'There are pro-eating disorder groups, and it’s terrifying' - Shropshire clinical psychologist

All this week, the Shropshire Star has been looking at the devastating impact of eating disorders on people's lives.

Clinical psychologist Dr Beatrice Cox
Clinical psychologist Dr Beatrice Cox

Today psychologists and counsellors tell us about the impact these terrible diseases have on the body and mind.

Mental health services are “on their knees” due to a lack of funding, a Shropshire clinical psychologist has claimed.

Dr Beatrice Cox, who practises privately in Oswestry, says the complexity of eating disorders makes them some of the hardest mental health issues to treat – but says services are not getting the funding they need.

“Eating disorder services try really hard, the workers on the ground want to do their best,” she said.

“But with mental health services are on their knees it’s getting harder and harder. There certainly aren’t enough services to meet demand. That is absolutely true.

“It’s all about money, the NHS doesn’t have the money to provide the services that people need.”

Where to get help:

  • The sooner someone gets treatment for an eating disorder, the better their chances of recovery.

  • Anyone worried about their own or someone else’s health can contact eating disorder charity Beat’s Helpline, 365 days a year, via phone on, email, anonymous one-to-one webchat or social media messaging here.

  • Or call: Adult Helpline - 0808 801 0677; Studentline - 0808 801 0811; Youthline - 0808 801 0711.

As part of our series of articles on eating disorders Beatrice has given the Shropshire Star an insight into how a psychologist approaches and treats someone with an eating disorder.

She said: “I follow the NICE guidelines, which is what the NHS and private psychologist should follow.

“These guideline suggest it should be family therapy as a first line of treatment for eating disorders – mainly because an eating disorder affects everyone in the family.

“You want to work with the family around communication, eating, and have them all in the room together, which is important.

“We use family therapy to work towards a more collaborative stance between adolescents and parents.

“We want to mobilise parental strengths and resources to enable parents to directly intervene. We want to empower parents to exercise authority over their children’s eating. Family therapy aims to allow adolescents and parents to discuss and establish therapeutic goals together.”


Beatrice believes that psycho education important in outlining to those with eating disorders exactly how living with one will affect their lives.

“That means sitting down and explaining all the side effects such as the impact that eating disorders can have on menstruation, fertility, the cardiovascular system, and gastrointestinal system, for example constipation,” she said.

“Eating disorders can effect sex hormones, which can impact on bone density resulting in a higher risk of broken bones. Malnutrition can lead to dry skin, and brittle hair which can fall out. It’s giving them a wider picture.”

One thing that Beatrice does after meeting a patient is to establish what social media channels they are on.

This is because of a worrying trend of ‘pro’ groups online.

“There are pro-eating disorder sites and groups, it’s terrifying,” said Beatrice.“When you put anything that is not positive or is not pro-eating disorder or suicide they just kick you out.

“It is just full of pictures of people emaciated and not looking well, but other members are saying ‘it’s amazing’ and ‘keep going’. When you look at the content being shared it’s very dark.

“Once these sites shut down they just pop up elsewhere. You can’t control it.


“This is the world teenagers live in, we have to get into that world. Young people on on their phones for hours a day on social media. That is an arena which we have to understand.

“If I am meeting with someone I will ask them what groups they are members of on social media or accounts they have on Facebook, Instagram and Twitter because it’s important to know.”

Beatrice says she finds that often the people she sees will be members of these groups.

Once she has built up a relationship with a patient and has built up family therapy, she will look towards providing the person with cognitive behavioural therapy, or CBT as it is more commonly known.

“It’s about looking at the way people think, their view of themselves, distorted thoughts about their appearance, what is reasonable and unreasonable amounts to eat in a day,” she says. “It’s about gently getting them to bend those thoughts a bit.

“We will set goals. But their goal and ours will be very different, and that is where building the relationship is important.”

Beatrice admitted that seeking and getting the correct treatment early is key for treating an eating disorder. But she admits that health professionals face difficulties, not only with the complexity of the conditions themselves, but with funding for the services.

“Eating disorders are one of the most difficult mental health issues to work with,” she said. “They have a high re-lapse rate. That way of thinking is very hard to abolish.

“People need different service depending on where they are at. As a private psychologist I wouldn’t want to take anyone on with a BMI that is really low as I don’t have the whole team with a dietician and someone to do bloods and take weight. I would refer to other services.”

* Beatrice provides psychological interventions for a range of mental health difficulties and can be contacted via email at drbeatricecox@gmail.com

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