Issue 1 | Identifying and Screening People at Risk
About this resource
Issue One | July 2012
Welcome to the e-bulletin
Welcome to the first edition of the NEDC e-bulletin – your link to research, practice and a network of other people interested in eating disorders.
The e-bulletin is a monthly communication that will be sent to all NEDC members. Anyone with an interest in eating disorders may subscribe to receive the bulletin by going to the NEDC website.
The topic and scope of each issue will vary however the focus will be on information and resources accessible from the NEDC website with an emphasis on:
- Emerging research that is linked to the NEDC Clearinghouse database. New articles are uploaded to the website every month. 34 full articles have been added to the database since the website was launched in April.
- Specific issues in eating disorders prevention and management. This month the focus is on screening populations at high risk of developing an eating disorder.
- NEDC Projects. In 2012, the NEDC will be focussing on a gap analysis to identify the priority steps to be taken to improve approaches to eating disorders on a national basis. Have your say by completing a survey or joining an e-network discussion on gaps. Link
- Professional development events and resources. This month the bulletin includes information on the National Eating Disorders Collaboration annual National Workshop and the ANZAED annual conference, both of which will be held in Adelaide in August this year. Link
We hope you enjoy this first edition. Please pass this bulletin on to your friends and colleagues. If you would like to suggest topics or events to be featured in future editions of the bulletin, please contact us at email@example.com
The NEDC professional collaboration network
NEDC is delighted to introduce the brand new NEDC Professional Collaboration Network, an e-network designed for professionals in Clinical Practice with an interest in eating disorders. Having completed its initial trial run, membership in the e-network has now being opened up to all appropriate professionals and we would love to have you involved to join the conversation.
The e-network will provide an opportunity to:
- Extend your professional network
- Share knowledge and resources
- Broaden your knowledge of service providers and service approaches
- Access support for professional problem solving
- Enhance your professional development in the field of eating disorders
- Contribute to the development of approaches to eating disorders that work in your professional context
Through the NEDC e-network participants will have a unique opportunity to join in discussion with frontline clinicians and some of Australia’s leading experts in eating disorders. This project is the first opportunity in Australia to influence the development of a nationally consistent approach to eating disorders and the e-network is one way in which you can easily join the discussion in a time of change and influence the outcomes for better approaches to eating disorders.
Each month, in addition to the discussion topics and questions raised by network members, topics will connect with research and articles in this e-bulletin. There will also be opportunities to contribute to discussion of complex case scenarios and provide valuable insights for the NEDC’s two priority projects for 2012, the Gap Analysis Report and the Prevention and Early Intervention Report.
LinkedIn, our chosen social media platform provides a moderated and professional social media environment in which to explore complex case issues, national standards and emerging evidence. To ensure further security for discussion the e-network will be a closed group with new membership screened to ensure clinician participation only. We have completed a fact sheet addressing LinkedIn security which can be found here. Any other questions about the e-network can be directed to firstname.lastname@example.org
Gap analysis question of the month
Every month we will be using the e-network to address specific questions for the 2012 gap analysis report. This report will play an essential role in identifying any priority gaps or opportunities for further development of the eating disorders sector in Australia. This month's question is:
Screening – who is screening and how?
Screening for eating disorders relies on the assumption that early identification can lead to earlier access to treatment, reducing the physical and psychological complications of eating disorders. Screening questions in particular may help people to identify and talk about body dissatisfaction or disordered eating with a health professional leading to earlier access to treatment.
Do you routinely screen clients/patients for eating disorders? What methodologies do you use for this? What screening questions do you use?
Join now to participate in this and other discussions with other clinical professionals. We look forward to seeing you on the network!
Article: Should I ask about eating?
An article published in the European Eating Disorders Review in 2012 and uploaded to the NEDC database this month is “Should I Ask About Eating? Patients’ Disclosure of Eating Disorder Symptoms and Help‐seeking Behaviour” by Nicola Gilbert, Jon Arcelus, Rebecca Cashmore, Barbara Thompson, Chris Langham & Caroline Meyer.
The article explores how and when women with eating disorders first disclosed their eating problems and how this affected their help seeking. The authors recommend initiating discussion of eating problems as a strategy to promote earlier identification and access to treatment for people with eating disorders.
