It’s not like you have cancer or any life threatening illness – family doctor

It’s not like you have cancer or any life threatening illness – family doctor

“It’s not like you have cancer or any life threatening illness …. See you in four weeks.”

– GP in Australian town, August 2013

This is 2013 and here is a family doctor who does not understand the seriousness of Anorexia Nervosa. This doctor is not alone in his ignorance (surely it must be ignorance). His deplorable summing up is a stark reminder that our medical practitioners need to be educated about eating disorders. Urgently. Now.

Why?

Because ignorance can lead to misdiagnosis; it can be triggering and cause severe relapses. The words above were spoken yesterday to a mother of two young children.

This mother recently spent more than two months in a private clinic in a capital city, many miles from her home, for treatment of her chronic Anorexia Nervosa. Yesterday, she sought to see a local doctor because she has been experiencing relapse symptoms. She drew on all of her courage to make the appointment in the first place.

Her eating disorder was telling her to stay home, it was shouting in her brain that she was weak for seeking help; the eating disorder was enticing to listen to, as always. But this young mother knew she had to fight such thoughts – they were her illness thoughts and they were robbing her of her true self. She needed understanding. She needed support. She needed reassurance. She needed help to defuse the tormenting triggers of the eating disorder that were threatening to dominate her mind again. So she went to the local clinic … and hours later, wrote this email:

I am waiting for my usual doctor to return from long service leave but in the meantime I have been seeing other GPs. My fight feels weakened by my interaction during this afternoon’s appointment. I already knew my blood tests were fine – the dietician had assessed those results, and weighed me, this morning. This doctor wanted to weigh me (which I said he could do, that was Ed talking numbers), and of course I weighed more than I did this morning at the dietician. Different scales, different time of day, had shoes on…. So the doctor was happy to note that I had gained (??) weight. He said  he was also reassured that my mood is stable, I am not suicidal and my living circumstances are pretty ideal. In summing up he said:

It’s not like you have cancer or any life threatening illness so I don’t have any particular concerns to follow up. See you in four weeks.

My heart sank and I told myself I knew better: one in five die from this illness, some just die in their sleep. I must keep telling myself over and over that I know better and keep fighting. I must not follow my (Ed’s) reaction to starve myself and create cardiac complications. I am tempted to do this and show this doctor the reality of this illness. No, don’t do it, I am trying to tell myself! Be sensible. You are more resilient than that. You might hear myself pleading (with the small part of the real me) to push on. My eating disorder is very loud. I have decided to go to bed. I have silent tears rolling down my cheeks as I lie on the bed. I have had my milk milo supper, I have not achieved all my house jobs today but I remind myself that lack of tidiness does not matter. I will go to sleep telling myself tomorrow is a new day. No, I have not told my husband anything about today’s appointment. I am still not strong enough to share with him. It feels this will be my life-long battle. I am sad.

I feel sad, too, that this young mother had such a negative experience when she bravely sought help to keep her eating disorder at bay. She was injured rather than helped. Her eating disorder was bolstered, big time.

One Click is All it Takes

Doctors are busy people, but it takes but a moment to click on a website link.

If the Australian doctor had clicked on the National Eating Disorders Collaboration website he would have quickly discovered that Anorexia Nervosa is a serious and potentially life threatening mental illness. A person with Anorexia Nervosa has not made a ‘lifestyle choice’: they are actually very unwell and need help. All eating disorders come with severe medical complications and increased mortality rates. The risk of premature death is increased for people with all types of eating disorders.

• The risk of premature death for women with Anorexia Nervosa is 6-12 times higher than the general population
• The risk of premature death for women with Anorexia Nervosa is ‘much higher’ than other psychiatric disorders
• For females with Anorexia Nervosa and diabetes, there is a 15.7-fold increase in mortality rates when compared with females with diabetes alone

Eating disorders and suicide The risk of premature death in people with eating disorders relates in part to medical complications associated with the disorder; however suicide has also been identified as a major cause of death in people with eating disorders. Research shows that 1 in 5 individuals with Anorexia Nervosa who died prematurely had committed suicide.

What are the risks associated with Anorexia Nervosa?

The risks associated with Anorexia Nervosa are severe and can be life threatening. People with Anorexia Nervosa may experience the following physical problems:

• Anaemia (iron deficiency)
• Reduced/compromised immune system function
• Intestinal problems (e.g. abdominal pain, constipation, diarrhoea)
• Loss of or disturbance of menstrual periods in girls and women
• Increased risk of infertility in men and women
• Kidney failure
• Osteoporosis– a condition that can lead to human bones becoming fragile and easy to fracture
• Heart problems (e.g. cardiac abnormalities, sudden cardiac arrest)
• Death

For more detailed information on Anorexia Nervosa visit the Knowledge Hub.

Awareness

Having awareness about Anorexia Nervosa and its signs and symptoms can make a huge difference to the duration and severity of the illness. Seeking help at the first warning sign is much more effective than waiting until the illness is in full swing. If you or someone you know is exhibiting some or a combination of these signs it is vital to seek help and support as soon as possible. Equally, it is vital that our doctors are sufficiently informed to offer that help and support – now.

GET HELP

In Australia, Butterfly’s National Support Line and Web Counselling Service provides free, confidential support for anyone with a question about eating disorders or negative body image, including sufferers, carers, family and friends, teachers, employers and more.
Phone: 1800 ED HOPE / 1800 33 4673
Email: support@thebutterflyfoundation.org.au
Website: www.thebutterflyfoundation.org.au/web-counselling.

In the USA, contact the National Eating Disorders Association helpline.

In the UK, BEAT is only a click away.

Knowledge is Power

Everyone – sufferers, families, nurses and clinicians – can learn about eating disorders by reading good books. Here’s a few of mine:

My Kid is Back – Empowering Parents to Beat Anorexia Nervosa. Routledge. 2010.
A Clinician’s Guide to Binge Eating Disorder. Co-editors Andrea Goldschmidt, Daniel Le Grange. Routledge 2013.
Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends. Co-author Janet Treasure. 2^nd edition: Routledge 2013.
Ed Says U Said – Eating Disorder Translator. Co-author Cate Sangster. Jessica Kingsley Publishers, UK, 2013. Australia and NZ click here.
A Collaborative Approach to Eating Disorders. Co-editor Prof. Janet Treasure of Routledge. 2012.
Memoir A Girl Called Tim, Escape from an Eating Disorder Hell, New Holland Publishers 2010.