This life: Recovery position

Visiting some friends in eating disorder units (EDUs) has made
me think about the best methods of helping those with anorexia. The
conditions in these units aren’t always those which are going to
promote recovery.

EDUs often virtually force feed patients whether informally or on a
section. Patients accept that they have to eat to get out of the
unit and to avoid peer pressure but resent every mouthful. On some
units those who try to leave the dining room at mealtimes are
physically restrained – occasionally a patient is pinned down and
fed high-calorie liquid through a syringe down her throat for
refusing to eat.

There can be 24-hour toilet supervision or patients have to use a
commode to conserve energy if on bed rest. Patients are often
weighed early every morning and the day involves shuttling between
the dining room and the lounge for rest periods.

I am a recovered anorexic who was once under the care of an EDU for
18 months and in a residential project for two years. I had two
in-patient admissions lasting six months each time. I was funded to
go to a private clinic since there was a long waiting list to get
into the nearest NHS hospital EDU.

The difference between the care I received and what some of my
friends have experienced is that there was a programme on the unit
I was in. There was a morning group every day, a weekly
psychotherapy group, drama therapy, body image work, yoga and OT
groups such as assertiveness. The food was high quality and we were
given a choice. I met an eating disorders dietician who I talked to
every week about all my food worries. She convinced me fat wasn’t
deliberately being added to the food and there was nothing hidden
in it. However, my anxiety was over-medicated and I was given
strong antipsychotics that usually knocked me out. Sometimes it was
distressing to watch very ill patients being spoon fed and we all
had to sit at the table until everyone had finished.

In-patient care should still be there for those with eating
disorders whose weight is life-threatening or with health problems
resulting from starvation, laxative abuse or vomiting. There also
needs to be a high staff-to-patient ratio with a lot of support at
mealtimes instead of just surveillance. Food should be appetising
and not just the usual hospital fare. Therapy should be on site and
ward rounds at least every week. A primary nurse should be
allocated and seen every few days – time with other staff should be
unconditional. Social workers should be connected to the

People in the community with anorexia should be provided with
therapies and long-term work with therapists, social workers or
psychiatric nurses. Weight should be monitored in case it falls
dangerously but professionals must realise it is not always a true
indicator of how someone is feeling.

Alex Williams is a volunteer and uses mental health

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