In recognition of Eating Disorders Awareness Week (26 February – 3 March 2024) we met up with Serena Williamson, Lead Dietitian in our All Age Eating Disorders Service.
Serena joined the Trust in 2019 and has been supporting the service on its transformation journey in that time. She leads a small team that supports people with Avoidant Restrictive Food Intake Disorder – or ARFID for short.
So why did you decide to work in eating disorders?
I had always wanted to work with young people. Previously I had worked in paediatrics as part of my job in trauma when I worked at an orthopaedic hospital and then I moved across to child and adolescent mental health services in Birmingham. The unique mix physical and mental health was an area that really interested me so I decided to go into eating disorders and it’s been my specialism ever since!
Although it can be quite a challenging area to work in, the outcomes are really positive and my work feels really worthwhile. I now support our team of dietitians and am very proud to be part of such a caring, dedicated and fast developing the All Age Service in The Black Country.
Your area of focus is ARFID, how would you describe this type of eating disorder?
The ARFID terminology is still relatively new in terms of a diagnosis and it has previously been known as other things in the medical world such as selective eating or paediatric feeding disorder. ARFID is now crucially recognised globally as a mental health diagnosis in the ICD 11.
People with ARFID don’t eat enough food or a wide enough range of foods. The restriction can be extreme and can lead to difficulties maintaining a healthy weight or growth and/or nutritional deficiencies or other physical health problems.
When a person develops ARFID, they are not restricting due to worries about their body weight or shape and develop the eating disorder for other reasons. This might be down to a lack of interest in eating, or an extreme difficulty with the smell/texture/taste of certain foods or feeling anxious about eating following a negative experience with food or concern that food may harm them in some way; for example choking or sickness.
How do you treat this type of eating disorder?
Everyone is different so it’s about working with the individual and their family or carers to find treatment that could work for them. This might involve cognitive behavioural therapy, support from dietitians, occupational therapy, family based work, psychology or psychiatry input or a combination of these.
The research is still really early around AFRID specific treatments but the early research is looking positive and we will soon be able to share the outcomes of our pilot.
What help is available in the Black Country?
We have an All Age Eating Disorder service that treats a range of eating disorders. For people with ARFID we have a pilot across the Black Country where we assess and diagnose the condition. We work as part of a multi-disciplinary team and assess patients as individuals to look at what’s driving the restriction and how severe it is. For some people it can be managed in primary care, others might need more specialist help from our team.
We offering training to other professionals and services to help build awareness and online resources are increasing that we can point people to as well.
We have seen some people that have lived with ARFID for years come forward for help because it’s being talked about more and that’s really positive. For someone to understand what you are going through and help identify what’s driving your eating behaviours is sometimes really eye opening for people. We’ve had examples of people who have sadly had negative experiences and told that nothing can be done – that’s not the case, help is available.
Where can people get help?
We would encourage people to visit their GP or speak to their health professional and they can refer them into our All Age Eating Disorder service. If you are in school speak to a teacher or a school nurse who will be able to guide you to help.
The BEAT website, Be Body Positive and ARFID Awareness UK have some great resources for people to read.
It’s important for people to get help as early as possible and referrals coming into the service will be screened and urgent cases will be seen within a week.
We notice that many individuals and families have adapted their lives to accommodate this type of eating disorder but help and support is available.
Contact details
All Age Eating Disorder Service (Sandwell and Wolverhampton)
Black Country Healthcare NHS Foundation Trust
Edward Street Community Base
West Bromwich
West Midlands
B70 8NL
Tel: 0121 612 8301 (Monday - Friday, 9am - 5pm)
All Age Eating Disorder Service (Dudley and Walsall)
Ladies Walk
Sedgley
Dudley
West Midlands
DY3 3UA
Tel: 01902 947 220 (Monday - Friday, 9am - 5pm)