Lincolnshire mental health team shares tips for eating disorder care

The holiday season brings joy for many, but for those with disordered eating eating, Christmas can heighten pressure and struggles with food.

Social events and food-related gatherings can heighten anxiety and stress for patients and their families.

Following the Covid-19 lockdown, the number of people reporting eating disorders has spiked.

In Lincolnshire, the number of children and young people accessing specialist eating disorder treatment has risen in recent years.

Between 2019 and 2021, in particular, there was a 130% increase in eating disorder referrals in Lincolnshire.

Lincolnshire Partnership NHS Foundation Trust’s CAMHS - a mental health service - sees around 60 young people for eating disorders each year, peaking at 90 in 2021–22.

Nationally, the numbers peaked at 12,460 young people accessing treatment for eating disorders across the UK in 2021–22, up from 7,580 in 2018–19.

Although figures have dipped more recently, they remain above pre-Covid levels and fluctuate during periods of heightened stress, such as exams and school returns.

Health bosses are keen, however, to emphasise that eating disorders can affect anyone, regardless of age, gender, or background.

“They’re not exclusive to a young person accessing more social media than somebody who isn’t; it’s difficult to narrow down and say it’s X, Y and Z,” said Kerry Bowles, who leads the LPFT eating disorder team.

Amy Butler, head of children and young people’s services at Lincolnshire Partnership NHS Foundation Trust (LPFT), said: “It’s a mental health condition that is far less influenced by some of our societal factors like deprivation.

“Evidence tells us that if you’ve got a child living in an area of high deprivation, they’re more likely to have mental health needs, but actually, with eating disorders, it definitely doesn’t discriminate in that way.

“If anything, sometimes it can be our more affluent families that tend to have more challenges around eating disorders. So it really does go against the grain in terms of the young people and families that it impacts.”

The LPFT team emphasises the importance of reaching out for support if you’re concerned about someone’s eating or weight, and not self-diagnosing.

Lincolnshire offers accessible mental health services with a direct referral system and self-referral options.

Speak to trusted adults, professionals, or services like Beat and FREED for resources and advice.

“In Lincolnshire, we’re really fortunate because our mental health services have a front door; we have an access point for people.

“So our advice is always to speak to a trusted adult, speak to a teacher or GP, but equally, there are routes through which people can access us directly for advice, support, and referral.

“If you’ve got a concern about mental health or someone’s well-being… you don’t need to meet a diagnostic criteria. If you’re concerned, reach out for some support.

It doesn’t necessarily mean referral into a service; it can just be that actually, we are here to provide some expertise and advice.”

FREED (First Episode Early Intervention for Eating Disorders) says the holiday season, especially Christmas, presents unique challenges for those with eating disorders.

The organisation has released a pamphlet, 'Eating Disorders: A Guide for Christmas & the Holiday Season,' with tips for patients, families, and supporters.

With an increase in social events and food-related gatherings, both patients and their families may experience heightened anxiety and stress.

FREED offers practical guidance to help people navigate these challenges, stressing the importance of planning and communication.

Kerry and Amy stress that open communication and understanding are key to supporting those with eating disorders and mental health challenges.

“It’s really important to be open with any young person, no matter what mental health difficulties they’re having – eating disorders or otherwise.

“What’s important is that you ask them, ‘What can I do to help you and what’s going to be helpful for you, for instance, tomorrow evening when we all sit down to eat, when we’re having family members round in the next few days?’” said Kerry.

“It’s about seeing what adjustments can be made to make that better; it’s the most important question you can ask.”

Amy added that ensuring a young person felt listened to would help empower them and provide a sense of control.

Expecting a 'picture perfect' Christmas can lead to feelings of lost control or devaluation if plans go awry.

For individuals struggling with eating disorders, FREED suggests preparing for social events by discussing potential difficulties with close family or friends ahead of time.

This includes managing comments on appearance or food intake, which can be triggering during festive gatherings.

What could be perceived as a “positive comment” to many, such as praise for weight gain or loss, can have a negative impact on someone with an eating disorder.

“Others may discuss their own diets and unhelpful thoughts about food, weight, or exercise at this time of year,” says the guide.

“Have an escape plan for these conversations and anticipate how you can challenge this talk in your own mind.”

It’s also recommended that individuals visualise the event beforehand and, if needed, take mini breaks to remind themselves of their progress.

Practising social situations with a trusted person can also provide reassurance.

In terms of holiday meals, FREED advises planning the timing and portioning of food to reduce stress.

Plating meals in advance can help avoid comments about food.

“Sit-down meals like a Christmas dinner can be really challenging when you have an eating disorder.

“Once again, planning is key, as last-minute or rushed decisions can be stressful. Some people find it helpful to have a practice Christmas dinner with just one or two trusted friends or family members ahead of time.”

For those receiving inpatient treatment, FREED encourages open communication with the treatment team to ensure adequate support during the festive period.

For families and supporters, FREED recommends creating a relaxed atmosphere with distractions like games or music.

Preparing for potential difficulties and ensuring support for the person with the eating disorder can help create a more positive and inclusive holiday experience.

The full guide can be found here.

Lincolnshire residents have access to a dedicated eating disorder service.

Established in 2016, the LPFT team provides timely, specialist support, with appointments offered within a matter of days depending on the severity of the case.

“We’re really proud of the service we’ve built here,” said Amy.

“Not only do we meet national access and waiting time standards, but our team goes above and beyond to reach out to young people and families across the county, including in more rural or deprived areas.”

She said the county was “very fortunate” to have the resources available.

The team highlights online resources like BEAT and FREED, offering support for those with eating disorders.

As the festive period approaches, the message from Lincolnshire’s eating disorder experts is clear: reach out for help if you have any concerns, and remember that you are not alone.

With the right support, the holidays can be navigated despite eating disorder challenges.

Where can you get help?

- If you or a loved one has concerns about eating disorders, there are several options available.

- For help, call the NHS 111 Emergency Mental Health Support line (dial 111 24hrs a day), which links directly with local crisis teams.

- And the Lincolnshire Here4You advice line on 0800 234 6342 (open 24/7) for anyone seeking emotional wellbeing and mental health support for children and young people, open to parents too for help and advice.

- LPFT also has a confidential self-referral form available here: https://www.lpft.nhs.uk/young-people/lincolnshire/young-people/self-referral/self-referral-form

- The Samaritans offer a free 24/7 helpline at 116 123, providing round-the-clock support. You can also reach them by email at jo@samaritans.org or visit samaritans.org for local branch details.

- For additional resources and information, FREED can be found at: https://freedfromed.co.uk/

- Beat Eating Disorders is also available at: https://www.beateatingdisorders.org.uk/

- Lincoln County Hospital also has a Mental Health Urgent Assessment unit attached to the A&E department and dedicated teams available in emergencies to assess mental health issues.