HEALTH PROFESSIONAL REPORT
This report is produced by Reach Out and Recover (ROAR), an online tool for adults who are experiencing disordered eating and body dissatisfaction. The Victorian Centre of Excellence in Eating Disorders designed ROAR in consultation with experts in the field and with consumers. It aims to: assist adults to identify problems with eating and body concerns; support and promote consumer help seeking; facilitate consumer-health professional collaboration; and guide health professional treatment responses.
Why is the person giving you this report?
This report is provided to facilitate the consumer-health professional collaboration and enhance the likelihood that the person will engage in an appropriate form of treatment for their concerns. Research has identified that only 23% of people with eating disorders seek treatment and there are substantial barriers to treatment seeking for people with disordered eating and body dissatisfaction. Thus, care must be taken to respond appropriately to the person’s needs.
What the person has identified
The following are the person’s responses to questions in areas that they have difficulties with. Questions and responses from the ROAR online tool are not presented below if the person chose not to answer a question, or if the subject matter of the question was not a problem for them. A full list of questions is available at ROAR .
DO I HAVE A PROBLEM?
| These questions are about your eating and body image over the last few weeks | |
| DIETING AND EATING RESTRICTION BEHAVIOURS | |
| I have been trying to limit the amount of food I eat to influence my weight, shape, or size | Never |
| I have hardly eaten anything at all for periods of time (e.g., fasted or skipped meals), to influence my weight, shape or size | Never |
| I have tried to exclude (e.g., not eat) foods that I like in order to influence my weight, shape, or size | Never |
| I have followed strict food rules or dieting plans that dictate what, when, and/or how much to eat to influence my weight, shape, or size | Never |
| EATING BEHAVIOURS | |
| I have eaten really large amounts of food in one go (what others would think is unusually large) | Never |
| I feel totally unable to control my urges to eat. I have a fear of not being able to stop eating voluntarily | Not at all true for me |
| I have eaten really large amounts of food in one go (unusually large) and felt that I could not stop eating or control what or how much I was eating | Never |
| THOUGHTS ABOUT EATING | |
| I feel like food, eating, and/or trying to control my eating rules my life | Not at all true for me |
| Controlling what, and how much I eat is very important for how I think and feel about myself as a person | Not at all true for me |
| I have strong feelings of guilt during or after eating | Never |
| BODY IMAGE | |
| I am dissatisfied with my weight, shape, or size | Not at all true for me |
| I wish I were thinner/smaller | Not at all true for me |
| I wish I were more muscular | Not at all true for me |
| THOUGHTS ABOUT BODY IMAGE | |
| My weight, body shape, or size is very important for how I think and feel about myself as a person | Not at all true for me |
| I am afraid of gaining weight or becoming fat | Not at all true for me |
| I am afraid of losing weight or becoming thin | Not at all true for me |
| Thinking about the weight, shape, or muscularity of my body stops me from concentrating | Never |
| To be in control of my life, I need to control my weight, shape, or size | Not at all true for me |
| BEHAVIOURS TO CONTROL WEIGHT, SHAPE, AND BODY SIZE | |
| I have tried to control my weight, shape, or size by making myself sick (vomit) | Never |
| I have tried to control my weight, shape, or size by using laxatives and/or diuretics | Never |
| I have tried to control or change my weight, shape, or size by using pills or supplements (i.e., protein powders, meal replacements) | Never |
| I exercise specifically to improve my body shape or size and/or to try to control my weight | Not at all true for me |
| I feel extremely guilty if I miss an exercise session | Not at all true for me |
| I continued to exercise despite illness or injury, or if exercise interfered with important activities | Not at all true for me |
| I have tried to control or change my shape, or size by using anabolic steroids | Never |
SHOULD I GET HELP?
