Eating Disorders
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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