Eating disorders
eating; anorexia; nervosa; bulimia; binge; eating; overeating; obese; thin; dieting; vomiting; exercise; body; image; weight;
Contents
What is an eating disorder?
Let's turn it round and ask what is disordered eating? It is when someone feels so unhappy with the way she looks that her whole life becomes centred on food, exercise and body image. Sometimes an eating disorder can be life threatening unless it is brought under control.
More females have eating disorders than males, which is why we talk about ‘her’ in most of this topic, but some males do get eating disorders.
The main eating disorders
Anorexia nervosa
- Anorexia nervosa is when people are so afraid of becoming fat that they starve themselves.
- Even when they are really skinny, they continue to ‘diet’ because they still think that they are fat.
- This can mean that they are obsessed by thoughts of food and may have a constant fight to convince themselves that they are not hungry.
Bulimia nervosa
- This is about binge eating then getting rid of the food by ‘purging’, ie. taking laxatives (to make themselves poo) or by deliberately making themselves vomit (throw up).
Compulsive overeating
- Compulsive overeating can become like an addiction in someone's life. We all have comfort foods which can cheer up the odd ‘bad hair’ day, but this is about constantly overeating to make yourself feel better.
- Compulsive overeaters can feel empty inside, and may use food as replacement for what is missing.
What an eating disorder looks like
There are many symptoms of an eating disorder, and some of them are listed below. These may not relate to everybody, and sometimes it can be difficult to notice any signs at all. Some of these signs can relate to different problems and not to eating disorders.
- thinking and talking about food and dieting a lot of the time
- knowing about the amount of energy (joules) in every type of food
- eating very little, although the person may cook elaborate meals for others - or eating very large amounts of food sometimes
- often going to the toilet after meals and vomiting
- strenuous exercise routine, even exercising when she is injured or unwell
- severe weight changes:
- looking very thin, and still losing weight
- weight going up and down all the time
- or very large weight gains
- sudden mood changes, irritability, depression, sadness, anger, difficulty in expressing feelings
- poor concentration and being unusually tired
- intense shame about her body and fear of gaining weight
- constantly in pursuit of thinness.
If there are several of these signs together, it could mean she has an eating problem.
Causes of eating disorders
There is no clear cause for eating disorders. This makes it more upsetting for family, friends and the sufferer, as they all try to think about what could have started it and what to do about it. If you know what causes something, often you can change the cause and the person will recover. If you don’t know what caused the problem, this can make it difficult to help the person.
However, the following factors may add to the risk that someone has of developing an eating disorder.
Individual factors
- high personal expectations, always striving to be perfect in everything.
- setting unrealistic goals that the person believes will bring love and respect from family and friends.
- feeling the need to gain control over one's life.
- overwhelming feelings of not being good enough, leading her to starve herself so that she gains a sense of being in control again, or following the binge-purge cycle.
- having low self-esteem - this can be hard to see because some people seem to be really ‘together’ on the outside, even when they are feeling bad inside.
- depression; being sad or irritable much of the time, avoiding doing things with friends.
- those who have difficulty expressing their own needs and feelings (particularly negative feelings) may be at risk.
Family factors
- there are no typical family patterns, but problems with relationships and communication, or family conflict can make the person feel unvalued and alone.
- family emphasis on being worthwhile only when you are very good at study or sport, very well behaved, thin and attractive can have a severe impact on some young people, who feel worthless if they do not match up to the family expectations.
Cultural factors
- being constantly bombarded with the message that you have to be thin to be beautiful or desirable.
- the media portrays happy, successful and feminine women as always thin.
- women who are required to be thin for their careers (models, dancers and athletes) are more frequently affected by eating disorders.
Research suggests more men are suffering from eating disorders because the muscular and lean image of men in the media is having an effect on men’s health in the same way it does on women’s. More men, however, are over-exercising in the attempt to develop the ideal body shape. This can cause health problems too.
What can trigger eating disorders?
