eating disorders
help services Mental Health First Aid Training and Youth Mental Health First Aid Training resources include: England:
http://www.mhfaengland.org Scotland:
http://www.smhfa.com/index.aspx Northern Ireland:
• • • •
http://www.publichealth.hscni.net Wales:
http://www.mhfa-wales.org.uk B-eat:
www.b-eat.co.uk Time to Change:
http://www.time-to-change.org.uk
if they would like their programme reviewed. They can tentatively explore if the person exercises when ill or to compensate for eating, if they feel anxious if they miss a session, if they exercise in secret – all potential signs of exercise misuse. Similar questions could be added within standard health screening procedures. Simply asking someone how they are
may well be the invitation they need to open up. Eating disorders offer a source of comfort, control, and keep the person safe within their self- made consistent, dependable comfort zone. However, they may recognise the problem and want to recover (contemplating change) but may be scared or ambivalent. Exercise professionals and managers
could be trained to use motivational interviewing techniques to gently challenge ambivalence. Learning these skills will help them to provide more effective interventions for all members looking to make lifestyle changes. Referral and support: The first
port of call for referral is the person’s GP, who will diagnose and then refer on to other support services. In the UK, eating disorders are treated by a combination of psychotherapy, nutritional counselling and medication (anti-depressants). Adults with anorexia may be referred to specialist eating disorder services, while children/ adolescents are referred into child and adolescent mental health services. Challenge stigma: Help to
remove the fear, ignorance and shame attached to all mental health conditions by connecting with national campaigns (such as Time to Change) and even organising fundraising events to support allied charities. Promote annual mental health events (World Mental Health Week, Stress Awareness
56
Day) by organising a range of mind-body programmes (Nia, ChiBall, pilates, yoga, relaxation, mindfulness) to celebrate mental, and physical, health. Promote body confidence: Use
Need for vigilance: Eating disorders affect 1.6 million people in the UK
realistic body images to advertise and promote services. A primary target for exercise is improving health, and there is no single image of a perfect body. Promote healthy behaviours:
Provide leaflets or talks on the risks of over-exercising and steroid misuse, as well as more positive topics such as healthy exercise, healthy eating and the energy balance required for exercise (food is fuel). People may not be aware that a behaviour is problematic, or that it may place them (or someone else) on the pathway to developing a problem. Exercise – a double-edged sword:
Exercise offers numerous benefits to combat the debilitating effects of eating disorders, both physically (improving bone density, decreasing risk of CHD etc) and psychologically (improving mood, self-esteem, confidence, body image and reducing anxiety). There is also evidence to suggest that exercise reduces binge eating. However, exercise may be over-used
by individuals with eating disorders to control weight, and a medical assessment may identify exercise as a risk factor for maintaining the problem. Yet refusing or restricting access to the gym may not be the solution: they will find other ways. Exercise professionals should consult with GPs and other professionals to find an appropriate way forward. There is currently insufficient evidence from which they can prescribe exercise specifically for eating disorders, so any advice provided should be in accordance with recommendations from other professionals involved in the person’s treatment plan.
Read Health Club Management online at
healthclubmanagement.co.uk/digital
conclusion Mental health is a societal issue and is everyone’s business. No-one develops an eating disorder overnight – they develop over time, and must be acknowledged and treated appropriately to promote recovery. Currently, just 50 per cent of those
diagnosed with eating disorders recover fully. No-one can be held responsible if a person ignores advice or denies there is a problem, and sometimes caring support is rejected and fuels the denial. However, we are accountable for the
information that we offer or do not offer. Ignoring or dismissing a person who is experiencing mental health distress is the equivalent to walking past someone who has been involved in an accident or medical emergency. We need to ensure we have the knowledge and confidence to play our part in addressing the issue.
ABOUT THE AUTHOR Debbie Lawrence, MA, is co-author of the recently published Complete Guide to Physical Activity for Mental Health (Bloomsbury Publishing). She is a qualified counsellor and trained with Mind Cymru to deliver youth mental health first aid. She has developed and delivers the Level 4 Physical Activity for Mental Health qualification for Moving Minds Training and Fitness Wales. LinkedIn:
http://uk.linkedin.com/ pub/debbie-lawrence/29/2aa/3a
healthclub@leisuremedia.com debbie lawrence
january 2012 © cybertrek 2012
PHOTO:
ISTOCKPHOTO.COM/ARTIN NOVAK
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