This study supports previous evidence suggesting substantial help‐seeking delays for individuals with eating psychopathology and highlights the potential role of healthcare providers in initiating help‐seeking. We know from previous research that many people with eating disorders are reluctant to seek help for an eating problem (i.e., due to shame or stigma), that they are more comfortable help-seeking for related problems or consequences of the eating disorders (i.e., anxiety, depression, gastrointestinal problems, weight loss and concerns about weight), and that although they may not volunteer information about the specific eating problems in health care appointments many would welcome questions from health care providers about eating behaviours.
The study confirms that mothers and friends are the first to know about eating problems. Telling a GP is the fastest way to access treatment.
Article: Identifying people at risk of eating disorders
This is an abridged version of the article. The full article can be read here.
Prioritization of prevention, early identification and early interventionPrevention, early identification and prompt intervention are necessary to reduce the severity, duration and impact of the illness. Early intervention for eating disorders includes strategies that enable people to access services as soon as they are needed: early in the development of the illness, early in help seeking and early in recurrent episodes of illness, with immediate access to treatment and support
Early intervention depends on early detection of symptoms. Long delays in seeking treatment for eating disorders are related to poorer long‐term health and quality of life.
People with eating disorders often do not seek help, or only seek help after a long period of illness. There is an average delay of approximately 4 years between the start of disordered eating symptoms and first treatment, and this delay can be 10 or more years. A reduction of this delay can result in improved health and quality of life.
The majority of people with eating disorders have contact with health professionals but they do not specifically talk about their eating problems. This means that many people are not diagnosed with eating disorders at an early stage because they present with apparently unrelated complaints. Common health presentations include emotional problems, weight loss, and gastro-intestinal problems.
Research suggests that the most common first points of professional contact are GPs, and for younger people, school counsellors. People involved in sports may contact a physiotherapist for their injuries. Adults with eating disorders may contact a health professional for infertility treatment.
While people may not volunteer information about their eating problems, many people would welcome questions regarding their eating behaviour as a first step towards getting help.
Screening questions may help people to identify and talk about their body dissatisfaction or disordered eating with a health professional leading to earlier access to treatment.
Screening can be effective for eating disorders because:
- Eating disorders are complex illnesses with serious consequences for health and quality of life
- Early detection and intervention can reduce the severity and impact of the illness
- High risk groups can be identified
- Screening tests are available
Screening questions for eating disorders can be as simple as the five questions in the Eating Disorders Screen for Primary Care (ESP) and SCOFF screening tools. The questionnaires do not diagnose eating disorders but identify the possible presence of an eating disorder and when a more detailed assessment is warranted.
Screening for high risk groups
Eating disorders occur in both males and females; in children, adolescents, adults and older adults; across all socio-economic groups; and from all cultural backgrounds. Within this broad demographic however there are some groups with a particularly high level of risk.
Based on the known risk factors for eating disorders, high risk groups who may benefit from screening for eating disorders include:
- Women, particularly during key transition periods: from school to adult life, pregnancy and menopause.
- Women with Polycystic Ovary Syndrome or Diabetes
- Athletes and people engaged in competitive fitness, dance and other physical activities where body shape may be perceived as affecting performance
- People with a family history of eating disorders
- People seeking help for weight loss
Eating disorders in males
A focus on specific groups at high risk should not distract from the prevalence of eating disorders in other populations. In particular, there is growing awareness of eating disorders occurring amongst males. Current research suggests that males make up approximately 25% of people with anorexia or bulimia and 40% of people with binge eating disorder. In a recent study lifetime prevalence for anorexia nervosa in adolescents aged 13 – 18 years found no difference between males and females.
- A significant amount of weight lost, or rapid weight loss
- Excessive gym attendance – consistently or in bouts of extreme activity
- Exercise despite injury or obvious illness
- A reduction in performance
- ‘Dizzy spells’ or fainting whilst exercising
- Difficulties concentrating or remembering
- Signs of purging
- Indications from others who are concerned
Screening for excessive exercise
Compulsive exercise describes a rigid, driven urge to exercise. This is a serious health concern that often requires the intervention of someone close to the individual, such as a family member, friend or coach who recognises these warning signs and encourages professional help.
For more information on compulsive exercise please read the following articles from the NEDC Clearinghouse:
Mental Health First Aid
For professionals who do not have a background in working with people with eating disorders, the Mental Health First Aid guidelines may provide useful starting place to support recognition and safe responses to people who are developing or experiencing an eating disorder. The guidelines provide an evidence based set of general recommendations about how you can help someone who is developing or experiencing an eating disorder.
