oxford NHS practise for the last 30 years.
And both have got some really useful insights and experience to bring to this topic.
So to get it started, obviously, Rebecca was talking about how to get help for eating disorders,
but also some of the barriers that people can face in doing so.
And one of the issues that was raised ahead of this,
this session was that many people with eating disorders might believe that there are not enough for treatment.
So we were keen to hear your thoughts on this.
You know, how you would respond to this and when and to hear your thoughts about when do you think people should seek help.
So, Debbie, can I come to you first on that? Yes. I think Rebecca was saying.
There's often a huge ambivalence in wanting to seek help.
And that will hold people back.
The trouble is that the longer the eating disorder continues and the more entrenched it becomes and the more difficult it is to treat.
And we know that there's no strong evidence that people who get treatment quickly
and are more likely to make a better recovery and a longer lasting recovery.
So we'd really encourage people to seek help as soon as as soon as possible.
And I think in a minute, Robbins is going to talk about how do you know if you're real or not?
And I just say from a GP perspective, and I think the main stumbling block is often we don't know if it's actually making the diagnosis,
actually sort of realising that the person in front of you has an eating disorder.
And that's the problem that they're coming in with.
But once we've made the diagnosis and discussed it with a patient, then we we're really keen to get you help straight away.
You know, we wouldn't sort of say, well, let's wait for a while and just see how it goes.
If it were if it's a binge eating problem or something that hasn't been there for that
long and we probably recommend some form of evidence based self-help to start with,
then we signpost you to that and support you through the process.
But if it's a more complex eating disorder, perhaps anorexia nervosa and perhaps complicated by other mental health problems,
then we'd want to refer you really immediately and then we would refer you to the specialist eating disorders service.
And that's what's recommended by Nice. Yeah, no.
Well, I just wondered what you felt about this. How well am I really ill.
That question. Yeah. Yeah. Thank you. Thank you, Debbie.
And and thank you, Rebecca, for the for the excellent talk. Very clear.
So I'm an experimental psychologist and I'm interested in that point that in answering this question that Rebecca mentioned about self-evaluation.
So I think that point that that how do we know whether or not our behaviour is is typical or not is something very difficult in all sorts of contexts,
including whether we have eating disorders. So self-evaluation is it is and is an issue.
And we have to evaluate both our internal physical states, our sensations,
our perceptions of our hunger, for instance, but also what we're thinking about at the moment,
whether these thoughts are our typical, but also whether our interpretation of the outside world and social media is typical.
And all of those factor into a decision about whether or not I my behaviour is not is not typical.
And so in my experimental work, I look at the concept of agency.
So agency is this idea that we can act to make things happen.
We can act to help ourselves. But what we find is that people differ in terms of their their sense of agency.
And and that that that's both a belief in whether I am a Gentech.
Can I change things? Do I have the resources I need to change?
But also, is my agency typical?
So again, I don't know whether or not what I think of as my agency maps onto what Rebecca or or or Cathy or any of you in the audience is your agency.
And and and so that fundamentally interferes with our it's a barrier to whether or not we're going to seek help,
because we may think that we are typical or not.
And and so what we do in some of these experiments and is look at how people agency is expressed and we see these differences,
but also how you can help and train people to become more agentic.
And so one of them, I think the main barriers that comes out of this is that notion that it's actually very,
very difficult to know whether or not you need help because because all we have is our own internal internal sensations.
And key and I just was gonna come back to you, Debbie, because I know that Sam,
obviously we've been talking about the barrier in terms of, you know, feeling confident about whether it's okay to seek help.
Am I in enough a built or also in a moment about actually reaching services.
But I know that you've had expect to make a lot of people from sort of. And I've come across a lot of different barriers that people face.
I wondered if you were to say a bit more about that. Yes.
I mean, Rebecca and her talk touched on people's ambivalence, the stigma that they want to avoid, if possible.
And people would binge eating problems in particular, can live for years with their eating disorder because it's the sort of guilty secret.
They feel ashamed.
They they feel it's self-inflicted, you know, and that they don't deserve help or perhaps they don't want help because they're not underweight.
So, you know,
it's a real shame if people feel that are the blocks of them coming forward and then if your eating disorder is more anorexia nervosa spectrum.
