'Hungry for Words: A cross-disciplinary approach to articulating, communicating and understanding male anorexia'

Lead Research Organisation: University of Nottingham
Department Name: Sch of Cultures, Languages & Area Studie

Abstract

The research network will investigate aspects of the eating disorder (ED) anorexia nervosa (AN) in males by bringing distinct arts & humanities perspectives to medical and health sciences thus mapping a field of cross-disciplinary enquiry. The collaboration is informed by the AHRC's highlight notice 'Cross-Disciplinary Research Networks Exploring Emerging Areas of Cross-Council Enquiry' and focuses on the AHRC highlighted areas of well-being and mental health.
Whilst EDs in females (e.g. anorexia, bulimia) are being explored fairly extensively in medical and cultural approaches, there is significantly less engagement with male EDs in general and male AN in particular. Despite being perceived as a 'female-only-problem', ED-charities suggest that male AN is an increasing problem in Western countries and highlight the need for greater awareness and more research. The relationship between human beings and food is highly complex and affects many aspects of life, involving biological, psychological, economic, social and cultural factors. This stresses the need for a wider and cross-disciplinary engagement that also takes questions of gender into account. All this makes our proposal timely and highly relevant and emphasizes its potential to stimulate innovative research.
Our network of international UK- and US-based investigators facilitates significant boundary-crossing exchange between medicine, psychiatry, mental health science, education, english, modern foreign languages, linguistics and mathematics to develop a joint research agenda. We also collaborate closely with named partners from 4 ED-charities in our research and impact activities (educational events with schools and UG students, a workshop with teachers, student training events). Our project has significant potential to impact on individuals, health and educational professionals, the wider public and policy-making and for future collaborative work across the disciplines. It is situated in the emerging discipline of health humanities that provides a platform for linking health disciplines with the arts & humanities encouraging innovative applications of the latter to improve the well-being of individuals and societies. It is also informed by the interdisciplinary work of Nottingham's Institute of Mental Health.
At the heart of our network is the desire for further research on, and to raise awareness of, male AN. It explores aspects of male AN in the UK and draws comparisons with North America, Germany, France and Italy in 3 areas of personal narrative: literature (fiction and autobiographical writings), online egodocuments (personal accounts in weblogs and forums), and oral accounts (client-led oral communication in a wider therapy context). Whilst participating researchers from academic institutions bring a distinct arts & humanities perspective to these 3 areas, the proposed key activities are not primarily designed to advance individual disciplines but to spark new conversations with participating scholars from medical and health care sciences. The project facilitates comparisons across different areas and explores how personal narratives can add to the understanding of male AN in a medical and healthcare context. Developing a joint research agenda has the potential to inform and transform the treatment and management of male AN framed by cross-disciplinary research questions:
How can personal narratives of male EDs delivered in literature, online egodocuments and client-led oral accounts
- help males with AN in an innovative manner?
- aid and inform their treatment beyond established medical definitions and paradigms of socio-culturally constructed concepts of disorder and gendered behaviour?
- be used in educating and training health care professionals?
- contribute to greater public knowledge, awareness and understanding?
How, in turn, can insights from healthcare professionals aid to the understanding of these 3 types of personal narratives?

Planned Impact

The network activities will benefit the following 6 groups:

Group 1: School pupils from secondary schools
The age group identified by researchers as most vulnerable regarding EDs is early- to mid-adolescence. By holding interactive educational events tailor-made for this age group of boys and girls we will contribute to their education and awareness regarding healthy eating behaviour, (over-)exercising, EDs in general and AN in particular. Sessions are aimed to show pathways to positive body image and building self esteem thus contributing to their well-being and quality of life. In separate informal groups led by a trained male ED-charity facilitator, boys in particular will benefit from an approach that breaks down concepts of AN as a 'female-only' problem and encourages them to voice any issues they may have. All pupils will benefit from personally coming to know charity-workers, some from the local area, who can provide confidential help and support beyond this event and equip them with useful further information and addresses. An additional benefit is that we encourage young people to a campus visit who may not have visited a university otherwise potentially leading to their social, educational and cultural benefits.

Group 2: Male undergraduates
Another group recognized as vulnerable for EDs is students, particularly in their first year when facing significant life changes. Young men from this group will benefit from our expert-led tailor-made workshops addressing specifically male EDs and AN in the new environment of a university. Other benefits regarding their education, awareness beyond gendered concepts, self esteem, body image, quality of life and well-being are comparable to group 1. They also benefit from being introduced to specific support networks for students: students' counselling and support services and, at UoN, the newly established 'EDs and Students Service' in addition to local charities off campus.

Group 3: Teachers and school staff (e.g. nurses)
They will benefit by increasing their knowledge and awareness of male AN in boys and by discussing best practice and integration of the topic into teaching activities. Their recommendations, ideas and concerns will be communicated to policy-makers attending the final symposium with a view to feeding EDs and male AN into the National Curriculum.

Group 4: Health and Educational Professionals (in training)
Through 2 training sessions with students in Medicine, Nursing, Psychology, Education and other relevant disciplines the project has the potential to influence the training and approach of future health professionals. Students will benefit from specialist sessions (by First Steps ED-charity, participants, PI and CoI Micali leading UCL's MSc in EDs) on problems and perspectives of recognising and treating male AN. They will benefit further from learning about the importance of cross-disciplinarity and how arts & humanities knowledge and practice (e.g. regarding personal narratives) can enhance well-being and mental health. In addition, opportunities for exchange with other students on different programmes will broaden their horizon helping them to become reflective practitioners.

Group 5: Members of the public
Through dissemination of the network's activities in the media and on the website the wider public will benefit from raised awareness for male AN, potentially leading to more caring open-minded communities equipped with information how to seek help and support for themselves and others.

Group 6: Policy-makers
The network has the potential to inform and transform policy-making on mental health and EDs in general and male AN in particular by engaging in exchange with government representative and NHS spokespersons during our final symposium and presenting to them at relevant national and international conferences. More awareness regarding male AN, e.g. mirrored in an update of the 2004 NICE guidelines will be of public benefit.
 
Title 'The Year I Didn't Eat' by Sam Pollen (2019) 
Description We invited the editor Elaine Bousfield of Sam Pollen's teenage novel 'The Year I Didn't Eat' (2018) to perform a reading from the text followed by Q&A and further discussion to 40 pupils (year 10) from a local school. The novel addresses mental health issues in teenagers and its main protagonist is a 14-year old boy with anorexia nervosa. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2019 
Impact After the reading the pupils talked important questions about mental health: how to look after your good mental health, where to get help if needed, how to raise problems. The teachers reported an increased interest in the topic after the visit. The attending counsellor from a local eating disorders charity was there to talk in confidence with those who wanted to. We are continuing to engage with the school, e.g. by improving their library provisions on mental health self help books. 
 
Title Animation: 'Consider Eating Disorders in Men' 
Description As part of our AHRC follow-on-funding we co-created with animation team WovenInk an animation on the lived experience of me with eating disorders. The film focuses on the experience of men who visit their GP for the first time to seek help for problems with eating. It is based on authentic input from seven men with lived experience of eating disorders sharing voluntarily and sensitively their own stories. The animation was directed by WovenInk with drawing by Mathilde Laillet. 
Type Of Art Film/Video/Animation 
Year Produced 2020 
Impact Launched during Eating Disorders Awareness Week (March 2020), the animation is creating a powerful impact with individuals commenting how sensitive, engaging, informative and insightful it is. Healthcare professional have reported that it has given them insights and information on the topic of eating disorders in men and increased their readiness to consider that men and boys might have this illness. This is currently a clear gap in medical practice. The animation is also a central part of a our learning tool for healthcare. 
URL https://www.youtube.com/watch?v=Sbbdee4N4yA
 