Risk and early identification - information on the NEDC website
The following resources and links may be of interest:
A national eating disorders gap analysis
The NEDC is working to identify the priority steps to be taken to improve approaches to eating disorders on a national basis.
In 2012, the gap analysis will focus on identified gaps and areas for improvement in service delivery and identified gaps in information available to people with eating disorders, their families, professionals and the general public.
As a provisional working title we are calling this A Nationally Consistent Approach to Eating Disorders: Opportunities to Implement National Standards. The title emphasizes the positive nature of the report – looking for practical opportunities for change – and the relationship between this report and the National Framework.
The immediate objectives of the NEDC Gap Analysis are:
- To develop an overview – a snapshot in time - of services in Australia that address eating disorders
- To explore the perceived relevance of information resources on eating disorders from the perspective of their intended audiences – families, teachers, frontline clinicians and other professionals
- To profile current state initiatives and approaches to eating disorders that have the potential to provide strategic options for the development of eating disorders approaches in Australia
- Prioritization of gaps in current practices as the basis for achievable strategic action
This project starts in May 2012 and will finish in December when the report is submitted to the Department of Health and Ageing.
Have Your Say: Opportunities to get involved in the Gap Analysis
A number of surveys will be used to collect information during the year. If you can make the time to complete a survey, and forward the survey to others, this will really enhance the breadth and depth of our information.
E-network discussion topic
Join the e-network discussion group on LinkedIn now to discuss screening for eating disorders. Who is currently screening, what tools are clinicians using and who is being screened?
Eating disorders service provision review
If you or your organisation provides clinical services for people with eating disorders, we would like to invite you to complete this brief questionnaire.
Clinician's experience with eating disorders
If you are a clinician we would like to invite you to complete this brief survey to assist us in identifying what is available in Australia to support clinicians to respond to eating disorders and related issues of health and well-being.
Professional development events and resources
The 3rd Annual NEDC National Workshop
Break the silence on eating disorders
You are invited to join the conversation at the 3rd Annual NEDC National Workshop to be held 22nd to 23rd August 2012 at the Crowne Plaza, Adelaide.
Across two days the National Workshop brings together experts in mental health, health promotion, education, research and the media, as well as those with a lived experience of an eating disorder to share evidence and discuss strategic priorities for improving approaches to prevention and treatment of eating disorders in Australia.
The first day of the NEDC National Workshop is an opportunity for people with expertise or an interest in eating disorders to hear from leading international and national keynote speakers, participate in interactive workshops and network with members and others to share the latest evidence in the prevention and treatment of eating disorders. Speakers include:
- Prof Pat McGorry, 2010 Australian of the Year; Chair of the NEDC; Executive Director of Orygen Youth Health (OYH)
- Prof Howard Steiger - Director of the Eating Disorders Program, Douglas Institute, Canada
- Prof Mimi Israel - Psychiatrist-in-Chief, Douglas Mental Health University Institute, Canada
On Thursday, the NEDC presents four professional development workshops suitable for a diverse range of interests/expertise.
- Workshop 1: Evidence from Experience Forum
10am-3pm, The Balcony Room, Richmond Hotel, 128 Rundle Mall, Adelaide
- Workshop 2: Prevention Workshop: Should I Say Something?
9am -12.30pm Crowne Plaza, Adelaide
- Workshop 3: Prevention in Practice
1.30pm – 4.30pm Crowne Plaza, Adelaide
- Workshop 4: Communicating about Eating Disorders
9am – 4pm Crowne Plaza, Adelaide
Book early to secure your place.
In order to get the desired audience numbers and level of engagement we would love to get your help in promoting the event. We have attached three promotional documents below: if you could circulate these amongst your networks that would be much appreciated.
2012 ANZAED conference: Adelaide
23 - 25 August 2012, Crowne Plaza Adelaide
"One decade on: where are we now?"
Once again the NEDC National Workshop will be held on the two days before the ANZAED conference so that you have the option of coming for an extended conference on eating disorders. Part of the event this year will also include the ACEDA Body Image Forum on 24th August. This year attendees of the ANZAED conference will:
- Hear local & international experts presenting the latest research and clinical approaches
- Choose from a large selection of practical workshop options to attend during the conference
- See short presentations on a range of topics including research, treatment, service development, body image & early intervention, as well as young investigator sessions
- View poster presentations, hear leading experts debate and have your say
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