Experiences of professionals in recognising and diagnosing eating disorders | Annabel Cuff

Mental health professionals tended to have better knowledge of eating disorders, possibly due to their knowledge of mental health literacy

Annabel Cuff, Research Support Officer II

Research shows that it is vital for persons with emergent eating disorders to be diagnosed and treated as early as possible as this leads to improved outcomes. Professionals such as educators, doctors, psychologists, dentists, gastroenterologists, counsellors, sports trainers and others are excellently placed to recognise a potential eating disorder and could contribute significantly to earlier diagnosis.

Yet, although persons with developing eating disorders come into contact with various professionals, and despite the fact that better recognition and diagnosis could save sufferers years of distress and harmful habits, diagnosis levels remain low. Patient evasiveness, cultural differences between practitioner and patient, the similarity of eating disorder indicators to symptoms associated with other conditions, and potentially inadequate eating disorder knowledge among professionals may make them difficult to diagnose.

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In 2022, the Faculty for Social Wellbeing was commissioned by Dar Kenn għal Saħħtek to carry out research on the experience of professionals who come into contact with potential eating disorder sufferers. This study examined professionals’ knowledgeable of eating disorders and whether they feel empowered to take the necessary actions to help potential sufferers. Data was collected via an online questionnaire which received 123 valid replies, and four focus groups held with a total of 15 professionals.

Overall professional knowledge of eating disorders was found to be good, although there was some discrepancy within as well as between professions regarding the extent of that knowledge. Mental health professionals tended to have better knowledge of eating disorders, possibly due to their knowledge of mental health literacy. Avoidant/Restrictive Feeding Disorder (ARFID) was the least well-known eating disorders. It emerged that all professionals experience eating disorders within their clientele – hence, indicating that eating disorders may be more widespread than one imagines. While most practitioners do follow up with the person, typically there are no guidelines as how to do this. Setting up protocols should become widespread practice, especially as the majority of professionals stated that they tend to find it difficult to approach potential eating disorder sufferers and do not feel confident in their knowledge of the subject.

Four overarching themes emerged from this study – namely, professionals’ experiences with eating disorders; failures in systems and training; family, friends and significant others; and education. Participants across all professions revealed that their formative training contained very little specific instruction about eating disorders and that what they know about eating disorders was mostly acquired through self-study.

Additionally, current systems tend to view eating disorders as conditions that can only be tackled by professionals from the field, however, it became clear that various professionals are able to recognise that an individual could have an eating disorder. Participants also expressed disappointment in systematic practices that perpetuate unhealthy habits – within the family as well as culturally, and called for a cultural shift that gives prominence to healthy eating habits, the serving of healthy foods and sensible portions in restaurants, and a sports-mindset that are currently lacking in our country.

A supportive system, i.e. family, friends or significant others, is a crucial element of recovery from eating disorders. These people encourage sufferers to seek treatment and support them along the way. Conversely, unsupportive family or friends tend to encourage dysfunctional habits and are more likely to be a liability. Along with family, educational establishments serve as centres of influence in the transmission of knowledge and values and in the formation of good habits, meaning that teachers and other education professionals should not be overlooked as valuable collaborators. Finally, this research showed that there is a desire among professionals from various fields to learn more about eating disorders.

While certain professions, such as doctors or psychiatrists, are typically seen as being better placed to diagnose eating disorders, the emergent data from this study confirm that any professional that comes into contact with clients, students or patients is in a position to help potential sufferers.

It is hoped that this study will raise awareness of the importance of eating disorder knowledge among professionals in Malta. Enlisting the help of practitioners in identifying and tacking eating disorders and improving the outlook for sufferers will cut short the time sufferers spend living with an eating disorder and improve outcomes for sufferers.