Title Being Elsewhere: Photography and poetry exhibition by Rinzing Kelsang 
Description Rinzing Kelsang is a Nottingham-based Hungarian photographer working mostly as a street and event photographer, both locally and internationally. 'Being Elsewhere' - exhibited at Nottingham's Institute of Mental Health as part of the Hungry for Words network and launched during Eating Disorders Awareness week - compiles a series of mostly candid images that express a sense of dislocation and a deep longing for being elsewhere, both physically and mentally. Kelsang became involved with the AHRC network during the 'Hungry for Words drop-in cafes' as part of the 2017 Being Human Festival. He started 'Being Elsewhere' to produce a coherent body of work based around one theme. While doing that he found that photographing, selecting and sequencing the images became a way of self-reflection that contributed to the process of improving his own mental health and self-development. Prior to engaging with 'Being Elsewhere', his experience of not feeling at home was associated with various degrees of mental anguish and depression. After completing the project Kelsang feels that he has gained clarity and direction and has found his unique voice as a photographer. Most importantly, 'being elsewhere' is no longer a burden, but is a newfound sense of inner freedom coming from a deeper connection with the world around him. The poems displayed alongside the photographs are not meant to be read as descriptions of the images, but they work parallel to them. They have been written by Kelsang following a similar process to that of his photography. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2018 
Impact Stimulated by Kelsang's photos and poems visitors of the exhibition have become engaged in discussion of topics related to 'being elsewhere', mental and physical health in males and females including - lead by the link to our project - eating disorders in males. At the launch event Kelsang made the connection between creative practice and overcoming mental health issues clear thus highlighting the potential of art and literature as intervention to the audience. 
URL http://www.rinzingkelsang.com/nottingham#3
 
Title Caren Garfen exhibiting from 'Room for Improvement' on eating disorders 
Description Caren Garfen is an award winning artist specialising in textiles and painstaking hand stitching creating carefully considered pieces with profound messages. One strand of her art engages with eating disorders and general health care issues. She exhibited parts of this work during our conference 'Image and Narrative: Illness, Recovery, Change Conference' at The University of Nottingham in April 2019. Her exhibits engaged with gender politics in eating disorders using work from her collection 'Room for Improvement'. Caren has established an international reputation for her accessible yet challenging issue-based art. Her work has been exhibited widely in the UK and Europe, as well as in Japan, USA, Canada and Australia, and can be found in public and private collections. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2019 
Impact The artwork drew in the audience and encouraged them to look differently at eating disorders. Knowledge exchange with Caren Garfen has led to improvements in the project's artistic engagement with the public, avoiding visual stereotypes, employing wit and generating new creative approaches to engage with healthcare practitioners. 
URL http://www.carengarfen.com/
 
Title Consider Eating Disorders: Excessive Exercise and Eating Disorders 
Description This film has been co-produced with people with experience of excessive exercise and eating disorders and is aimed to be used in training for sports professionals and others. 
Type Of Art Film/Video/Animation 
Year Produced 2023 
Impact In surveys approx. 200 viewers (as of 2.3.2023) have reported that this film helped them to be more confident to seek help or to reach out to someone who might need help. 
URL https://www.youtube.com/watch?v=s5DgLQP8s8g
 
Title Poems on Male Disordered Eating 
Description Through poetry networks we sent out a call for poems dealing creatively with male 'disordered' eating and received thirteen entries. We involved a panel of experts to identify the five that communicate the topic in the most accessible way to a public audience. The poems are displayed on our website. 
Type Of Art Creative Writing 
Year Produced 2018 
Impact The poems have been read by project members, staff from EDs charities, GPs, health practitioners et al, and they have also been used as teaching material for the UG peer mentoring module (session on EDs). These groups of readers commented on raised awareness and insight into the situation of affected males but also of carers conveyed through the poems. The poems have also provided material for scholarly analysis in one article (Bartel and Baker, 2019) and for a poster presentation as part of the 2018 Southampton International Health Humanities Conference. 
URL https://www.nottingham.ac.uk/research/groups/hungry-for-words/community-outreach-events/poetry-compe...
 
Title Reading by author Ulrike Draesner 
Description The German author Ulrike Draesner contributed to our workshop on literary representations of anorexia nervosa and eating disorders (June 2016) and delivered a reading of excerpts from her novel 'Mitgitft' (2002) that deals with anorexia nervosa and issues of gender. Draesner also gave a Q&A session and contributed her expertise to the workshop of academics and postgraduates. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2016 
Impact Draesner's reading and Q&A session gave insight into the creative practices of dealing with EDs and into details and challenges of publishing and marketing texts on such taboo matters responsibly. 
URL http://www.draesner.de/en/mitgift/
 
Title Stand-up comedy show by Dave Chawner on 25th January 2018 
Description We invited Dave Chawner, stand-up comedian, author and eating disorders and mental health ambassador, to perform his stand-up comedy show on his experience with eating disorders to an audience of students, university staff, staff from eating disorders charities and the general public. The gig was introduced as part of the AHRC award by PI Heike Bartel with reference to the network's website containing further information and links to our partner charities. The event was attended by 42 people. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2018 
Impact A feedback questionnaire gathered the audience's very positive response including answers to the question 'What did you get from the event?': 'It was good to address taboos.' 'I learnt [...] about the effects of EDs on male bodies.' 'That eating disorders can effect boys too.' Prior to the show Chawner was also interviewed by a final year student for a student newspaper on the topic of male mental health. 
URL http://www.davechawner.co.uk/
 
Title Story- and photobook (ed. by Mafalda Rakos and Ruben de Theije) 
Description 'A Story to Tell: Or Regarding Male Eating Disorders', (Salzburg, 2020), created and edited by photographer Mafalda Rakos and journalist Ruben de Theije uses sensitive and ethically considerate photos and personal stories of men with a history of an eating disorder that challenge general perceptions of the illness. Bartel has contributed an academic article to the volume. 
Type Of Art Creative Writing 
Year Produced 2020 
Impact We had planned to further public engagement with the topic by exhibiting the photos, collages and other artworks in Nottingham, London, Vienna and Amsterdam accompanied by talks and Q&A sessions. These plans had to be delayed due to Covid-19. 
URL https://astorytotell.info/
 
Title Video-Poems on Male Disordered Eating 
Description Together with film maker Jack Delaney from Simply Thrilled we have created video-poems of five of the poems received through our open call for poems on male 'disordered' eating. We have asked project members, inc. a mental health nurse, a GP, staff from EDs charities, students, teachers and researchers, to voice these powerful personal narratives about lived experience as sufferer, carer or family member. In the creative process of 'translating' the words into the medium of film and involving people with different perspectives on the topic in making the poems public, we reached new dimensions of awareness and communication. 
Type Of Art Film/Video/Animation 
Year Produced 2018 
Impact We have used the video-poems in training sessions on EDs (e.g. as part of the Peer Mentoring UG module at The university of Nottingham), in sharing our findings with partner charity First Steps EDs and as material for academic conferences (ED International Conference in 2019) and public presentations of our work (e.g. Health Humanities conference 2019). Viewers of the videos have reported a change in knowledge and understanding of male EDs and an increase in emotional involvement in the topic. 
URL https://www.nottingham.ac.uk/research/groups/hungry-for-words/community-outreach-events/poetry-compe...
 
Description The number of men and boys affected by eating disorders (EDs) is on the rise in the Western world. Yet EDs - serious mental illnesses that are often accompanied by severe physical complications and other conditions, and have a high mortality rate - are still largely perceived to be a female-only problem. Our network set out to further interdisciplinary research into narratives of male EDs (with particular focus on anorexia nervosa), and to raise awareness among professional audiences and the general public. For this we undertook research into three types of personal narratives of male EDs, namely 1. literature, 2. online ego-documents, and 3. client-led oral accounts. The research findings of our qualitative approach to narratives of male EDs have added the all-important human perspective and voice of the individual to the quantitative findings of clinical research in a sensitive and ethical way. The work undertaken in our network has started to fill the gaps in research into male EDs by addressing the need for capturing, analysing, comparing and communicating the experiences of men and boys to future and current healthcare professionals, those in pastoral roles and the general public.
The particular collaborative aim of our interdisciplinary network was to bring together medicine and health sciences, and arts and humanities, to raise awareness of and support educational initiatives in this under-researched area, and to lay the foundation for future collaborations. The funding period has been particularly productive: we have met our original objectives, as well as forming new collaborations. As planned, our three main research workshops, our final symposium and several informal working meetings and conferences have provided forums for highly fruitful interdisciplinary engagement and dissemination of our research findings. We have particularly benefitted from exchanges with medical professionals, who provided input into the project's arts and humanities approaches.

