A patients guide to Eating Disorders
SYMPTOMS, TREATMENT AND SUPPORT
You are worth more
Although my problems will always be in the background, I like to think I will get better. For now I am just looking forward to moving on.
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Can’t find what you’re looking for or need general assistance with any aspect of information or a referral?
Contents
you can contact our central enquiry line on
Who are we?
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0854 467 0120 24 hours
Living with an Eating Disorder?
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Alternatively please email us at: huntercombemarketing@fshc.co.uk
Physical Symptoms
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How do you know if you have an Eating Disorder?
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Our Eating Disorder Services
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Case Study: Charlotte’s Story
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Our Eating Disorder Services Locations
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Useful information
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How to make a referral
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www.huntercombe.com
Edited by Dr Mark Earthrowl Consultant Psychiatrist Eating Disorders Huntercombe Hospital Maidenhead
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Who are we? At The Huntercombe Group we provide three specialist areas of care: Adult Mental Health, Specialist Brain Injury and CAMHS (including eating disorders). With 55 hospitals and specialist centres across England and Scotland, we work in partnership with the NHS and Local Authorities to provide person-centred quality health care services.
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Living with an eating disorder? Our Eating Disorder services are delivered across 4 of our 5 CAMHS hospitals for children and young people (from the ages of 11 to 25 ) at Huntercombe Hospital – Edinburgh, Huntercombe Hospital – Stafford, Huntercombe Hospital – Maidenhead and Huntercombe Hospital – Cotswold Spa. Our eating disorder services are established and wellresourced. We have gained a proven track record of working successfully with young people even with the most severe eating disorders. The Huntercombe Group are now considered one of the leading eating disorder treatment providers in the UK. Our Consultant-led multi-disciplinary teams include: doctors, nurses, therapists, physiotherapists, dieticians, occupational therapy assistants, social workers, teachers and catering teams. We provide care and treatment seven days a week, 365 days of the year. We also operate an emergency admission programme for patients who require immediate admission and treatment in an in-patient environment.
Eating Disorders are serious mental conditions that stem from feelings of low selfesteem and an inability to cope appropriately with concerns and problems in everyday life. Eating Disorders can cause both physical and psychological symptoms in equal measure leading to a significant deterioration in physical health and wellbeing.
At The Huntercombe Group we understand just how complex and challenging these disorders can be and we believe that recovery and improvement can be achieved with the right care and treatment delivered within environments that are age appropriate and outcome led. We offer programms of treatment for: • Anorexia Nervosa • Severe Bulimia Nervosa • Other associated eating disorders (EDNOS) And whose health has deteriorated as a result of their illness. Anorexia in itself is now the third most common chronic illness amongst young women* (young men are also affected by the condition with a 27% increase in male diagnosis between 2010 and 2013*) Both disorders include a pre-occupation with food and intake of food either significantly in consuming large amounts then purging (Bulimia) or significantly reducing or lowering your calorie intake, both disorders can also often be associated with over-exercising.
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Physical symptoms of both conditions can vary but may include:
Physical symptoms of both disorders are distressing and challenging but so too are the psychological symptoms which can include: feelings of guilt and worthlessness, exercising excessively, depression, anxiety, isolation and unrealistic opinions about body weight and shape, taking appetite suppressants (such as diet or slimming pills) and making yourself vomit after meals. It’s important to note that eating disorders affect everyone differently and if you are at all concerned about these symptoms or the symptoms of a loved one you should seek help as soon as possible. In the first instance this would be your GP, or if you are already under the care of a psychiatrist or mental health team you should inform them. Finding the right treatment and care for these complex disorders can be difficult and often more severe cases can only be improved following admission to a specialist hospital for the treatment of eating disorders, where care will involve not only managing your physical symptoms but your psychological and emotional symptoms as well.
Anorexia Nervosa
Bulimia Nervosa (severe)
• Severe weight loss
• You may have a sore throat (from purging)
• Feeling anxious or nervous
• You may feel anxious or nervous,
• You may have difficulty sleeping and/or feel tired all the time
• You may also notice you have bad breath and be suffering recurrent mouth infections
• You may feel dizzy
• You may experience stomach pains
• Stomach pains
• Your periods may be irregular (girls)
• You may also notice growth of downy hair over the body (Lanungo)
• The condition of your skin may be poor
• For girls periods may stop or may not start at all • You may feel cold • Suffer from constipation • You may notice your hair falling out
• You may have difficulty sleeping • You may be experiencing symptoms of de-hydration • You may feel faint • You may have kidney and bowel problems
• You may also feel moody and irritable
Behavioural Symptoms • Perhaps most characteristic of all is feeling you are fat when you are in fact underweight. • You may have dry skin and brittle nails. • Missing meals, avoiding fatty foods or eating very litle. • Lying about what you’ve eaten. • Lying about how much you weigh.
