Siubhán O’Donnell’s story conveys a message of hope, and that is very important, says Dr Sarah Prasad, consultant psychiatrist with the eating disorders programme at St Patrick’s Mental Health Services in Dublin.
“Early presentation for treatment of an eating disorder is key to a good recovery rate and a normal life. Recovery is always possible,” she says.
There are two peak ages for first presentation with eating disorders; adolescents, and young adults aged 18-26. Both of these are times of physical and emotional change, and it may be that someone who is struggling will look for something to control; this becomes a coping strategy when other parts of their life, such as the transition to or from secondary school, are difficult.
Prasad says treatment programmes for patients in the younger age group usually involve whole families. Older teenagers and people in their early 20s who are affected are making the transition to adulthood and are more focused on themselves as a person.
The origins of eating disorders are very complex. There is no one root cause of eating disorders, but Prasad says comprehensive evaluation of a patient shows a combination of factors.
For example, a person with low self- esteem might idolise cultural norms or stereotypes such as bodyweight, or might value what they consider perfection. They might start to believe, for example, if they are 10kg lighter and have a more socially acceptable figure, they will feel better or be more popular.
They are often perfectionists who strive for A grades. They might be traumatised as a result of bullying or abuse. They could be an athlete who has always paid very close attention to their diet.
“Eating disorders are not just about looking good,” says Prasad, whose patients range in age from late teens to mid-50s. Some people develop disorders in their 30s; it often happens that vulnerable people can take the “looking good” message to extremes, at any age.
The development of a disorder is very complex and could be rooted in childhood or early adolescence, when self-esteem is formed.
“There could be elements of depression, anxiety and family history,” says Prasad. “There is pressure on women of all ages in terms of weight and shape.”
Prasad says it is important for parents who are worried their child has an eating disorder to engage with them about it. (About 10 per cent of her patients are male.)
If the child becomes defensive, it is better not to attempt to diagnose them at home but to seek help from a GP, who can refer them to an expert. The amount of help available varies around the country.
Prasad’s team at St Patrick’s comprises clinical nurse specialists, a psychologist, a dietitian, a nurse co-ordinator, occupational therapists, a social worker, a junior doctor and a cognitive behavioural therapist.
If you are worried that you or someone close to you has an eating disorder; if you feel eating controls their life, or yours, and has an impact on how they live, you should seek help from a GP, or from school counsellors or student services, who can refer you to an expert.
