What Are Eating Disorders?
Eating disorders are complex, life threatening conditions from which people can and do get better with appropriate treatment. Eating disorders can affect anyone. They can be seen as a way of coping with unmanageable feelings.
The term “eating disorder” refers to a group of conditions characterised by:
- Severe disturbances in eating
- Emotional and psychological distress
- Physical consequences
People experiencing an eating disorder share many of the following features:
- They are likely to have dieted
- Self-esteem is low
- There is a marked over-concern with body shape, weight and size and obsession with food
- Thinness is seen as a magical solution to problems while weight gain is feared
- The person affected is likely to have difficulty identifying and expressing their real needs
- They may view their body as larger than it actually is (distorted body image)
- They may have problems around control
- They may have found it hard to talk about their feelings and to deal with conflict
- They may be depressed and may become isolated
- They may experience mood swings
The disordered eating can take various forms, from fasting (self starvation) to consuming vast quantities
of food beyond what the body needs to satisfy its hunger (bingeing). Excessive exercising or self-induced
vomiting, the use of laxatives or diuretics are used to avoid weight gain (purging). All of these behaviours, sustained over time, will have a serious effect on both physical and emotional health.Because the behaviour of a person with an eating disorder revolves around food and eating, eating disorders are often mistakenly believed to be primarily about food. It is important to realise that the behaviour around eating is an outward sign of emotional distress. It may be the only way the person has of communicating their distress. Treatment of an eating disorder will therefore require attention to both the physical and the psychological aspects of the condition.
Anorexia Nervosa is characterised by a significant weight loss resulting from excessive dieting. Most women and an increasing number of men are motivated by the strong desire to be thin and a fear of becoming obese.Anorexics consider themselves to be fat, no matter what their actual weight is. Often anorexics do not recognise they are underweight. In their attempts to become even thinner, the anorexic will avoid food andtaking in calories at all costs, which can result in death. Anorexics usually have low self-esteem and sometimes feel they don’t deserve to eat. The anorexics usually deny that anything is wrong.
Bulimia Nervosa is characterised by a cycle of binge eating followed by purging to try and rid the body ofunwanted calories. A binge is different for all individuals. For one person a binge may range from 1000to 10000 calories, for another, one cookie may be considered a binge. Purging methods usually involvevomiting and laxative abuse. Other forms of purging can involve excessive exercise, fasting, use of diuretics,diet pills and enemas. Bulimics are usually people that do not feel secure about their own self worth. They usually strive for the approval of others. They tend to do whatever they can to please others, while hiding their own feelings. Food becomes their only source of comfort. Bulimia also serves as a function for blocking or letting out feelings.
Binge Eating Disorder is characterised by consuming large quantities of food in a very short period of time until the individual is uncomfortably full. Binge eating disorder is much like bulimia except the individuals do not use any form of purging (i.e. vomiting, laxatives, fasting, etc.) following a binge. The person who binge-eats is therefore likely to put on considerable amounts of weight over time. Like all eating disorders, binge eating is a serious problem but can be overcome through proper treatment. Unlike anorexia and bulimia, binge eating is thought to be almost as common among men as it is among women. It is believed that the number of people who binge-eat far exceeds the number who present for treatment. Compulsive overeating is characterised by uncontrollable eating and consequent weight gain. Compulsive overeaters use food as a way to cope with stress, emotional conflicts and daily problems. The food can block out feelings and emotions.
Why might a person develop an eating disorder?
There is no single cause, which can explain why a person develops an eating disorder. It is usually a combination of factors (biological, psychological, familial and socio-cultural) that come together to create conditions in which an eating disorder is more likely to take hold. The disorder often develops gradually as a response to an upset in a person’s life. This could be a traumatic event, a loss or major change in a person’s life, bullying or critical comments about weight or shape. The distress they feel will relate not only to the current upset but also to a store of past upsets they have never been able to express. A person without a strong sense of who they are and who is concerned with meeting the standards and expectations of others is more vulnerable. This explains why eating disorders occur so often during adolescence when identity is an issue, the opinion of peers is so important and parental expectations are resisted. Eating disorders occur in societies that promote thinness as a means of achieving health, success and happiness. Dieting has been proven to be an important risk factor in the development of eating disorders.Eating disorders do not start out as a conscious choice and are not a wilful form of ‘attention seeking’.
A few words about recovery
It is precisely because the eating disorder serves a purpose that it becomes very difficult to stop its progress. The longer it is established, the more it will take on a life of its own and take over the life of the person affected. They are caught in a bind. For many, overwhelming feelings of helplessness, guilt, shame and self-disgust become an insurmountable block to seeking help. Recovery is about taking responsibility, establishing one’s own boundaries and accepting those of others. It can only begin with the will to change. It will require commitment and it will take a lot of courage. It cannot be forced.Much sensitivity, compassion, respect, understanding and patience will be needed by the family, friends, G.P. and other members of the treatment team if a person is to be successfully encouraged and supported on their journey towards recovery.