Strand 1 - Literary representations of male EDs: We established a theoretical, historical and cultural framework for the analysis of English, German and French narratives of male EDs, taking into account the latest research on masculinity studies; autobiographical writings; illness, recovery and addiction narratives; and literature for young readers (educational and self-help books). The work undertaken addressed crucial differences and similarities between narratives of female and male EDs and situated the topic in relation to women's writings on EDs. Furthermore, we explored how insights from healthcare professionals help us to better understand narratives of EDs, but also, importantly, how these narratives can be used to raise awareness in schools, HE institutions, and the general public, and in training healthcare professionals. The strand yielded academic publications by Bartel (2018; 2019; 2020), including the first monograph on the topic 'Men Writing Eating Disorder: Autobiographical Writing and Illness Experience in German and English Narratives' (2020); Bartel and Baker (2020); Calamita, Bagley and Robson (eds. 2018). The creative dimension of this strand, which delivered creative writing and drama workshops with pupils, a poetry competition, stand-up comedy and collaborations with creative partners (see below), has provided a stimulus for publications by Perez and Crawford (2018; 2017) on the benefits of creative workshops for people with mental health problems and for carers and practitioners.

Strand 2 - Online representations of male EDs: Research undertaken as part of this strand took the form of detailed analyses of teenage health websites, bringing an applied linguistics approach to online discussions of male eating, diet, body shape and weight. Hunt's research, presented in workshops and at academic conferences, identified particular linguistic patterns. The team led by Perez addressed particular issues regarding the ethics of online and social media communications and their use in research. Perez' work (2019; 2018: 2017) is currently setting best practice examples through several academic publications on the ethical challenges of the use of online data in research at a time where the majority of children and adolescents use digital media for self-expression on topics that include body image and concerns about weight and shape. In addition, knowledge exchange in this strand outlined the potential of online communication for engaging young people, and we worked with Kooth, an online counselling and emotional well-being platform for children and teenagers.

Strand 3 - Oral representations of male EDs: This strand gave insights into problems and perspectives of oral communications with males affected by EDs in therapy settings. Particular emphasis by Mills and Wright was placed on the problems presented by: a perceived female-centric framework for EDs that often makes males reluctant to speak out about their EDs; power relationships in the discourse between client and therapist; how to accommodate highly individual lived experiences with EDs in research; findings are currently feeding into Mills' PhD. Foye has disseminated her research on the treatment of male EDs in 2018 on the digital platform 'The Mental Elf' that presents latest health research, connects experts, provides professional development and facilitates conversation between stakeholders and patients. Foye has also published articles on EDs and emotional intelligence medical journals (2018), whilst CoI Micali led an important plenary session on EDs across gender and ages at an international conference in Montreux in 2018 that brought psychiatrists and medical practitioners together.
Key findings
The personal narratives of EDs by males analysed in all strands of the project vary considerably in terms of content and style. However, all texts of the corpus we analysed 'raise in their individual ways points that health care providers should attend to' (Bartel 2019). For example, a high proportion of personal narratives relate problematic initial contacts with primary care practitioners, and a recurring observation is that GPs appear reluctant to consider an ED diagnosis in male patients, in part because EDs are viewed through a 'female-centric' lens. The evaluation of our corpus has identified further key issues - currently neglected - that should be routinely considered when diagnosing or treating males who present an ED. These include the perception of extreme eating behaviour such as bingeing and purging as shameful and 'unmanly', EDs in non-heterosexual men and the association of EDs with homosexuality in heterosexual men, the effects of some EDs on sexual function in men, adverse reactions to female practitioners when seeking help, the role of sport and over-exercising, patterns of drug and alcohol abuse, and difficult father-son relationships. The network concluded that a cross-disciplinary approach with emphasis on personal narratives and combining arts and humanities and medical perspectives goes further than, for example, medical case vignettes or quantitative clinical research alone in helping health professionals, as well as a wider public, to understand lived experiences of male EDs in all their complexity. Such increased understanding has, in turn, the potential to lead to early intervention, support timely recovery and reduce the considerable personal cost and healthcare expenses that come with long-term treatment. We have received AHRC follow-on-funding and funding from Wellcome to take this aspect further, and in 2020 we completed a creative, arts-based and patient-centred training tool.
Exploitation Route The network provided the opportunity to explore ideas for short and long term research and projects indicating ways in which our findings can be taken forward. Examples are:
- Undertake more qualitative and quantitative research on male EDs and on other groups currently considered as 'atypical' for EDs, e.g. LGBTQ, BAME, aged 30 plus, age 52 plus, individuals with learning disabilities.
- Develop training regarding the identification and recognition of male EDs at primary care level combining medical expertise with the communicative and creative approaches of arts & humanities. We have made a start on this with our animated training tool used by the Royal Colleges of GPs, Nursing and Psychiatrists and others (supported by AHRC follow-on-funding). There is, however, a clear scope for much more training in the field, e.g. regarding EDs and excessive exercise, muscle dysmorphia, binge eating disorder and obesity. [In 2020, with further funding from AHRC, we have developed a successful arts-based training tool for primary health carers: 'Consider Eating Disorders in Men'.]
- 'Hungry for Arts': Take the findings from our research into narratives of EDs ('Hungry for Words') to further investigations of arts-based approaches to communicate narratives of illness, recovery and health.
- Research the role and potential of (real and virtual) 'Drop-in cafes' as community-based approaches for the public to address mental health issues
- Establish a detailed and practice-orientated theory of interdisciplinarity as a methodological reference point for projects like 'Hungry for Words' that bring medicine & science and arts & humanities together. This research could be situated in the discipline of Health and Medical Humanities.
Sectors Agriculture, Food and Drink,Communities and Social Services/Policy,Creative Economy,Education,Healthcare,Leisure Activities, including Sports, Recreation and Tourism,Government, Democracy and Justice,Culture, Heritage, Museums and Collections,Other

URL https://nottingham.onlinesurveys.ac.uk/consider-eating-disorders-in-men-beat-cpd-training-rcgp-3
 
