| More information about types of eating
disorders
The Eating Disorder Continuum
What causes Eating Disorders?
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Other Eating Disorders
Why can’t people just stop their eating
disorder?
Do I have an eating disorder?
Seeking help
How do I help a friend or relative I think
might have an eating disorder?
Recovering from an eating disorder
Diets don’t work
But what is there apart from dieting?
What about the obesity ‘epidemic’?
The Eating Disorder Continuum
The term ‘eating disorder’ describes a range
of behaviours, thoughts and feelings. Eating disorders span
a continuum that looks like this:
This continuum shows only a sample of behaviours and feelings.
There are all sorts of ‘disordered eating’ patterns.
For descriptions of anorexia nervosa, bulimia nervosa, and
binge eating disorder, click here.
Studies have shown that disordered eating affects most women
(up to around 60 %) at some point in their lives. A smaller
percentage of men (estimated to be about 10-15 %) are affected.
The current thinking is that about 1 % of women develop anorexia
nervosa, and 2-3% bulimia nervosa, in their lifetimes. The
numbers for men are much smaller.
Despite lots of theories, no-one knows exactly what causes
eating disorders. They are described as ‘multi-factorial’,
meaning many factors are associated with the development of
the disorder. Trying to isolating one ‘problem’
that led to the disorder, for example, your relationship with
your mother/father, or being a perfectionist, is too simplistic.
The disorder needs to be looked at from all sorts of angles
if it is to be understood and overcome. Everyone is different.
With the right help, the chances of recovering from an eating
disorder are good. And the earlier someone with an eating
disorder can get help, the better.
What causes eating disorders?
Eating disorders are complex and no one eating disorder is
exactly the same.
No-one really knows what causes eating disorders, although
there are some common factors associated with developing eating
disorders. These include:
- negative body image
- adopting an ideal body shape or weight based on excessively
thin models represented in the media, and rejecting one’s
own natural body shape and weight
- weight loss dieting
- peer pressure regarding body shape and weight
- teasing and harassment about your body shape and weight
- poor self esteem
- being a perfectionist
- gender – social beliefs that being a ‘real’
woman or man requires a certain
- body shape or weightpoor emotional literacy – meaning
finding it hard to deal with emotions like anger, guilt,
sadness, fear
- trauma and sexual abuse
- puberty hits you first, before all your friends
- you or your parents have a history of obesity, or your
family has a history of eating disorders.
This list doesn’t cover everything. It is still possible
to have an eating disorder even if you don’t relate
to any of these things. Everyone is different.
Eating disorders are not normal behaviour that ‘everyone
goes through’, or ‘will grow out of’. They
are serious, and if untreated, can continue for many years
causing much physical and mental suffering, even death.
They are highly treatable and the earlier you get help, the
better your chances of recovery.
Anorexia nervosa
‘Anorexia’ is a medical term meaning absence
of appetite. Anorexia can be a part of many types of illness,
including depression. But anorexia nervosa is a specific illness
in itself which is characterised by:
- the person severely restricting the amount of food she
or he eats
- losing body weight to an unhealthy level
- an intense fear of getting fat, and/or losing control
of eating
- often a disturbed body image - still regarding yourself
as fat despite being quite underweight
- rigid rules about food and eating, eg developing a list
of ‘good’ and ‘bad’ foods
- social withdrawal
- anxiety and depression
- mood changes and irritability
- loss of menstrual periods (girls and women).
This is not a full list of characteristics, but someone with
anorexia nervosa will have at least a couple of the ones listed
above. At the most severe end of the continuum, anorexia nervosa
is a life-threatening illness.
Bulimia Nervosa
Bulimia nervosa is an eating disorder characterised by the
following two cycles:
· A ‘binge cycle’, where the person loses
‘control’ around food and eats a vast amount,
usually foods that are ‘forbidden’ under their
particular diet program. A person usually binges in secret.
He or she feels a sense of loss of control, shame, and distrust
of self.
· A ‘purge cycle’, where the person attempts
to compensate for the binge and avoid gaining weight by one
or more of the following unhealthy measures: self-induced
vomiting, abuse of laxatives, fluid or diet pills, excessive
exercise, or fasting.
People often binge as a result of finding it difficult to
manage their feelings. But the binging and purging cycle brings
even more difficult emotions to handle (such as shame and
guilt). For this reason, the cycle can continue on indefinitely,
and can be very hard to break. Specialised, sensitive care
is required to stop the cycle, and to find new, sustainable,
healthy ways to live.
Binge Eating Disorder
Binge Eating Disorder is characterised by periods of binge
eating but without the ‘purge cycle’ that characterizes
bulimia. As in bulimia, the person still experiences guilt
and bad feelings as in bulimia, and requires the right help
to find new ways to find new, sustainable, healthy ways to
live.
Other Eating Disorders
It’s important to remember that eating disorders, as
strictly defined by psychiatrists, are at one extreme of the
eating disorder continuum.
There is a wide range of other disordered eating patterns
and not all people with eating disorders have a clear cut-diagnosis.
For example, anorexia and bulimia may be present at the same
time, or one may develop into the other. Or someone may develop
special rituals or unusual behaviours around food that aren’t
anorexia or bulimia.
Even if you assess your situation to be somewhere else on
the eating disorder continuum, it is still serious, not ‘normal’
or healthy. The earlier you seek treatment the greater your
chances of moving off the eating disorder continuum altogether.
Why can’t people just stop
their eating disorder?
