Eating disorders
What are eating disorders?
Everyone needs food to live.
When we are stressed, our ‘normal’ eating patterns often change. We might lose our appetite, get cravings for certain foods or eat for comfort. Our eating habits usually return to normal once the problem is sorted out.
However, for some of us, food begins to dominate our whole lives like an addiction. It becomes a way of coping with feelings like anger, sadness, guilt, loss or fear.
An eating disorder is a sign that a person needs help in coping with life and sorting out emotional problems. Focusing on food and eating, or not eating, is a way of avoiding other more painful problems.
Eating disorders include anorexia nervosa, bulimia nervosa, binge eating, compulsive eating and obsessional behaviour around food. Although there are different labels to distinguish the different disorders, the boundaries between all of them overlap.
Eating disorders are more common among women, although up to 10% of people with eating disorders are men and in centres which see children with anorexia nervosa, the proportion of boys is 25-30% .
Anorexia nervosa
Anorexia nervosa is one of the top three chronic conditions affecting young people in their teenage years. It affects about 8 out of 100,000 people in the general population, but about 1% of teenage girls. It usually starts in the mid-teenage years, but can start as early as eight.
Anorexia nervosa is about denying food rather than loss of appetite. In fact people who suffer from anorexia think about food all the time.
Controlling food intake is a means of staying in control. Giving in to the urge to eat is seen as losing control. People with anorexia are not trying to starve themselves to death, but to cope with living. Anorexics are terrified of being or becoming fat.
Food and fluids are usually restricted to things that are low in calories and are often carefully measured.
The anorexic hides their fear of failure with their success at losing weight. The anorexic often has low self-esteem combined with high expectations and perfectionist tendencies.
Effects of anorexia on health include
- Poor circulation
- Low blood pressure
- Brittle bones
- Increased facial hair
- Loss of periods/infertility
- Fainting and dizziness
- Hair loss
- Dehydration
- Kidney damage
- Low body temperature
Bulimia nervosa
Bulimia is the second major eating disorder. It affects about 1-3% of adolescents, and usually starts during the late teens and early adult years. People with bulimia tend to be able to keep their condition a secret because they are usually of normal weight.
Bulimia consists of binge eating or the excessive intake of food over a brief period of time. There is a sense that eating has become out of control, together with a fear of becoming fat.
To prevent this happening, after bingeing bulimics will make themselves sick, or use laxatives and diuretics to purge their bodies. Other behaviour may include fasting, excessive exercise, and a preoccupation with body shape and weight.
Effects of bulimia on health include
- Tooth decay
- Irregular periods
- Damage to bowel
- Constipation
- Heart and kidney disease
- Intestinal damage
- Puffiness – especially face and fingers
- Increased hair growth on face and body
- Mineral imbalances in the body
What are the causes of anorexia and bulimia?
- There are possible genetic linkages as eating disorders tend to run in families
- Some studies have shown that fighting during mealtimes may predict later bulimic behaviour
- Dieting can increase the likelihood of developing bulimia by up to eight times
- An underlying desire to delay the onset of puberty and adulthood, and the responsibilities that go with it, are common to anorexia
- Being a high achiever and setting yourself impossibly high standards are common to anorexia
- Difficult events in childhood – negative life events concerning parents, bullying and teasing at school, physical abuse, sexual abuse.
- High levels of family disturbance in particular seem to be associated with greater severity and chronicity of bulimia nervosa.
What treatments are available for anorexia and bulimia?
- Early and mild cases can be treated in the community with support from GPs, Community Psychiatric Nurses, School Counsellors, and by involving the family. Self-help groups are another useful source of support.
- For more moderate to severe cases Cognitive Behavioural Therapy would be the treatment of choice. This talking therapy might be offered in conjunction with anti-depressants.
- More resistant cases of bulimia will require admission to hospital for treatment.
Recovery
Getting better after an eating disorder is a long slow process.
In the early stages of recovery the person concerned may feel sick, over full, experience swelling in the stomach after eating. They may also feel depressed and tempted to slip back into their old ways. They may also experience feelings of anger.
With time though their eating will return to normal and they will find other ways of coping with life’s difficulties.