Description At a time when NHS statistics record sharply rising numbers of eating disorders (EDs) in men and boys, results from Bartel's AHRC-funded comparative and interdisciplinary research network on creative approaches to communicate and articulate EDs in males has transformed the understanding of this complex illness. The impact of literature- and arts-based research and training resulting from the network includes the following: - healthcare practitioners reported dramatic increases in confidence to spot the signs of EDs in men and to begin a conversation with them; - an international cohort of professionals working in strategic positions with young people reported growing confidence and knowledge of EDs in males, affecting, in turn, the confidence and knowledge of the young people they support; - organisations and practitioners in the creative sector in the UK and abroad have adapted their practices. 1. Contribution to education at schools and HE institutions: a.) Secondary schools: The network has raised awareness of EDs and related mental health issues among pupils and school teachers and is shifting the perception of EDs as 'female only' disorders. Following advice from schools, parents and EDs charities we framed all our educational events with schools so that they addressed broader issues of mental and physical health and well being, self-esteem and self-confidence, and we situated the topic of EDs within this framework. With support from expert charities we have delivered several events with schools: i.) The 'Hungry for Words - Self-confidence and self-esteem for young people' workshop (at The University of Nottingham, Jan. 2017) was aimed at both students and teachers. The event was very successful, fully booked within days and attracted 72 pupils (mainly year 11 and 12) and teachers from 6 schools in the East Midlands area. The feedback from students, measured via clickers and open feedback questionnaires, highlighted an increased confidence and knowledge of the issues following the event. ii.) Teachers delivered follow-up work in their schools, and one Nottingham school received further support in dealing with EDs among males from our partner EDs charity First Steps EDs. iii.) Teachers also highlighted their own need to acquire greater knowledge and skills regarding EDs in males and females, and youth mental health in general. In response we organized an accredited training day for 13 teachers led by the charity Mental Health First Aid England (MHFA), with a dedicated session on EDs (to which PI Bartel contributed). The event 'sold out' within two days providing a powerful testimony to the need for addressing EDs and mental health in the school sector. Teachers reported in feedback questionnaires how useful they found the training, and greater collaboration between participating schools was one result of the event. Bartel's appointment in 2018 to the Board of the White Hills Park Federation Trust - a collective group of secondary schools in Nottingham - means that outcomes of the network are continuing to steer collaborations focusing on mental health and EDs between schools in the region. It has led e.g. to workshops with local schools on mental health in teenage fiction at The University of Nottingham) b.) HE institutions: Addressing demand in HE voiced by teaching staff and Student Services at the University of Nottingham, we have collaborated with MHFA on a training event for staff with pastoral roles at four UK universities which included a session on male EDs. In addition, we have collaborated with EDISS (EDs in Student Services). One result of this is that a 2-hour session on EDs, co-taught by Bartel and EDISS, is now part of the regular syllabus of the annual module 'Peer Mentoring' at the University of Nottingham', which prepares undergraduates to take on support roles for first year students. Furthermore, we have contributed to the training of future health practitioners, undergraduate and postgraduate students of Medicine, Nursing, Psychology at the University of Nottingham, and of MSc students in 'EDs and Clinical Nutrition' at University College London, through seminars, meetings and creative events. These students confirmed in their feedback that they felt better equipped to diagnose and provide treatment for men and boys with EDs after considering the issues raised through personal narratives. In addition, students from the postgraduate course in EDs commented that their expert knowledge of the wide range of EDs had been broadened even further, with one praising 'the depth and insight' acquired through 'the voice of real people personally [] on top of the specialised expertise of the various speakers'. 2. Collaboration with charities: Six 'Hungry for Words' workshops and meetings have been attended by stakeholders from the charities First Steps EDs; Kidscape; Kooth; and Men Get EDs Too. These provided opportunities for knowledge exchange and collaboration. In turn, network members have attended training events and conferences organized by these charities. These collaborations have resulted in joint training events providing specialist education about male EDs to future health care providers, e.g. to students on the MSc in EDs and Clinical Nutrition at UCL. The network has established a particularly close working relationship with Derby-based First Steps Eating Disorders. This charity has distributed Bartel's research and consulted with the network on numerous occasions, e.g. on the social media campaign 'Break the Silence. EDs have no gender' (2018) and 'Consider Male Eating Disorders' (2020) which both specifically targeted men and boys during EDs Awareness Week. Our collaboration included sharing research findings based on our linguistic, literary and cultural analysis of representations of male EDs for the 2018 campaign, which reached 1509 people on its 'peak day' (2020 analysis pending at state of writing). PI Bartel has become closely involved in the work of First Steps as academic advisor and, since Dec. 2018, is shaping as a trustee the new direction of this growing charity as it becomes a Charitable Incorporated Organisation. Bartel and other network members have also been involved in the 2019 launch of a new EDs charity with a focus on male EDs and accompanying conditions, Male VoiceED, and are helping to establish the organization by providing academic support and creative input. 3. Public engagement: Broadening knowledge and understanding among the general public was a key aim of the project. As part of the Being Human Festival in November 2017 and November 2020 we organized 'Hungry for Words Cafés' in five venues across Nottingham (2017) and online (2020). These provided an open opportunity for men to talk about any issues regarding food consumption and share their stories via an anonymous story-board. The 2017 event attracted media attention and was featured on Notts TV News. Anecdotal evidence obtained from men during the drop-in cafés suggests a strong focus in the male population on food, diet, exercise and image. Contradicting common assumptions, we found that male volunteers were very forthcoming in sharing stories about food and eating, but clearly preferred the public venue and the opportunity to speak one-to-one with a listener rather than in a group. These are important findings for the provision of EDs therapy for males, echoed by research on gender and therapy settings, which we have shared with our EDs charity partners. The drop-in sessions have also increased referrals to our charity partner First Steps. Our stand-up comedy night in January 2018 with award-winning comedian and mental health campaigner Dave Chawner on his lived experience of anorexia was open to the public and attended by 35 people. In feedback questionnaires the audience reported a change in knowledge of and attitudes towards male EDs. The very positive feedback included, 'You have given me the confidence to speak up about my own problems with food - as a man! Thank you!' Our poetry competition in May 2018 invited carers, family members, friends, co-workers or men affected by EDs to write poems about male 'disordered' eating, providing further proof that this topic is of great interest to groups in the general public. The 11 participants expressed gratitude to the network for providing a platform and further creative means to make their voices heard (see 4.). Feedback from the 12 project members who ranked the poems provides anecdotal evidence of the impact of these personal poetry narratives: 'They have expanded my awareness and grasp of how it can feel for different individuals. I am really grateful that they have put these out there, and I think they can be very impactful for other men to read.' 4. Creative events: We have worked closely with representatives of the creative industry to exchange knowledge about representations of male EDs in literature, media, culture and art. The German authors Ulrike Draesner and Ulrike Almut Sandig, for example, have provided insights into the working practice of writers on the topic of EDs in two workshops. We have also worked closely with comedian and author Dave Chawner who wrote his 2018 book Weight Expectations. One Man's Recovery from Anorexia during a period of close collaboration with the network concerning narratives of EDs. Chawner has engaged in extensive knowledge exchange with us and the network facilitated his appointment as patron to First Steps in 2018. Our project has led to collaborations with photographers Rinzing Kelsang and Mafalda Rakos. These resulted in an exhibition of Kelsang's photography and poetry, 'Being Elsewhere', with a focus on mental and physical health as part of EDs Awareness week 2018 at Nottingham's Institute of Mental Health, and in Bartel's contribution to Rakos' photobook 'A Story to tell: Or Regarding Male Eating Disorders' (published 2020). In addition, our poetry competition on male disordered eating resulted in 11 impressive submissions ranked by a panel of experts, and in June 2018 we collaborated with academic and medical partners in the production of five videos in which they lent their voices to the poems' lived experience, thus showing the great potential of literature and art to engage both sufferers and practitioners. The video poems are introduced and exhibited on the network's website. Working with these creative stakeholders has given us insights into effective and creative ways of raising awareness about male EDs and related mental health issues in the general public, and among healthcare professionals and medical researchers. The various audiences of our readings, stand-up comedy gig, video-poems and photo exhibition in all cases reported an increased understanding of male EDs, greater awareness, and a reduction of inhibitions surrounding talking openly about the topic. Reports from our various impact, public engagement and knowledge exchange activities have shown that the original network award has: 1) increased understanding of male EDs through public events that have raised the visibility of the topic and aimed to break down stigma; 2) supported educational initiatives in this area in secondary schools, by providing educational content and creative engagement for pupils, and training and networking opportunities for teachers through several events; 3) provided training on EDs in men and boys at HE institutions to students and staff; 4) provided support, knowledge exchange and research-based advice for three EDs charities. In 2020, AHRC follow-on-funding has enabled our team to co-create with animation team WovenInk an animated training film voicing the personal experiences of seven men with EDs in primary health care, this tool is currently having considerable impact on healthcare training and healthcare.
First Year Of Impact 2016
Sector Communities and Social Services/Policy,Creative Economy,Education,Healthcare,Culture, Heritage, Museums and Collections
Impact Types Cultural,Societal,Policy & public services

 
Description Animated training tool 'Consider Eating Disorders in Men'
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact Our animated patient-centred free online training tool, 'Consider Eating Disorders in Men', earned accreditation by the Royal College of General Practitioners in 2020. The tool has also achieved official endorsement from the Royal Colleges of Nursing and Psychiatrists in 2020. Among 140 respondents in the UK (May - Oct. 2020), the training generated significant increases in practitioners feeling more confident (after training) to: 1. spot the signs of EDs in men (19% > 85%); 2. begin a conversation with a male patient about his eating (32% > 87%); and 3. know when to refer a patient to a specialist EDs service (18% > 77%). With 86% of the 140 respondents reporting initially no knowledge of any other specialist resource on EDs in men, the tool fills a gap in training and will improve patient care.
URL https://nottingham.onlinesurveys.ac.uk/consider-eating-disorders-in-men-beat-cpd-training-rcgp-3
 
Description Expert Panel Student Minds
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact In 2020 I was appointed member to the Expert Eating Disorder Panel of the registered UK charity Student Minds. Since then we have held several meetings recommending initiatives, policy changes and research regarding the growing problem of eating disorders in the student population with particular focus on the particular challenges the Covid-19 pandemic has brought.
 
Description GP training at Chesterfield Royal Hospital
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact 22 GPs attended a training session on eating disorders in men and boys and on creative practices to communicate this under researched topic to health practitioners, which sparked questions and discussion afterwards, and participants reported increased awareness for eating disorders in males afterwards. The training has increased practitioners ability to spot signs and symptoms, raised their awareness for eating disorders in men and boys, contributed to their ability to make referrals, and increased for patients chances of early diagnoses leading to better chances of recovery.
 