An eating disorder can be seen as a way someone has developed
to cope with not only personal stressors, but also the pressures
living in our society brings. Everyday we are bombarded with
messages about how to be ‘good’, or ‘perfect’,
or simply, ‘thin’. Personal pressures in our lives
can be unrelated to eating or body image. Or they can be specifically
related, like being teased about body shape.
Looked at this way, eating disorders are an understandable
response to the stressful world we live in. To ask someone
to ‘stop’ their eating disorder would mean they
would have to remove instantly all the social and personal
pressures he or she feels. It would be like asking someone
to stop having diabetes.
For many psychological and physical reasons, people can’t
just ‘stop’ their eating disorder. For advice
on talking to a friend or relative about disordered eating,
see How do I help a friend or relative who I think might have
an eating disorder?
Do I have an eating disorder?
One of the hardest steps for anyone with an eating disorder
is admitting things are ‘not right’. Perhaps the
descriptions of disordered eating on this web-page sound like
you. Or perhaps someone has expressed concern about you.
Self-diagnosis of eating disorders is not always reliable.
Speak to someone who knows about eating disorders if you want
to find out more information.
For anonymous advice, ring the Eating Disorders Foundation
of NSW on (02) 9412 4499, or visit their website on www.edf.org.au,
the Eating Disorders Foundation of Victoria on 1300 550 236
(free call) or www.eatingdisorders.org.au.
Diagnosis is an important step to recovery, and these organisations
will be able to help you consider your options.
Seeking help
Because eating disorders involve so many complex factors,
attempting to tackle an eating disorder on your own is not
advised. You will need to find an understanding therapist
or counsellor who is experienced in working with eating disorders.
Other specialists may need to involved, for example with physical
health and nutrition. This will depend on where you are on
the eating disorder continuum.
Finding the right therapist for you could take some homework.
The Eating Disorders Foundation of NSW has a comprehensive
list of the types of therapy available for eating disorders.
See www.edf.org.au.
Facing an eating disorder takes great courage, and taking
the first step towards recovery is a great achievement in
itself.
How do I help a friend or relative
who I think might have an eating disorder?
You will need to prepare what you want to say before approaching
a friend or relative you think may have an eating disorder.
We recommend the following sites as starting points:
If you are concerned your friend or relative is in immediately
physical danger, or may harm herself, you might need to take
more direct action. Phone the Eating Disorders Foundation
of NSW on (02) 9412 4499, the Eating Disorders Foundation
of Victoria Helpline on 1300 550 236. If the person is suicidal
or in serious danger, contact the ACT Crisis Assessment and
Treatment Service on freecall: 1800 629 354 (24 hour service),
or 6205 1065.
Recovering from an
eating disorder
The chances of recovery from an eating disorder are higher
if the right professional help is found as early as possible.
But it is important to remember that everyone is capable of
recovery, no matter how ‘set in’ the disorder
may seem.
The process of recovering from an eating disorder can be
long, slow and challenging for all involved. It is also made
difficult by being constantly surrounded by ‘messages’
about weight and thinness in the media and society. Challenging
an eating disorder is not only about gaining back the life
you deserve, but questioning what is presented to you about
how you should be.
People who have recovered from eating disorders often state
they found their recovery a rewarding, positive experience.
They have learned who they are and where they want their life
to go.
For stories of recovery, visit the Eating Disorders Foundation
of NSW’s website, at www.edf.org.au,
or the Eating Disorders Foundation of Victoria on www.eatingdisorders.org.au.
There are also chatrooms to visit on both sites.
Diets don’t work
Scientific studies show that diets don’t work and are
dangerous. There is a strong link between eating disorders
and dieting.
Many diets can be damaging to physical and psychological
health. Among people who diet frequently, fluctuating weight
is the most common outcome – called the ‘yo-yo’
effect as someone goes up and down. This brings with it psychological
negative effects like depression.
There is a blurry line between where dieting ends and eating
disorders start – so the healthiest option is to avoid
diets altogether.
But what is there apart from
dieting?
Evidence shows that it is healthy behaviours, rather than
the achievement of any particular weight, that determines
someone’s optimal health. People can be on strict diets
and in extremely poor health. Someone can be overweight according
to a chart, but very healthy.
Healthy eating is about healthy, positive attitudes towards
food and eating. This means:
- Enjoying food without feeling guilty
- Being aware about when you’re actually hungry,
or full, or in between
- Stopping worrying about fat, food, size and shape
- Feeling good about yourself
- Enjoying being active (rather than ‘punishing’
yourself with exercise).
This may seem radical! But studies show again and again that
healthy eating and behaviour, as shown in the list above,
are the only sustainable way of attaining the most comfortable
weight for each individual. They also help us enjoy eating
for its social and emotional aspects, something that has been
forgotten by many so-called diet experts.
Recommended book: Kausman, Rick. If Not Dieting, Then What?
Allen and Unwin, 1998.
What about the obesity
‘epidemic’?
Recently the media has run a lot of stories on obesity, particularly
childhood obesity. Much of the response to this ‘epidemic’,
as it has been called, is getting children to eat healthy
food and exercise more.
But experts in nutrition point out that there is much more
to healthy eating and living than this. Healthy eating has
to do with attitudes and feelings, as well as choosing nutritious
food and making appealing meals.
As a society, we need to support children in promoting healthy
attitudes towards food and eating. We also need to accept
a wide range of body shapes and sizes and provide supportive
environments for children to enjoy eating. By doing this,
we can all start to take the focus off food and body image
and get on with living meaningful, healthy lives.
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