Eating Disorders

By Dietitian, Lyndel Costain BSc RD

What are Eating Disorders?

Anorexia nervosa, bulimia nervosa and binge eating disorder are all types of eating disorders. They can affect people of almost any age, of both sexes and of different backgrounds.

Eating disorders are not about dieting simply ‘going too far.’ If your life has been touched by an eating disorder, either directly or through friends or family, you will know what terrible illnesses they can be.

Eating disorders develop as a way of coping with problems, or painful feelings, that make people feel bad, stressed or unhappy. Low self-esteem and self-worth are also at the heart of eating disorders. Eating a lot, or not eating much at all, becomes a way to help people feel in control of their life and their emotions.

Eating disorders most commonly start between the ages of 15 to 25 years, and are thought to affect between 1-3 % of women. But they are not just female problems. Approximately 1 in 10 of all people with eating disorders are men.

To help in the diagnosis of different eating disorders, doctors use a standard set of criteria. There are also ‘atypical’ eating disorders, which don’t quite fit the criteria for anorexia or bulimia nervosa. Binge eating disorder is the best understood of these.

Causes of Eating Disorders

Eating disorders have no single cause, but are usually the result of a combination of factors, often finally triggered by a stressful event or difficult period in someone’s life.

Factors that can play a role include: low self-esteem, perfectionist tendencies, family relationships, being bullied, divorce in the family, the death of someone close, worries at work, school or at university, pressure to achieve academically, ‘thin is beautiful’ messages, unrealistic media images, long term health problems such as diabetes, depression or mobility problems, and sexual or emotional abuse.

Recent research also suggests that some people have a genetic tendency towards developing an eating disorder, which makes them more vulnerable to the effects of these factors.

Common Signs of Eating Disorders

Eating disorders are complex, and emotionally based, and while the following points don’t address what someone living with an eating disorder feels or experiences, they give some practical information.

Anorexia Nervosa

Symptoms of Anorexia Nervosa

• Excessive weight loss due to food restriction, and often, extra exercise
• Intense fear of being ‘fat’
• Feel cold
• Periods stop
• Mood swings, restlessness, deny there is a problem
• Dizzy spells, constipation, dry skin
• Food rituals
• A range of upsets in the body which are largely reversed (higher risk of osteoporosis is one exception) once the person becomes well nourished again.

Bulimia Nervosa

Symptoms of Bulimia Nervosa

• Intense body dissatisfaction
• Usually a healthy weight, but it can fluctuate a lot
• Feel out of control around food
• Mood swings, may avoid social situations
• Regular binge eating, followed by vomiting and/or laxative abuse or excessive exercise, to compensate
• Possible dehydration and upsets in potassium levels in the body
• Swollen face, eroded teeth (from stomach acid), dry skin
• Irregular periods

Binge Eating Disorder

Symptoms of Binge Eating Disorder

• People with binge eating disorder typically binge at least twice a week, but unlike people with bulimia nervosa do not vomit, use laxatives or over-exercise to compensate for the binge.
• Even though they find bingeing distressing, it becomes a way to hide from their emotions, to fill a void they feel inside, and to cope with daily stresses and problems in their lives.
• They may feel undeserving of love or friendship, and as with bulimia nervosa, bingeing can be used as self-punishment for feeling badly about themselves.
• People with binge eating disorder are usually, but not always, overweight. Depression is common.

Night Eating Syndrome

This is not a true eating disorder, but deserves mention as it is often overlooked as a reason why people find it hard to manage their weight.

Symptoms of Night Eating Syndrome

• People with ‘night eating syndrome’ report eating large amounts of food in the night, often without fully realising what they are doing.
• They then try to compensate by eating less during the day.
• Night eating is thought to be a response to stress and anxiety, and it is not yet clear if it is sleep disorder or an eating problem.

Eating Disorder Treatment and Help

Eating disorders are serious, complex and sometimes life-threatening health problems and people really do need specialist care to help support their journey to recovery. Of course, people need to want to get better and this can often be difficult for them to feel sure about since their eating disorder has become their way of coping with day to day life. Because of their low self-esteem they may also feel that they don’t deserve help.

Going to the GP is usually the first step towards getting help. They can refer on to specialist NHS or private services, local counsellors, dietitians or whatever will be most helpful.

A number of treatment options are available. But good support involves help with restoring a regular, balanced eating pattern, looking after any medical needs and addressing underlying psychological and emotional worries.

This has been a very general introduction to eating disorders. More detail about different eating disorders will follow in future articles. Meanwhile, more information and advice can be found at:

Support

You are not alone. You can talk to other members on the Eating Disorders message board in Members Forum. Swap war stories, get support and advice, and make new friends.