People don't. Well, it's get getting back to this thing that people just don't feel they've got an illness and they they
they I think they are very fearful that they'll lose control or they'll be fools to gain weight.
They don't want to gain weight. If they get engaged in treatment, that they'll be kind of trapped.
Once they go into treatment. I think for students in particular, we've got fitness to study guidelines now,
which are very helpful for doctors and also university tutors when we're trying to make the difficult decision about when a person becomes too ill,
you know, to continue to study safely.
And students who perhaps are really ill and very underweight with an eating disorder may be aware of these guidelines.
I mean, that freely available to read on the Web.
And so that would stop them from coming forward because they'd be worried that they'd be told they can't study and perhaps they have to go home,
perhaps even had to be admitted to hospital. So that's a big barrier. As far as a GP surgeries go.
I mean, I don't know if any of you have tried to contact your GP recently for help.
Not had anything to do with an eating disorder. But the system is under a huge amount of pressure.
And now, particularly with kov it, you know,
we're seeing very few people face to face because we don't want bringing to bring people who potentially positive into the surgery.
So nearly everything is done on the telephone. And if you ring up for an appointment in the morning, first of all,
if it's an eating disorder you're wanting to disclose, you're probably feeling quite anxious about it.
And then you're told, well, the duty doctor will ring you back and you may not know who that doctor is.
So it's a bit of pot luck, you know, as to how that initial assessment is going to go.
And I mean, many jeepneys will be very well, very lovely in a warm and open and sympathetic.
I'm delighted, you know, that you have phoned in.
But, I mean, we all know that, you know, some doctors don't have that sort of manner and perhaps they're feeling very pressured, perhaps there.
Oh, my goodness. I don't know how to deal with this. So if you're unlucky, you know, you may have a false start.
And I think if that happens to you, don't lose heart and just ring back the next day or ring back and speak to another doctor.
Rebecca was saying the same because, you know, we are here very much for you and we do want to try to get your help as quickly as possible.
So, yeah, just see if the system doesn't work for you the first time. Try again.
There's one other thing I wanted to mention, which is because people find it so difficult to present directly with our eating problem,
they will often come in and see the doctor or phone in at the moment with with problems that are actually secondary to the eating disorder.
So typical things would be tummy troubles, you know, irritable bowel syndrome or constipation, tummy ache,
loose motions, or they may have period problems, irregular periods or periods have stopped completely.
They could be feeling very anxious or depressed and present with those symptoms.
And so the GP will cottoned on to those. And very often then you go down a route of investigating and even referring sometimes on to a
gastroenterologist or a gynaecologist when we're missing completely what the real problem is,
the underlying problem. And then so there can be a big delay there.
I think if if patients are aware of that, then perhaps they can help a GP to get to the diagnosis more quickly.
And then, of course, when we move on, there are barriers. Even when you've been referred as we're going to touch on now where the long waiting times.
Yes, absolutely. Thank you. But it sounds like key messages. Yes.
Try to be as a parent as you can about the various symptoms related to anything and to really possessed.
And I think, you know, if you don't feel a rapport with the first GP,
you talk to your perfectly entitled to ask to speak to another doctor, you know, and and it's and it's easy to do, actually.
So don't let that be a stumbling block for you in getting help.
Yeah. Great. Thank you. Very helpful advice. Yes. So I asked you touched on there.
Obviously, some people did raise in advance of this session that they can sometimes be long waits for eating disorders, services.
And so really the question was about where can people get support in the meantime?
But also they can we anticipate changes in service availability for eating disorders going forwards.
So, Rebecca, maybe I could come to you, first of all. Yes.
Thank you. Thank you, Cathy, and I've enjoyed hearing from everyone as well.
So I mentioned a little bit in my talk about other sources of support whilst of waiting for treatment, including staying in contact with your GP.
Looking at the resources available on beat and self-help programmes.
And in terms of changes in service availability, back in 2015, 2016, there was a guide.
There was some sort of guidance put in place which said that for children and young people that they shouldn't have to wait too long for treatment.
And they actually specified the services needed to see them within one week for urgent cases and within four weeks for non urgent cases.
So this was a sort of standard put in place for children and young people.
And it was very much influenced actually by campaigning that people dead, including Bayt,
who played a key role in really saying, look, people can't just wait for treatment for this period of time.