Description Training of mental health nursing students
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact 18 mental health nursing students have attended a training session on eating disorders in men and boys and on creative practices to communicate this under researched topic to health practitioners, which sparked questions and discussion afterwards. Participants reported increased awareness for eating disorders in males afterwards and reported changes in their behaviour in their practical work as a follow-up. This increases the chance of accurate diagnoses of this under represented illness leading to effective intervention and better chances of recovery as well as an increased awareness of eating disorders in males as part of the mental health screening.
 
Description 'Consider Male Eating Disorders': A creative approach to improving access to treatment in primary health care for men and boys with eating disorders
Amount £24,082 (GBP)
Funding ID AH/T003820/1 
Organisation Arts & Humanities Research Council (AHRC) 
Sector Public
Country United Kingdom
Start 07/2019 
End 07/2020
 
Description Biomedica Research Centre fuding
Amount £24,322 (GBP)
Organisation University of Leicester 
Department NIHR Biomedical Research Centre
Sector Hospitals
Country United Kingdom
Start 01/2018 
End 01/2019
 
Description CLAS Impact Fund
Amount £3,000 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 03/2017 
End 09/2017
 
Description Eating Disorders: Delineating illness and recovery trajectories to inform personalised prevention and early intervention in young people (EDIFY)
Amount £3,913,565 (GBP)
Funding ID MR/W002418/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 08/2021 
End 08/2025
 
Description Eating Disorders: Delineating illness and recovery trajectories to inform personalised prevention and early intervention in young people (EDIFY)
Amount £3,913,565 (GBP)
Funding ID MR/W002418/1 
Organisation United Kingdom Research and Innovation 
Sector Public
Country United Kingdom
Start 11/2021 
End 10/2025
 
Description Funding for participation in Being Human Festival 2018
Amount £100 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 11/2017 
End 04/2018
 
Description Nottingham Impact Accelerator Award
Amount £4,800 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 01/2020 
End 06/2020
 
Description Postgraduate Placement Nottingham
Amount £1,014 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 12/2017 
End 05/2018
 
Description REF 4* funding
Amount £1,400 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 02/2020 
End 06/2020
 
Description REF 4* funding for Impact Activities
Amount £2,000 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 02/2019 
End 07/2019
 
Description RPA Health Humanities Seedfunding for Collaborative Research
Amount £3,500 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 01/2019 
End 07/2019
 
Description RPA Texts, Languages and Society Impact & Outreach Grant
Amount £3,000 (GBP)
Funding ID A2RVUN 
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 01/2019 
End 07/2019
 
Description Wellcome Prime Fellowship (matched funded by the University of Nottingham)
Amount £12,259 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 03/2020 
End 04/2021
 
Description Collaboration with Eating Disorders Charity First Steps Eating Disorders 
Organisation First Steps Derbyshire
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We provide opportunities for knowledge exchange with this charity and contribute with our research expertise in particular to a social media campaign targeting men and boys with eating disorders. We facilitate contacts with Nottingham schools through our Widening Participation network and provide a framework for educational input by First Steps. We support and collaborate with regards to EDISS (Eating Disorders in Student Services), a service provided by First Steps at the universities of Nottingham and Nottingham Trent.
Collaborator Contribution The eating disorders charity First Steps, based in nearby Derby, and their Eating Disorders in Students Services (EDISS) based at the universities of Nottingham and Nottingham Trent provide opportunities for knowledge exchange, collaboration and joint public engagement and impact activities. The charity also provides training for network members for public engagement and other activities, i.e. drop-in cafes with members of the public, and contributes to educational events with schools.
Impact The collaboration with First Steps has led to: - Two joint educational events with schools in January 2017 and May 2017 - One training session by First Steps for network members in engaging with members of the public on the topic of food, eating, diet and body image - A social media campaign 'Break the Silence - Eating Disorders have no gender' targeting men and boys to which the project added research findings and networking contacts. This was launched as part of EDs Awareness week 2018 and the number of people reached during that weak peaked at 1509. PI H. Bartel and team members S. Bipin and D. Hunt are involved in next phases of the campaign. - Input into a training session at The University of Nottingham for 12 members of teaching staff at four UK universities. - One joint training session for undergraduates at The University of Nottingham, module 'Peer Mentoring' (2018)
Start Year 2016
 
Description Collaboration with Eating Disorders Charity Male VoicED 
Organisation Male Voices with Eating Disorders
Sector Charity/Non Profit 
PI Contribution Male VoicED is a new Eating Disorders charity with particular focus on male eating disorders and comorbid conditions launched in February 2019. Member of our network are active in supporting this charity and developing future projects together.
Collaborator Contribution PI Bartel and members Foye and Chawner supported the public launch of Male VoicED and are currently planning to collaborate on a project to raise awareness in GPs for male eating disorders.
Impact Future planning.
Start Year 2019
 
Description Collaboration with mental health research group Leaders Unlocked 
Organisation Leaders Unlocked
Country United Kingdom 
Sector Private 
PI Contribution Bartel contributed as local advisor to the works of Leaders Unlocked, particularly regarding student mental health, and eating disorders.
Collaborator Contribution We benefited from the youth-led citizen research approach of Leaders Unlocked, hearing from young people about their mental health needs, sharing creative ideas to raise awareness and benefiting from the access they had to peers to review our animation.
Impact Outputs were limited to virtual outputs but include a poster campaign and a showcase to a broad audience.
Start Year 2019
 
Description International collaboration with German partner 
Organisation Landesfachstelle Essstoerungen NRW
Country Germany 
Sector Public 
PI Contribution We brought the concept and creative material from our UK training tool to colleagues in Germany.
Collaborator Contribution Our German partners delivered exchange of knowledge about procedures, experiences and funding in Germany.
Impact As a result of our knowledge exchange and partnership we are planning a joint German training tool to educate healthcare practitioners in Germany about eating disorders in males. This is modelled on our successful UK tool.
Start Year 2020
 
Description 'Consider Male Eating Disorders' one-day conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The day organised by PI Bartel with partner eating disorders charity first steps brought together patients, practitioners, researchers and others to discuss approaches to the topic male eating disorders. The event facilitated exchange of knowledge, sharing of experiences and led to plans for collaboration on a training tool for healthcare on the topic.
Year(s) Of Engagement Activity 2019
 
Description Being Human Festival 2017: Hungry for Words Cafes 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Hungry for Words? Let's talk about food, weight and shape- with men. Just like women, men and boys often have concerns about weight, body shape, diet and exercise which may lead to problems around food including over- or undereating. Men find these things even more difficult to talk about than women.
Our open café sessions lead by members of the research network previously trained by the EDs charity First Steps Derbyshire were part of the 2017 Being Human Festival on one afternoon in September 2017. They provided men with an opportunity to share their experiences around food, weight and shape, and to discuss their thoughts, feelings, behaviours and perhaps difficulties. In five different cafés across Nottingham we offered an easy way of starting to talk about what can be a taboo subject: issues connected with food and eating that affect men physically, psychologically or socially. Our drop-ins for men of all ages, ethnic groups and backgrounds did not offer therapy but a space to talk openly one-to-one in a public space to a good listener. Further information was provided for those who wanted it and has lead to two referrals by affected individuals to our partner EDs charity. The 14 men wo participated were also invited to contribute a few words, sentences or images to our storyboard showcased on our website to encourage a wider conversation and raise greater awareness. Results of the sessions, e.g. choice of topics and words, have lead to two poster presentations at academic workshops (Bartel and Bipin) and have inspired plans for further collaborative research on the role of mental health drop-in sessions in public places by J. Hollands, S. Bipin and H.Bartel.
Year(s) Of Engagement Activity 2017
URL https://beinghumanfestival.org/event/hungry-words-lets-talk-food-men/
 
Description Blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Interview with Nottingham's Future Food Beacon of Research Excellence for their Blog. This has led to greater recognition of our work and three requests for further information leading to possible collaborations.
Year(s) Of Engagement Activity 2019
URL https://blogs.nottingham.ac.uk/futurefood/2019/09/20/using-narratives-to-understanding-eating-disord...
 
