30 Dec Helping Patients with Eating Disorders
My name is Kel O’Neill. I am neither a GP and nor do I work in primary care. I’m also acutely aware that my specialist topic might not seem of immediate importance to you. However, I ask that you be kind enough to lend me 10 minutes of your time to read this blog – it could quite literally save someone’s life.
I’m a counsellor and trainer in private practice and I specialise in eating disorders. eating disorders are complex mental health problems, which potentially have system-wide physical health complications.
I fear that currently in primary care mental health issues might take back seat to immediate physical symptoms such as joint pain, cardiac issues, cancer and a myriad of other health issues that you see many times each day. Certainly, the fact that GPs currently receive NO standard training in eating disorders implies further challenges in helping patients affected by these issues.
Not what it may seem on the surface
Yet, according to the Adult Psychiatric Morbidity Survey (2007) around 6.4% of adults display signs of an eating disorder. This means that the average GP, seeing 30-40 patients a day, supports at least 10 adults affected by these conditions every week. Furthermore, with the highest mortality rate of all mental health conditions as many as 20% of these people will die as a direct result of their illness – either through medical complications or suicide.
These statistics highlight only one reason why I am so passionate about this issue. eating disorders can affect anyone of any age, gender or lifestyle. Most patients are not underweight; many have a ‘healthy’ body size, some are even overweight.
My patients (whom I would refer to as clients) often report many years of suffering. They report being dismissed by some medical professionals, usually because specialist services have tight referral criteria (typically a low BMI) and they simply have been deemed “not sick enough” for treatment. Of course, I appreciate that referral criteria are a boundary, placed on you as well, just as much as it is placed upon the patient. Funding is grossly lacking, and waiting lists can be months and months in length.
Where you come in
Often GPs place a patient on a waiting list (if they can) and then the person is all but left to their own devices; most will continue to deteriorate while they wait. Some may access private support, but many don’t even realise that this is an option!
You may well feel disempowered by this patient group. You’ve perhaps been ill-equipped by your training. Personally, I have sent patients to their GP for physical health checks, blood tests and heart checks only to have the patient return to me the following week to state that the doctor wasn’t sure what to check for, or, even worse, didn’t understand why they might be necessary. Equally, I have sent patients to Accident & Emergency with symptoms that might be life-threatening a matter of hours after they had already seen a GP. I wasn’t over reacting; the patients were admitted, with complications such as severely low potassium, dangerous blood pressure readings, dehydration and ketoacidosis.
I worry what might have happened to my patients if I hadn’t seen them that day. Might they be dead? This is a responsibility I carry, despite not being a medical professional.
In this scenario, the GP isn’t to blame. How can you be, if you have not been appropriately educated on the topic? But that lack of training can cost lives and, now that you are aware of this, the onus is on you to seek out the information you require.
I could write pages upon pages on this topic – but I appreciate that your time is precious, that this is one of many topics before you, and that I might only have your attention for a few moments. I hope, for some that read this, your interest and concern will be captured and that you’ll want to get in touch.