| These questions are about the impact of your eating and body concerns on your health and wellbeing over the past few weeks. | |
| PHYSICAL WELLBEING | |
| Made you feel physically unwell (e.g., dizzy, faint, weak, fatigued or drained)? | Never |
| Resulted in rapid weight loss or gain, or ups and downs in weight | Never |
| Made you feel very cold, or have cold hands and feet | Never |
| Caused you problems in looking after another health problem | Never |
| EMOTIONAL WELLBEING | |
| Made you worried | Not at all |
| Made you feel guilty or ashamed | Not at all |
| Made you feel worse (bad / critical) about yourself | Not at all |
| Made you feel distressed | Not at all |
| Made you feel different or isolated from other people | Not at all |
| Made you use to drugs or alcohol to cope | Never |
| RELATIONSHIPS | |
| Caused problems with your relationships with others | Never |
| Made you feel misunderstood by others | Never |
| Made you put off or avoid connecting with friends or family | Never |
| ENJOYING AND PARTICIPATING IN EVERYDAY LIFE | |
| Got in the way of doing things you used to enjoy | Never |
| Made it difficult for you to eat with others | Never |
| Taken time from other important everyday activities or plans | Never |
| Made it difficult to concentrate | Never |
| Interfered with your work / study performance | Never |
| Made things difficult for you financially | Never |
| Caused problems with being able to take good care of yourself | Never |
I WANT AND NEED HELP
| These questions are about how you feel about seeking help and making changes. Making changes means reducing dieting and restriction, binge eating and overeating, exercise and other behaviors used to control weight, shape and size. | |
| THOUGHTS ABOUT MAKING CHANGE | |
| How ready are you make changes in your eating and body concerns? | Not ready |
| How important is it for you to change? | Not at all important |
| How confident are you in your ability to change? | Not at all confident |
| FEELINGS ABOUT SEEKING HELP | |
| I worry that people would think less of me if they knew I was getting help for eating and body concerns | Not at all true for me |
| I worry that health professionals would judge me if I revealed my eating and body concerns | Not at all true for me |
| I would feel like there was something wrong with me if I got help for my eating and body concerns | Not at all true for me |
| If I got help for my eating and body concerns I would be afraid of losing control | Not at all true for me |
| If I got help for my eating and body concerns I would be worried that I will feel too uncomfortable | Not at all true for me |
Immediate Actions
Clarify the problem
- What is the nature and extent of the person’s disordered eating and body dissatisfaction and level of distress?
- Does the person meet diagnostic criteria for an eating disorder?
Consider medical and mental health risk
- Does the person have associated medical or mental health risks that require immediate or emergency care?
- Conduct a medical review including investigations to determine medial risk
- Go to www.ceed.org.au for eating disorder and medical risk assessment guidelines
NEXT STEPS
Help the person access appropriate treatment (go to Health Pathways). Consider the person’s eating disorder or mental health treatment needs, medical or psychiatric treatment, or emergency care needs.
Disordered eating, body dissatisfaction and eating disorders occur in adults of all genders, ages, and body sizes
Asking help for problems with disordered eating and body dissatisfaction takes considerable courage. There is significant stigma associated with eating disorders and with high weight (obesity) in the community and among health professionals. People who do not fit the stereotypical picture of an eating disorder may fear that their concerns will not be taken seriously or that they are not ‘sick enough’ to get help. It is imperative that the person’s concerns are not dismissed. Convey to the person that you recognise that their concerns reflect serious health problems that require evidence-based treatment. People should not be left to feel as though they should be strong enough to fix their problems themselves through sheer willpower.
People experience high levels of shame or embarrassment about disordered eating and body dissatisfaction
This report facilitates self-disclosure by providing a tool for the person to share their concerns. Further clarification of concerns will be required. It is crucial that health professionals take a non-judgemental stance and offer support to the person and allow them time to open up. Express to the person that they are not to blame for their concerns; the causes of disordered eating and body dissatisfaction are multifactorial and there are biological and psychosocial contributors.
People may be in two minds about seeking help or making changes
It is common for people to be hesitant about seeking help for mental health issues. This is especially the case for disordered eating and body dissatisfaction as some symptoms and behaviours in which people engage may be perceived to serve a positive or functional purpose. People often fear losing control, having to let go of coping strategies, and that treatment will cause weight gain. Communicate an understanding of the person’s difficulties in taking steps to seek help under these circumstances.
Past help seeking experiences may have been negative and people may have received unhelpful responses from health professionals
Negative experiences can delay or prevent treatment seeking. Along with dismissing concerns as not being serious, one of the most unhelpful responses people with disordered eating and body dissatisfaction can receive is to be directed towards weight management services. This is not a suitable option for people with mental health concerns and is likely to exacerbate their problems. The person needs to be made aware of the importance of engaging in evidence-based treatment for their concerns. Convey to the person the need to seek treatment at any stage, whether it is an early intervention type approach or whether the person has been struggling with disordered eating and body dissatisfaction for many years. Offer hope that treatment for disordered eating and body dissatisfaction can be effective.