Description Blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Interview with AHRC leading to Blog about our impact work. This has led to greater recognition and two enquiries about possible collaborations and advice.
Year(s) Of Engagement Activity 2019
URL https://ahrc-blog.com/2020/06/18/aim-high-and-involve-others-impact-top-tips/
 
Description Conference on Disorderly Eating at School of Advanced Study, University of London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact PI H. Bartel delivered a talk on 'Re-assessing Gender through Writing about Male Eating Disorders' and contributed to a round table discussion on 'Disorderly Eating: Food and Disruption in Contemporary Women's Writing' as part of this conference with focus on comparative literature research organised by the Centre for Contemporary Women's Writing at the School of Advanced Study, University of London. Bartel will contribute her research to a planned publication of proceedings from this conference.
Year(s) Of Engagement Activity 2017
URL https://modernlanguages.sas.ac.uk/events/event/8473
 
Description Conference on eating disorders in men and boys 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Together with partner eating disorders charity First Steps we organised a one-day conference at The University of Nottingham in December 2019 on the topic of eating disorders in men and boys with particular focus on communicating patients' perspectives through creative approaches. The event was attended by counsellors from HEIs and other institutions, staff from sports centres, researchers from across the UK, GPs, and men with lived experience. The day sparked questions and discussion on how to improve awareness and care for males with eating disorders, and led to concrete ideas for future training tools based on reviews of our current project, an animated training film.
Year(s) Of Engagement Activity 2019
 
Description Contribution to Being Human Festival 2021 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact In November 2021 we held an online Cafe at the Being Human Festival aiming to inform about and destigmatise eating disorders in men and boys. The event was aimed at the general public, sold out, and included discussion, a quiz and yoga exercises, and was supported by a helpline provided by eating disorders charity First Steps ED. The event was recorded through visual notes taken by Pen Mendonca.
Year(s) Of Engagement Activity 2020
URL https://beinghumanfestival.org/event/de-stigmatising-eating-disorders-in-men-cafe/
 
Description Contribution to Eating Disorders International Conference 2021 (online) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Together with CoI Dr Una Foye, Kings College London, Bartel presented the outcomes of her work on eating disorders in men at this international conference. The online workshop engaged audiences with the animation and training tool designed through AHRC-funding.
Year(s) Of Engagement Activity 2021
URL https://edic.beateatingdisorders.org.uk/
 
Description Health Humanities Conference: Image and Narrative: Illness, Recovery, Change 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Conference 'Image and Narrative: Illness, Recovery, Change Conference' brought together interdisciplinary researchers with focus on the topic of communicating illness, recovery and change in creative ways. PI Bartel co-organised and co-led the conference building on and integrating her work on male eating disorders and their marginalised narratives.
Other contributors included: Professor Susan Hogan on The Birth Project,
?Woven Ink, whose animation on eating disorders and pregnancy with King's College London won the CLAHRC Award for Communicating Research
?Narrative Experiences Online (NEON), the National Institute for Health Research (NIHR)-funded study of online stories of personal recovery
?Dr Elvira Perez Vallejos will lead a Flamenco-Yoga workshop and explore its contribution to health
?Penelope Mendonca, a graphic facilitator, will be visually capturing the key points of discussion and presenting her research on Values-Based Cartooning
?Opportunities to access relevant funding and training
?An exhibition by the textile artist Caren Garfen, whose work addresses issues in health, gender politics and women's issues in the twenty-first century.
Year(s) Of Engagement Activity 2019
URL https://www.nottingham.ac.uk/arts/events/image-and-narrative-illness-recovery-change.aspx
 
Description Health Humanities Showcase (2019) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact PI Bartel presented the project 'Hungry for Words' at the Health Humanities Showcase event at The University of Nottingham in Jan. 2019.
Year(s) Of Engagement Activity 2019
 
Description Hungry for Words - Self-confidence and self-esteem for young people: 26th Jan. 2017. A day of activities with schools from the East Midlands area held at The University of Nottingham 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact 'Great - whoever has organised it has hit a 'hot topic'', was the comment one teacher sent back shortly after we advertised our free event 'Hungry for Words: Self-esteem and self-confidence for young people', funded by our AHRC grant, that booked out within a few days. This day for schools held on 26.1.2017 on The University of Nottingham's Jubilee campus (10 am-2:30 pm) was very successful and attracted 72 pupils (mainly year 11 and 12) and teachers from 6 schools in the East Midlands area.
The event aimed to encourage an open forum for students to learn about self-esteem and self-confidence, how to cope with challenges such as eating disorders, Obsessive Compulsive Behaviour, (cyber)bullying and stress.

We started in the morning with a plenary session on 'Self Esteem' delivered by Jenny Langley, followed by workshops on Boys and 'Body Image' (Marc Thrasivoulou); 'Girls, Body and Self -Esteem' (Jenny Langley); Cyberbullying (Sam Marks). All three workshop leaders are working for / associated with charities that are closely linked to the topic and could give expert advice: Jenny Langley is founder of BOYANOREXIA (http://www.boyanorexia.com/ a registered Eating Disorders (EDs) charity dealing particularly with boys), author of Boys Get Eating Disorders Too (2006), associate trainer in educating about and raising awareness for anorexia in young males for the reg. EDs charity B-eat (https://b-eat.co.uk/). She is also associate trainer for the Charlie Waller Memorial Trust, working for young people's mental well-being, and associate of the EDs research team of the Institute of Psychiatry. She is also mother to a son who overcame anorexia nervosa. Marc Thrasivoulou is a Sport and Exercise Science Graduate and a qualified Personal Trainer, who has been working at the registered EDs Charity First Steps (http://firststepsderbyshire.co.uk/) for the past 9 years, in a variety of roles and capacities. Marc's main expertise is in the area of Compulsive Exercise and EDs. He has personal experience of an eating disorder, and has facilitated the Loughborough Eating-Disorder Activity Therapy project for those struggling with compulsive exercise. He is able to offer a Practical Exercise Service to those struggling with Compulsive Exercise and Physical Inactivity. Samantha Marks is a trainer for Kidscape, an anti-bullying charity founded in 1985, who equip young people, parents and professionals with the skills to tackle bullying and safeguarding issues across the UK. Samantha has been working in the charity and youth sector for the last ten years and is passionate making sure young people's voices are heard and listened to and that adults working with young people understand how to create safe environments and fulfil their safeguarding duties while also looking after themselves.

After the morning workshops students had lunch with our undergraduate ambassadors who reported great interest in the topics and good interaction between students. Over lunch with teachers the AHRC research team discussed further activities with schools and they all agreed that follow-up visits by trainers from local charities with related focus would be most useful to train and educate students, student ambassadors and, importantly, teachers further. With the additional money of £3000 we secured from CLAS for further impact we are planning to arrange a number of such visits. We will also look into further activities such as 'teachers' packs' and GP leaflets.

In the afternoon students could choose from four arts and humanities based workshops:
Elvira Perez: Flamenco-Yoga Workshop. Elvira Perez is a yoga instructor and led a fun and active workshop that could be enjoyed by all. This workshop gave students some ideas as how to deal with stress through movement and breathing combining relaxing and slow elements of Kundalini Yoga with energetic elements of Flamenco dancing. Originally, Flamenco dancing was the only way repressed groups in Southern Spain such as Romani Gypsies, Muslims and Jews were allowed to express themselves, voice anger, fear, power and desire (perhaps a bit like Rap or Hip-hop in our days?). So it is a great tool to show people how to express themselves and tell their 'stories'.
Danielle Mills: Not all therapists have two legs! What can we learn through interaction with animals? How can animals help us pick up and deal with problems we may be having: stress, loneliness, issues with self-confidence and self-esteem. How can they teach us important skills like non-verbal communication, compassion, assertiveness, creative thinking, problem-solving, leadership, teamwork, relationship skills, confidence and resilience? Danielle Mills is a qualified counselor who has set up Pony Partnerships (http://www.ponypartnerships.com/) specializing in Equine Therapy. Her hands-on workshop addressed some of these questions with the help of her therapy dog.
Dawn Bowden: Drama Workshop. How can we use Drama to better understand the things that might affect us and our peers, now or in the future? This workshop by Dawn Bowden (www.dawnbowden.co.uk) explored what it is like to experience stress through the creation of a character. Having considered the character students then creatively expressed how they might support her or him to develop both Coping Strategies and Resilience.
Heike Bartel: Creative Writing Workshop: Change Your Perspective. Stories allow us to experience what it is like to be in another person's skin or to tell stories about ourselves but from a distance and with the freedom to 'change the script'. Heike Bartel delivered a creative writing workshop where students could explore different perspectives: How do we see other people? How do we see ourselves? How do we pick up signs how someone is feeling? How can writing or telling stories help us becoming aware of problems surrounding us and our own perspective on things? Students particularly enjoyed meeting Danielle Mills' registered therapy-dog who was on site the whole day and helped to 'staff' the safe room, an area where students could withdraw to if they needed a break from the programme.