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How do you know if you have an Eating Disorder? GP’s use a questionnaire called “SCOFF” to identify the symptoms of an Eating Disorder. They do this by asking the five questions alongside. If you answer “yes” to two or more of these questions then you may have an eating disorder, and if you haven’t already we recommend you make an appointment with your GP.
Sick Do you ever make yourself sick because you feel un-comfortably full?
Control Do you worry you have lost control over how much you eat?
One stone Have you recently lost more than one stone (or six kilograms) in a three-month period?
Fat Do you believe yourself to be fat when others say you are too thin?
Food Would you say that food dominates your life?
Our Eating Disorder Services Our specialist eating disorder hospitals are for children, young people and young adults (aged 11 to 25 years old) suffering from severe eating disorders and who have not responded to community based healthcare intervention (we refer to this as Tier 3). The Huntercombe Group provides assessment and treatment for children, young people and young adults on both an in-patient and intensive day patient basis. With each patient we take a holistic and evidence-based approach to treatment and care, led by our teams of specialised healthcare professionals patients are placed at the centre of their own care, Our teams offer a range of treatment options and methods of approach that optimise the prospect of patient recovery, even in cases where treatment has been unsuccessful previously. We are also able to manage patients admitted at a very low body weight. The ethos of our work at The Huntercombe Group is to form trusting relationships with our patients and their families and encourage patients to focus on understanding and dealing with their feelings as well as achieving physical recovery and weight normalisation.
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All our hospitals feature on-site schools so patients are able to continue with their education by working alongside teachers and tutors to continue their studies whilst their treatment programme is underway. We encourage patients to work with their families to take a lead in their own care and once the patient begins to improve, with our high levels of specialist input, they and their families are supported in discovering how to make a successful transition to on-going recovery back in their home environment with their local services. This transition is aided by the gradual introduction of therapeutic weekend home leave as soon as it is safe and likely to be helpful to do so.
“ We firmly believe recovery is
possible and that by working in partnership with our patients we can promote, enhance and maintain their recovery through empowerment ”
*Inside Anorexia – Christine Halse, Anne Honey and Desiree Boughtwood *Kings College London: Number of people in the UK diagnosed with eating disorders is increasing
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Case Study
Charlotte, aged 18, suffered an eating disorder after being bullied at college and suffering immense exam stress. After an eight-week therapeutic programme at one of our hospitals she is “ready to move on” to university.
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Charlotte’s Story At the beginning I didn’t think anything was seriously wrong. But I was weighing myself every day, and was really unhappy at college where I was bullied. Plus I was having a lot of stress with my course work. My confidence and selfesteem went right down. On some days I did not eat anything.
Staff have helped me with relaxation and stress management. I have also been involved in Cognitive Remediation Therapy.
I must admit that at first I did not want to go to hospital. I was too upset, and was worried that I would be bored and lonely. But I discovered that with everything going on – and all the help that is offered – there is no time to be bored or lonely!
The hospital has great facilities – it feels relaxed but still professional! And having a young staff team is definitely good. It feels as though staff are on your side and genuinely want you to achieve your goals and get well. This has really helped improve my confidence, and to apply to university. Before I had little motivation to do so.
Since being at Huntercombe I have felt so much better. In fact, rather than having gone to other services first, I wish I had come here as soon as my problems started. This would have prevented me from getting as ill as I did.
They have also helped me with school work, producing my CV and making university applications. In the end I received offers from three universities – Leeds, Southampton and Birmingham! I can’t believe it im so pleased at how far I have come.
Although my problems will always been in the background, I like to think I will get better. For now I am just looking forward to moving on.
Our Eating Disorder Services Our services fall into two main categories:
Amazing Staff Charlotte’s mum explains how staff at Huntercombe involved the whole family in its therapeutic programme.
