Eating disorders are characterised by an abnormal attitude towards food that causes someone to change their eating habits and behaviour, and are diagnosed if your eating behaviour affects your health and wellbeing. At any given time 1.6 million people in the UK are affected by an eating disorder.
A person with an eating disorder may be obsessive about eating and become anxious about their weight and shape. This may lead to unhealthy choices about food with negative affects on their health.
Types of eating disorders
Eating disorders include a range of conditions that can affect someone physically, psychologically and socially. The most common eating disorders are:
anorexia nervosa – when a person tries to keep their weight as low as possible; for example, by starving themselves or exercising excessively
bulimia – when a person goes through periods of binge eating and is then deliberately sick or uses laxatives (medication to help empty the bowels) to try to control their weight
Some individuals may be told they have a non specific eating disorder meaning they have some, but not all, of the typical signs of eating disorders such as anorexia or bulimia.
People with anorexia nervosa do not eat enough. They may feel that their problems are caused by their appearance, and believe they appear overweight, even though they look slim to others. Their self esteem may be low and their health can be seriously affected. Physical problems including poor circulation and brittle bones, as well as kidney disease, may arise due to their mental health condition.
People with bulimia nervosa can to stick to a healthy eating pattern. They tend to binge, that is, eat a lot at once which makes them feel guilty and out of control so they then panic and punish themselves by starving themselves, vomiting, taking laxatives or over exercising. Physical problems may include tooth decay, constipation and intestinal damage, as well as heart and kidney disease.
What causes eating disorders?
Eating disorders have been linked to the social pressure in society to be a certain body type. However, the causes are often complex with a range of factors involved.
An eating disorder may include biological, genetic or environmental factors combined with a traumatic or stressful life event that triggers the behaviour. Other factors may include:
a family history of eating disorders
being criticised for their eating habits, body shape or weight
being overly concerned with being slim, particularly if combined with pressure to be slim from society or for a job, for example ballet dancers, models or athletes
having an obsessive personality, an anxiety disorder, low self-esteem or being a perfectionist
sexual or emotional abuse or a bereavement
stressful situations, for example problems at work, school or university
Do I have an eating disorder?
Doctors sometimes use a questionnaire to help identify people who may have an eating disorder. A doctor will then establish how many of the questions you may have answered in agreement and then make a decision on if you have an eating disorder.
Spotting an eating disorder in others
It can often be very difficult to identify that a loved one or friend has developed an eating disorder. Warning signs to look out for include:
repeatedly weighing themselves and looking at themselves in the mirror
feeling uncomfortable or refusing to eat in public places, such as restaurants
the use of “pro anorexia” websites and accessing other media to reinforce their behaviour
Who’s affected by eating disorders?
Eating disorders tend to be more common in certain age groups, but they can affect people of any age. Research shows conditions affecting more women than men at around 1 in 250 women and 1 in 2,000 men experiencing anorexia nervosa at some point. The condition often starts in the later teenage years.
Bulimia is around two to three times more common than anorexia nervosa, and 90% of people with the condition are female. It usually develops around the age of 18 or 19 years of age.
Binge eating affects males and females equally and usually appears later in life, between the ages of 30 and 40. It is difficult to precisely define binge eating and therefore it is unclear how widespread it is, but it’s estimated to affect around 5% of the adult population.
Treating eating disorders
If an eating disorder isn’t treated, it can have a negative impact on many areas of a person’s life. The physical effects of an eating disorder can lead to serious health conditions.
Treatment for eating disorders is available, although recovery can take a long time. It is important that the person affected wants to get better, and has the invaluable support of family and friends.
Treatment usually involves monitoring a person’s physical health while helping them deal with the underlying psychological causes. This may involve:
using self help manuals and books, possibly under guidance from a therapist or another healthcare professional
cognitive behavioural therapy (CBT) – therapy that focuses on changing how a person thinks about a situation, which in turn will affect how they act
interpersonal psychotherapy – a talking therapy that focuses on relationship based issues
dietary counselling – a talking therapy to help a person maintain a healthy diet
psychodynamic therapy or cognitive analytic therapy (CAT) – therapy that focuses on how a person’s personality and life experiences influence their current thoughts, feelings, relationships and behaviour
family therapy – therapy involving the family discussing how the eating disorder has affected them and their relationships
medication – for example, a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia nervosa or binge eating
There is useful information at NHS Choices on overcoming eating disorders.
What treatments are there for eating disorders?
Contacting your GP may help you assess any physical problems resulting from your eating disorder and can also help you to contact specialist eating disorder services.
The most successful treatment for eating disorders in the longer term may be by talking to a specialist who can help with your emotional needs and can help you take control of your eating. Talking treatments such as counselling or cognitive behavioural therapy (CBT) are generally considered to be the most effective way of treating eating disorders because they deal with the deeper emotional/thinking patterns that lead to the behaviour.
Help from carers
If someone you care about has an eating disorder, or is starting to show some of the symptoms, it is important that you let them know you are available for any help or support they ask for. You can offer suggestions, such as reading about the condition or joining a self help group, but they have to make the decisions and acknowledge they need to get the support for their situation.
There are a number of self help books available, in addition to online resources. These resources can be very helpful in describing strategies for improving your eating habits. They are generally written by medical health experts but draw on the experience of people who have eating disorders. The organisation BEAT provide a range of online resources about eating disorders and can be accessed via: www.b-eat.co.uk