Feedback we collected (via clicker) at the beginning and end of the day clearly indicated that students' understanding and knowledge of the topic had improved significantly throughout the event.
Question 1:'How clearly do you understand the impact that confidence and self-esteem has on mental health?' was answered after the event as follows: Very clearly 58% (24% at start); clearly 35% (42% at start); not very clearly 7% (34% at start).
Question 2: How clearly do you understand how to increase your confidence and self-esteem?' was answered after the event as follows: Very clearly 36% (8% at start); clearly 51% (22% at start); not very clearly 13% (70% at start).
Question 3: 'How knowledgeable are you about eating disorders and boys?' was answered after the event as follows: Very knowledgeable 42% (10% at start); reasonably knowledgeable 51% (34% at start); not very knowledgeable 7% (56% at start).

Open anonymous feedback delivered good anecdotal evidence of positive impact and 100% of comments said that this event was useful and they would recommend it for other young people. The day clearly raised awareness and sparked discussion, and teachers reported follow-up discussions and increased interested in the topics discussed after the event. We are currently planning with teachers and students our follow-up activities in schools in the region (school visits by trainers from local EDs and mental health charities).
Year(s) Of Engagement Activity 2017
URL http://www.nottingham.ac.uk/clas/about/news-and-events/events/hungry-for-words-self-confidence.aspx
 
Description Hungry for Words Final network symposium 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The final symposium of our AHRC research network (January 2018 at The University of Nottingham) was attended by 42 international delegates including members of the network and new associates and brought together an interdisciplinary group of established scholars, early-career researchers and students from medicine, computer science and arts and humanities, representatives from EDs charities, other health-orientated charities and the creative industries as well as delegates with lived experiences of EDs and colleagues from The University of Nottingham's Centre for Advanced Studies (CAS) advising on further projects and funding. A workshop on the research strand 'oral representations of male eating disorders' by D. Mills and C. Wright was also part of the programme. Outcomes were: discussing and disseminating research; reporting on public engagement and impact activities; planning further collaborations; addressing challenges. Delegates fed back very positive responses about networking opportunities, concrete plans for short and long term projects and increased knowledge facilitated by this event.
Year(s) Of Engagement Activity 2018
URL https://www.nottingham.ac.uk/research/groups/hungry-for-words/events/ahrc-research-network-hungry-fo...
 
Description International Health Humanities Conference, Seville 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact PI Heike Bartel delivered a talk at the 2017 International Health Humanities Conference: Arts & Humanities for Improving Social Inclusion, Education and Health: Creative Practice and Mutuality: 'Literary Representations of Anorexia Nervosa in Males'. The paper and following discussion outlined some of the questions and approaches developed in the AHRC network 'Hungry for Words' and highlighted Bartel's further research findings with regards to texts (fiction, autobiographical writings, pop culture) from 19th C - 21st C. This conference was a very good platform to disseminate research, exchange views with a broad range of international experts and practitioners and has led to useful further contacts and collaborations with academics, e.g. Steven C. Schlozman, Assistant Professor of Psychiatry at Harvard Medical School, psychiatrist at Massachusetts General Hospital and published author of fiction.
Year(s) Of Engagement Activity 2016
URL http://www.ihhcsevilla2016.es/
 
Description Interview for local tv channel Notts tv news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Media (as a channel to the public)
Results and Impact Our public engagement activity - drop-in sessions in 'Hungry for Words Cafes' in five cafes in Nottingham - encouraged men to talk openly about food and eating and was part of the national 2017 Being Human Festival. The widely advertised event sparked interest from local tv broadcaster notts tv. They interviewed PI Heike Bartel and one volunteer on site and decided to integrate the feature into a wider discussion about men and food/eating.
Year(s) Of Engagement Activity 2017
URL https://www.nottingham.ac.uk/research/groups/hungry-for-words/community-outreach-events/community-ou...
 
Description Introduction of network at Corpus Linguistics Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact PI Heike Bartel was invited to introduce the AHRC research network during a workshop on Corpus Approaches to Health Communications as part of the international Corpus Linguistics Conference hosted by The University of Birmingham in July 2017. The workshop has lead to further contacts and exchanges.
Year(s) Of Engagement Activity 2017
URL https://www.birmingham.ac.uk/research/activity/corpus/events/2017/cl2017/index.aspx
 
Description Invited lecture with Q&A the medical students at The University of Sheffield 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact I gave an invited 45 mins presentation on Eating Disorders in Men and Boys followed by 15 mins of Q&A as part of the further education & training programme at the Medical School, The University of Sheffield.The discussion afterwards sparked interest and questions and the organiser reported increased awareness for the topic afterwards.
Year(s) Of Engagement Activity 2022
 
Description KCL-SLaM Mental Health Nursing department presentation and discussion 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Information about the project was presented alongside an overview of the animation to members of the KCL-SLaM mental health nursing research monthly meeting. After a short presentation the group engage din a discussion about the animation and provided insight into aspects of the animation and toolkit that would be helpful to the nursing progession.
Year(s) Of Engagement Activity 2020
 
Description Keynote at International Health Humanities Conference in Taiwan 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I delivered a keynote on 'Re-Evaluating Narratives of Illness and Recovery: Writings on Male Eating Disorders' at the conference 'Research Institute on Interdisciplinary Medical Humanities (IMH 2019)' at Tamkang University, Taiwan (June 24 to 26, 2019): "Medical Humanities in the Age of the Anthropocene". The keynote sparked discussion and questions on the topic afterwards but also led to more general debates on the role of the growing discipline of Health and Medical Humanities in Taiwan and Eastern Asia leading to plans for future collaborations.
Year(s) Of Engagement Activity 2019
URL https://networks.h-net.org/node/73374/announcements/3753080/imh-2019-medical-humanities-age-anthropo...
 
Description Keynote at training day 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I gave a presentation and a workshop at a state-sponsored Eating Disorder Support Centre in Cologne. The topic was Eating Disorders in Men and Boys. Out of this event international collaborations evolved, e.g. with the Medical School at the University of Bochum (Germany).
Year(s) Of Engagement Activity 2022
URL https://www.landesfachstelle-essstoerungen-nrw.de/veranstaltungen/details/unter-dem-radar-1
 
Description Kooth online mental health representations and ethics 2/2 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This presentation presented a case study to illustrate the ethical challenges of online research. Kooth.com, and online platform that offer counseling services to children and young people was used as an example.
Year(s) Of Engagement Activity 2017
 
Description Launch of new film as part of online training on eating disorders 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact As part of Eating Disorders Awareness Week 2023 I co-deliverd a 2,5 hour online training session on Gym Culture and Eating Disorders, together with charity First Steps and others. We launched at this event a film on the topic.
Year(s) Of Engagement Activity 2023
URL https://www.eventbrite.co.uk/e/gym-culture-and-eating-disorder-prevention-and-recovery-tickets-54628...
 
Description Mental Elf Blog about Male Eating Disorders 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A blog was commissioned by the Mental Elf, a regional UK wide website and blogging platform to aimed towards facilitating a democratic conversation between patients, clinicians, researchers, carers, policy makers, health and social care professionals and others. The blog drew on recent research findings to create a discussion on how can we best treat men with eating disorders at a time when the media was reporting an increase in admissions to hospital for this patient group. The blog sparked social media conversations from practitioners, researchers and those with lived experience to understand the challenges and facilitators to achieving this "best practice".
Year(s) Of Engagement Activity 2018
URL https://www.nationalelfservice.net/mental-health/eating-disorders/men-eating-disorders/
 
Description Nottingham Health Humanities Early Bird seminar (February 2018) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Project team members included Dr Colin Wright, Sasha Bipin, and Emma Joyes. One other non-team member attended the session (a post-graduate student at UoN). The team presented their experiences of the 'Hungry for Words' Cafe and a synthesis of results was provided by Sasha. We discussed what we had learnt and what we might look to do differently next time.
Year(s) Of Engagement Activity 2018
 
Description Online mental health representations and ethics 1/2 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This was a presentation on online ethics part of the network 'Hungry for words'. The presentation focused on the challenges of securing online consent from participants
Year(s) Of Engagement Activity 2017
 
Description Online training for NHS Trust in York 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Online training (90 mins) delivered with Dr Una Foye and Mr George Mycock to 36 participants organised by the Quality Improvement Lead - Children and Young People's Mental Health Clinical Networks (Yorkshire and the Humber) NHS England (North East and Yorkshire) and NHS Future. Topic: Excessive Exercise and Eating Disorders with particular focus on men as part of Eating Disorders Awareness Week 2023 (focus on men and boys).
Year(s) Of Engagement Activity 2023
URL https://future.nhs.uk/system/login?nextURL=%2Fconnect%2Eti%2FYorkshireHumberMentalHealth%2Fview%3Fob...
 