CAMHS Specialist Eating Disorder Service (for children and young people from the ages of 11 to 18 years old)
Eating Disorders – Young Adults (For young adults from the ages of 18-25 years old)
These are offered at the following locations The Huntercombe Hospital – Edinburgh www.huntercombe.com/edinburgh
The Huntercombe Hospital – Maidenhead www.huntercombe.com/maidenhead
Binny Estate, Ecclesmachan Road, Uphall EH52 6NL
Huntercombe Lane South, Taplow, Maidenhead SL6 0PQ
Telephone: 01506 856 023
Telephone: 01628 667881
Email: huntercombe.edinburgh@fshc.co.uk
Email: huntercombe.maidenhead@fshc.co.uk
Delivers: CAMHS Specialist Eating Disorder Service
Delivers: CAMHS Specialist Eating Disorder Service
Unfortunately not only was the building itself so depressing, we felt that as a family the service was cutting us off. For example, we were told we could not discuss how Charlotte was getting on because of patient confidentiality.
It was then following some research I found Huntercombe, we arranged to visit and Charlotte and I knew this was the place she would begin her recovery. From that moment on, Charlotte has significantly improved and she has begun University, without Huntercombe I know this would not of happened.
The Huntercombe Hospital – Stafford www.huntercombe.com/stafford
The Huntercombe Hospital – Cotswold Spa www.huntercombe.com/cotswoldspa
Ivetsey Bank, Wheaton Aston, Stafford ST19 9QT
Station Road, Broadway, Near Worcester WR12 7DE
Telephone: 01785 840 000
Telephone: 01386 853 523
Email: huntercombe.stafford@fshc.co.uk
Email: huntercombe.cotswold@fshc.co.uk
Delivers: CAMHS Specialist Eating Disorder Service
Delivers: CAMHS Specialist Eating Disorder Service (in-patient)
Charlotte’s dramatic loss of weight coincided with her having a really difficult time at college. I also noticed small things, such as her taking more interestthan-usual when I was cooking. We have always been close as a family, and Charlotte agreed she had lost weight and did not want to lose anymore. But Charlotte’s weight continued to drop every time she went to the GP. It was a very upsetting time, and our anxiety levels were really at a height. Eventually she was referred to an NHS eating disorders outpatient service.
24/7 emergency admission available
24/7 emergency admission available
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24/7 emergency admission available
Eating Disorders – Young Adults (in-patient) huntercombe.com
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Useful Information
How to make a referral
You may ďŹ nd these sites and sources of information useful B-eat is a national eating disorder charity. Their website contains lots of advice, support and information. www.b-eat.co.uk NHS Choices is the national patient choice website and contains information relating to symptoms. www.nhs.co.uk Mind is a mental health charity, which offers some information on eating disorders. www.mind.org.uk Young Minds provides the latest up to date, easy read information for parents and patients. www.youngminds.co.uk Royal College of Psychiatrists provides a series of factsheets on eating disorders www.rcpsych.ac.uk The Association of UK Dietitians Dietitians have a key role to play in the management of patients with eating disorders. Their website outlines the role of their work with patients. www.dietitianmentalhealthgroup.org.uk
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A referral can be made by contacting the relevant hospital directly on the contact details listed on page 13. Referrals to the eating disorder services for inpatient treatment will only be accepted from the consultant or designated team member from the patient’s local NHS, CAMHS or CMHT, or from another inpatient service where the referral is supported by the local NHS team and commissioners. Funding for in-patient care is usually through NHS commissioning channels. Depending on the specific circumstances we may be able to accept private/insurance funding but would still require a referral from a consultant or commissioning team. Our Eating Disorder Consultant or Associate Specialist at our hospital will discuss the case with the referrer by telephone the same day to agree an immediate action plan. This may sometimes involve a planned admission within the next few days ( based on the local team’s prior assessment, and discussion with us) or an assessment with our team ( within 1-2 weeks). Patients who are physically or psychologically unsafe to remain in the community can be admitted within 24 working hours where indicated on the above contact details.
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The Huntercombe Group Tulip House, Craven Court Willie Snaith Road, Newmarket Suffolk CB8 7FA
@HuntercombeTHG
Telephone: 0845 467 0120
The Huntercombe Group
Website: www.huntercombe.com
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Telephone:
0845 467 0120 Website:
www.huntercombe.com The Huntercombe Group is part of Four Seasons Healthcare one of the largest healthcare operators in Europe.