Many things can trigger an eating disorder if someone is already vulnerable (that is they have some of the problems listed above). These include:
- a life crisis or the death of a loved person,
- family changes,
- moving home or school,
- a change of job,
- school problems,
- a personal failure.
An eating disorder may also develop when there is a gradual build-up of problems which on their own seem small. The person may interpret each small problem or failure as ‘evidence’ that they are not worthy.
Do you or your friend have a problem with disordered eating?
Check this out.:
- Do you avoid eating meals or snacks with others?
- Are you always counting kilojoules and working out how much fat there is in everything that you eat?
- Are you always weighing yourself and stressing about your weight?
- Is your exercise for fun or for weight control?
- Are you scared about putting on weight?
- Do you ever feel ‘out of control’ when you are eating?
- Do you regularly diet then overeat?
- Do you have set ways of eating, like always having to have some foods, or you must eat different types of foods in a certain order?
- Is your day geared around control of food, weight loss and dieting?
- Do you feel ashamed, guilty or disgusted with yourself after eating?
- Do you constantly worry about the weight, size and shape of your body?
- Do you feel that no one will care about you or your opinions unless you have a certain size shape and weight?
Bec says:
“If you or your friend have answered yes to several of these questions, then it’s time to get some help. It may be time to start to work on your self-esteem before you talk yourself into feeling bad about yourself because you don’t look like one of the media stars. In real life, without the make-up and the flattering camera angles, they rarely look like that either!”
Helping someone with an eating disorder
Being a friend or partner or family member of someone with an eating disorder can be very difficult at times, particularly if the person denies she has an eating problem and will not talk to you openly. Here are some ideas that might be helpful if you are unsure of what to do or say!
- Contact counselling and support groups to get some information. See the list at the end of this topic.
- Be ready to go slowly. The problem will not be solved overnight.
- Suggest to your friend that she has the right to get professional support and an assessment.
- Offer to help your friend to organise appointments and volunteer to go with her if she would like that.
- Recognise that the eating disorder started with an emotional issue that may not be fully worked out yet. Your friend may find dealing with the eating disorder stressful and have days when she does not want to change.
- Don’t talk about your friend’s problems to other friends.
- Telling your friend’s parents, a student counsellor or another trusted adult is not dobbing or breaking confidentiality if you are worried about her health.
- Accept your friend for who she is. Do things together that you have enjoyed before. Make comments about reasons why you like having her as a friend. Don’t talk about her eating disorder all the time.
- Be honest with your friend, and by showing her your love and care she will feel supported and able to accept the help that she needs.
What treatment is available?
- Changes in eating behaviour can be caused by several illnesses, so the first thing is to get checked by a doctor.
- Once an eating disorder has been diagnosed, a range of health practitioners may be involved, because the illness affects people physically and mentally - this may include psychiatrists, psychologists, doctors, dietitians, social workers, occupational therapists and nurses.
- Usually people visit the therapists or attend special programs.
- Admission to hospital may be needed for people who are severely malnourished through lack of food.
- Medication may be useful for depression and to correct hormonal and chemical imbalances.
- Dietary eduction can help the person learn new eating habits.
- Counselling and specific therapies are used to help change unhealthy thoughts about eating, and this can involve friends and family.
Resources
- your local Community Health Centre
- your doctor (General Practitioner)
- your school or university counsellor
- your local library for further reading
South Australia
Australia
General
- Body Image: a weight off my mind. A great booklet with activities and places to write your thoughts. Helpful information for everyone, but designed for young woman.
A Weight off My Mind (1Mb)
References
National Libraries of Medicine (USA) - Medlineplus, has a very large amount of information about eating disorders:
http://www.nlm.nih.gov/medlineplus/eatingdisorders.html
Report of The American Psychological Association Task Force on the Sexualisation of Girls. 2007, online (cited 5/3/07): http://www.apa.org/pi/wpo/sexualizationrep.pdf
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).