Description Presentation and engagement with MSc students 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Using the animation, poems and materials from the Hungry for Words work we developed a presentation about male eating disorders for postgraduate students and had a follow-up session with one of the men with lived experience who we developed the animation with to engage with a Q&A with the students. This led to student feedback regarding a change in their working (e.g. recognition of EDs in males in practice) and a student using the topic for their dissertation topic.
Year(s) Of Engagement Activity 2020
 
Description Presentation at Hungry for Words final workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was the final activity of the workshop which concluded on a round table that engaged a representative and inclusive group interested in male eating disorders
Year(s) Of Engagement Activity 2018
 
Description Public stand-up comedy show 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact We invited Dave Chawner, stand-up comedian, author and eating disorders and mental health ambassador, to perform his stand-up comedy show on his experience with eating disorders to an audience of students, university staff, staff from eating disorders charities and the general public. The gig was introduced as part of the AHRC award by PI Heike Bartel with reference to the network's website containing further information. A feedback questionnaire gathered the audience's very positive response including responses to the questions 'What did you get from the event?': 'It was good to address taboos.' 'I learnt [...] about the effects of EDs on male bodies.' 'That eating disorders can effect boys too.'
Year(s) Of Engagement Activity 2018
URL http://www.davechawner.co.uk/
 
Description Rinzing art exhibition 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact This is an photography exhibition launched at the Institute of Mental that explores mental health and wellbeing through street photography.The exhibition was launch at Eating Disorders week to bring awareness on male eating disorders.
Year(s) Of Engagement Activity 2018
 
Description School visit (Nottingham) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact This was a follow-up school visit and assembly in May 2017 in direct response to our event for schools in January 2017. A local school whose students and teachers had participated in the January 2107 day for schools had requested a follow-up assembly which was delivered by our partner charity First Steps Derbyshire after consultation with the research network. The issues of self-esteem and EDs had clearly resonated with students and teachers and further information facilitated through the award lead to more engagement with the topic at school.
Year(s) Of Engagement Activity 2017
URL https://www.firststepsed.co.uk/
 
Description Social Media Campaign Break the Silence. EDs have no gender 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Team members have contributed to this social media campaign by our partner eating disorders charity First Steps Derbyshire 'Break the Silence. Eating disorders have no gender' particularly aimed at men and boys. The campaign was launched with our help during eating disorders awareness week 2018 and peaked at 1509 viewers during that week indicating raised awareness and increased access to relevant information. Team members are actively involved in next phases of the campaign.
Year(s) Of Engagement Activity 2018
URL https://www.facebook.com/FirstStepsED
 
Description Training for Undergraduates at The University of Nottingham 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact We have been invited by the School of Cultures Languages and Area Studies' Mental Health Champion to contribute a two-hour session on eating disorders with particular focus on males to the module 'Peer Mentoring' as part of the Nottingham Advantage Award at The University of Nottingham. This module trains UG students in their 2nd and 3rd year to mentor first year students and puts a strong emphasis on mental health. The session on eating disorders is now a fixed part of the curriculum and will be embedded in the next sessions. The training was delivered by Dr Bartel and Ms Cropley, trained staff from EDs charity First Steps EDs.
Year(s) Of Engagement Activity 2018
 
Description Training session by Eating Disorders Charity 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Our partner charity First Steps Derbyshire delivered a training session and training material (November 2017) for the eight team members involved in the public engagement activity 'Hungry for Words drop-in cafes' as part of the Being Human Festival 2017. T. Franke raised our awareness for issues and potential triggers related to talking about food, eating and diet, gave background information and addressed any issues. In turn, team members used the opportunity for knowledge exchange.
Year(s) Of Engagement Activity 2017
URL https://www.firststepsed.co.uk/
 
Description Twitter account @ConsiderMaleEDs 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Since our launch of the animated film on eating disorders in men during Eating Disorders Awareness Week, our project has built a steadily growing numbers of followers on Twitter. We are engaging with current topics and disseminate further information and updates through this important channel.
Year(s) Of Engagement Activity 2020
 
Description Website Hungry for Words 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact As part of our research network we have set up a website to show events and research activities and provide further information on the topic through links to our partners.
Year(s) Of Engagement Activity 2017
URL https://www.nottingham.ac.uk/research/groups/hungry-for-words/index.aspx
 
Description Workshop on online representations of male anorexia and male EDs 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This workshop (June 2017) on online representations of male anorexia:
- Provided details of D. Hunt's applied linguistics research
- Identified issues regarding the ethics of online and social media communications (E. Perez)
- Exchanged knowledge with our partner A. Sefi from Kooth and other staff from the University of Nottingham
Year(s) Of Engagement Activity 2017
 
Description Workshop on topic modelling for textual analysis 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This workshop (June 2017) brought together applied mathematicians and experts in topic modelling Y. van Gennip (University of Nottingham) and B. Hunter (Claremont McKenna College, CA, US) to discuss effective ways of analysing large textual data on- and offline with team members H. Bartel, D. Hunt, D. Mills and E. Perez (all University of Nottingham).
Year(s) Of Engagement Activity 2017
 
Description Workshop with experts in eating disorders in men 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact In December 2019, we held a one-day workshop with clinicians, patients, third sector, students and exercise professionals at The University of Nottingham. The aim was to exchange knowledge about the topic of eating disorders in men and boys, get feedback on our (then) planned training tool and plan further joint activities and built a network. The event was co-organised with our partner charity First Steps ED.
Year(s) Of Engagement Activity 2019
 
Description Workshop with postgraduate students 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact This workshop (November 2017) with four invited postgraduate students from the MSc in Eating Disorders and Clinical Nutrition (UCL) took place in Brighton and was integrated into the National Conference of the eating disorders charity Men Get Eating Disorders Too. Led by PI Bartel, we fulfilled our aim to provide further information and networking opportunities for these future healthcare providers who will also act as further ambassadors for the project at University College London.
Year(s) Of Engagement Activity 2017
URL https://mengetedstoo.co.uk/mgedt-national-conference-round-up
 
Description Workshop: Literary Representation of Anorexia Nervosa 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact During this workshop (19th -20th July 2016 at The University of Nottingham) a team of 12 international academics, including literary scholars from English and foreign languages (French, Italian, German), 1 linguist, 1 medical professional (Co-I Prof. Nadia Micali), 1 psychoanalyst, 1 mathematician and 1 author, explored representations of anorexia nervosa and other eating disorders in males and females in literary writings (fiction, poetry, autobiographical writings et al) from 18th C to the present day. Talks by expert speakers (Dr Francesca Calamita, University of Virginia; Dr Katie Jones , University of St Andrews; Dr Petra Bagley, University of Central Lancashire; Dr Kathryn Robson, University of Newcastle; Dr Heike Bartel (PI), University of Nottingham; Prof. Elizabeth Boa, University of Nottingham) and a reading by author Ulrike Draesner from her novel 'Mitgift' (2002) sparked questions and responses about a cultural, aesthetic and historical framework for the under-researched field of 'narratives of male anorexia'. Literature depicting representations of anorexia nervosa and other eating disorders in females was used as a point of comparison and introduced by the editors (Calamita, Bagley and Robson) of a forthcoming volume presenting innovative angles on representations of anorexia and bulimia in post-1968 European women's writing (Peter Lang, expected 2017 for their series "Studies in Contemporary Women's Writing").
Year(s) Of Engagement Activity 2016