And so this this sort of guidance was put in place. And it's taking time for those sort of changes to filter through.
But actually, that's that's really helpful.
And I think what the NHS are now doing as well is they're piloting in a few specific areas using that guidance for adult eating disorder services.
So I think there is a big push towards early intervention and recognising how crucial that
is for eating disorders and how unacceptable is really for people have to have to wait.
Many people have to wait several months at least for treatment.
And I would encourage people to keep kind of campaigning and lobbying their MP because it's really difficult to do,
especially if you're affected by it, because it's very emotionally exhausting.
But I think it does make a difference. And I know other campaigns have been in place, for example,
around making sure that medical staff are better trained so that they can actually recognise and understand eating disorders,
so that we can sort of help with those kind of initiatives, the initial barrier to help seeking.
So I think, you know, there are barriers,
but I think we need to think together as professionals and also other sort of patient groups about how to overcome those.
And I think we are making some progress. Kate and Debbie, did you want to add anything to that?
I mean, I completely agree with Rebecca, and I feel terrible that people are having to wait so long.
I mean, I think it can be for longer than months at the moment in Oxford.
You know, it's I think the waiting time at the moment is every year for especially psychological treatment as an outpatient.
I mean, I think I would say if you're in that position on the waiting list,
please keep in touch with your GP and you may need to be a bit proactive about that.
We're not terribly good at remembering to ring people regularly, particularly the moment with kov it.
But if you could perhaps get in touch with the GP every couple of months and ideally you should actually come in and
have a quick physical chat be weighed and you may need blood tests and things depending on what the eating disorder is.
But if we find that your weight is dropping rapidly or your condition is deteriorating,
then we can right back to the specialist and appeal to them and ask to expedite your treatment.
And similarly, the eating disorder service will usually contact patients every three months or so just as a want to monitor them.
And as a safety net for the same reason. I think that certainly happens in Oxford.
Great. Thanks. Thanks very much. So we had to. Obviously, we've talked talked a lot about treatment, importance of getting treatment.
One of the questions that we asked was really about what the likely hit is, that people can actually ever make a full recovery from Levithan.
Everything they thought of, say, Rebecca, I know you picked up on this a bit in your toe, but I wonder if you could say a little bit more about that.
Yes, of course. And I think it's an important question.
Well, what kind of we we tend to say is that in terms of getting better, that you should be aiming for full recovery.
So sometimes when people say, you know, I've had treatment and did it was it was it was quite helpful.
But, you know, for the last 10 years, I'm sort of still having problems.
And maybe I just need to accept this is the way things are.
I would say that actually eating disorders, they don't have to be chronic in nature.
I think that that's assuming that, you know, you haven't fully responded to treatment,
so maybe you haven't had enough treatment or you haven't been able to implement the strategies from treatment for long enough.
Or maybe you need to go back and get this top up or receive another treatment.
What we definitely don't want to do when we help people to get better is to sort of aim for partial recovery.
I think people need to get fully out of their eating disorder because if you're sort of trying to go around with a bit of an eating disorder,
it's likely to just sort of slip, really.
So that that's one thing I would say that I really don't think eating disorders need to be chronic unless they are untreated or inadequately treated.
However, having said that, I think it's worth just being mindful that sometimes eating disorders can be a bit of well, they're often an Achilles heel.
So even if you recover and you well during times of stress and sort of difficult difficulties in your life,
or perhaps you may experience a depression or something like that, then actually the eating disorder might get triggered again.
And you might have a lapse in terms of your reaching and.
But what a good treatment will do is it will prepare you for that so that you can recognise the early warning signs.
And you know what you need to do to sort of get back out of it, if that helps answer the question.
Yeah. Thank you very much. And we also had questions about kind of why that KOPECEK about fate and how this might contribute to eating disorders.
And it really came to hear about your thoughts on this, about, you know, for example, sometimes people use food as a reward.
You know how we talk about seafood in our why this sort of cultural environment.
So many came to hear your thoughts on the role that the wider food culture might have in relation to eating and so to up.
And can we come to you first about that? Yes. Thank you.
Thank you, Kathy. So I think we're all very aware of the relationship between food and reward.
We think of food as being this substance that we eat for a reward.
But but more fundamental than reward and pleasure we get from food is discussed the feelings of nausea,
that food can generate anxiety, the negative sort of nervous feelings that food can generate.
And much of the much of the research that's been done on this in the neuro or neurobiology of hunger shows that that,
for instance, animals need to learn, for instance, that food reduces hunger and they need to learn that food is not disgusting.
So the starting point is that food is disgusting and and being hungry generates anxiety.
And those that the neurobiology of that suggests that effectively what what happens during life is this learning process.
Overcoming those initial tendencies to find food rewarding.
So the general culture thinks of food as this great thing that's on Master Chef, and everyone loves it all the time.
But there is constantly that that background of anxiety.
Animals get anxious without food. Animals show those disgust responses.
So so learning fundamentally about how to how to respond to those feelings.
And just to pick up on on Rebecca's point, I think about we imagine maybe that eating disorders might be like Kovar.
It's a virus that if it goes if we treat it, it goes away.
But psychological disorders aren't like that, primarily because we have memories and we will always remember that feeling that we had,
you know, that negative feeling, that experience that we had, whatever the context in terms of with food.
And that will always be a possible trigger or might be triggered by particular things.
So as Rebecca was saying,
when there's always mindful that that time these things are not eliminated because we have memories in our memories for these things,
some are imposed. If I know we're getting near the end.
But the wider context, I think it's just interesting to think about Kofod,
because in these animal models, what's been shown is that animals will demonstrate.
Lack of eating.
They will starve themselves to death under situations in which there is a relationship between the exercise that they're being allowed.
They can be given unlimited exercise and limited periods of time with food.
And even though there's enough food for them to eat, they will behave in a way that's just that that shows they're being disrupted by those schedules.
And they will not eat enough. And in covered world, obviously, one of their big a big effects.
I've walked into supermarkets where there is no food, where, you know, that we didn't know where we're going to get our food,
where exercise regimes are being being challenged by being only allowed to go out once a day.
But even those small changes in our big changes in our food consumption, on our scheduling of food,
our scheduling of exercise, partly due to this this culture that we're in will have profound impacts.
And so it's not it's not unexpected that people are reporting now that these that
their feelings are are not what they expected and perhaps they need support.
I did that answered maybe two questions there. Thank you. Thank you. Yeah. That's really interesting.
Thank you. Definitely. You know, important to think about the current challenges that people are facing as well.
Just one very brief question. I suppose, given the sort of impacts off of our wider experiences with food and why the food culture, it's you know,
it's not unlikely that people who struggle with eating disorders are going to be interacting with others.
He might be engaging in of dieting or high levels of exercise or restricting certain sorts of food,
which might make it particularly difficult for people with eating disorders to live it amongst.
And Debbie, outputted, if you've got any quick advice that you would give to people in that situation.
I mean, I think it's a really toxic environment, isn't it?
If you got an eating disorder and you're hearing about is how to get rid of that fact that you've put on during a pandemic,
you must do these exercises and things. So you almost caught up in that then they're bound to follow that.
So I think as friends and. Therapists,
we should be helping people really to see that that's really unhelpful for them and not to take those cues and behave in that way because essentially,
you know, it is fuelling their eating disorder. Actually,
that the resources that Rebecca shared earlier for four loved ones of people who are struggling with eating hopefully would be very helpful there.
So thank you all very much for a really interesting and informative discussion.
It's so good of you to give your time. And I'm sure people have found it extremely helpful.
So huge. Thanks. Also, thanks to those people who sent in questions and of course, massive thanks to Halie and Kyle,
who've done lots of work behind the scenes to make this all happen.
Just to highlight again that our next meeting will be on coping with trauma and that will be on the 6th of May.
And we've also rescheduled the last session, which unfortunately we had to move.
That was on overcoming mistrust and paranoia, and that will now be on the 20th of May.
So hopefully we'll be able to join us for those as you leave the meeting. You'll get a chance to give your feedback, please.
Do you share it? Because we definitely look very carefully at it and use it going forwards.
And then final word just to say, please do take the next 10 minutes. So say to up to readjusts before things maybe kick off here again at one o'clock.
If if your is full like that, say please take a moment, take some time, have a look at the resources that have been shared if helpful.