The NHS defines an eating disorder as having an unhealthy attitude to food, which makes the sufferer ill. However, it’s a relatively simple definition for a complex problem. Eating disorders control the lives of those who suffer from them. They can involve eating too much or too little, or being obsessed with weight and body shape. As this week marks Eating Disorders Awareness Week, (25th February – 3rd March), I discuss the different types and ultimately how to get help.
Beatingeatingdisorders.org.uk estimates that around 1.25 million people in the UK have an eating disorder. And contrary to popular belief, it’s not an exclusively female issue. The National Institute of Health and Clinical Excellence estimates that around 11% of those affected are male. Worryingly, hospitals treating boys is at a record high, according to statistics agency NHS Digital. The true figures (for both genders) could be even higher, as many sufferers do not seek help. One factor being blamed for this rise is body image pressure from social media. But eating disorders are a multifaceted mental health issue, with no one sole cause. This means that they are complicated to treat successfully – but recovery is possible.
Types of eating disorders
There are many different types of eating disorders. However, some are more well known than others. All are dangerous. In addition, eating disorders have the highest mortality rates among psychiatric disorders.
This is the disorder where sufferers try to keep their weight as low as possible. They do this by restricting their food intake, exercising to excess – or a combination of both. Anorexia sufferers often have a distorted image of themselves, and think they are fat even when severely underweight. A deep fear of gaining weight is common, which can make treatment very difficult.
People with bulimia are caught in a destructive ‘binge-purge’ cycle. They consume a lot of food in a very short space of time (binging), then try to compensate (purging). The latter takes the form of laxatives, diuretics, subsequent food restriction and/or excessive exercise. Bulimics often feel out of control when they binge, and rarely enjoy the food they consume.
Binge Eating Disorder
This involves eating large amounts of food, during a short period of time, on a regular basis. Sufferers experience a loss of control when eating, and find it difficult to stop – even if they want to. Sufferers feel uncomfortably full, upset and guilty when the binge is over. The binging usually takes place in private, and is typically not followed by any purging methods.
Other Specified Feeding or Eating Disorder (OSFED)
This is perhaps less known, but no less serious. OSFED refers to an eating disorder that doesn’t exactly match a specific diagnosis. It is a common form of disorder, and can have many manifestations. It is also possible for eating disorder symptoms to change over time, and/or overlap.
A more recent development is Orthorexia. However, this is not clinically recognised as an eating disorder. It refers to an obsession with so-called ‘clean eating’. This is where you only consume ‘pure’ or perceived healthy foods. It is typically very restrictive. Instagram has, in fact, been blamed for the rise of orthorexia, as extreme healthy eating gurus use it to promote their lifestyle.
What causes an eating disorder?
Unfortunately, there is no easy answer to this question. There are a lot of unhelpful stereotypes about who tends to suffer, and why. Statistically speaking, young females aged 12 to 20 are most likely to develop an eating disorder. But anyone – regardless of age, gender, ethnicity or socio-economic background – can succumb.
Identifying a single reason or a trigger for an eating disorder is usually not possible. More commonly, a number of issues combine. These include genetic, psychological, environmental, biological, social and cultural influences. Contributory factors can include stressful life changes, abuse/trauma, bullying, poor self-esteem and a perfectionist personality trait. A desire for control is another strong dynamic.
Recognising an eating disorder
Despite what most people might think, it isn’t always easy to recognise an eating disorder. Sufferers are very often secretive about their behaviour. They may also feel ashamed, guilty, or even be in denial about the problem.
However, there are a number of warning signs that can help to identify if someone has developed an eating disorder. For example, dramatic weight loss is one sign that may indicate anorexia. If the person avoids food, lies or is evasive about weight and food consumed, then this should raise another potential red flag.
Cutting food into tiny pieces, restricting food groups, and eating very slowly are also possible warning signs. Anyone who avoids eating with others, and wears loose clothes to conceal their weight loss, might also have a problem.
Bulimics often eat a lot of food very fast – and then visit the bathroom frequently. They may well seem agitated or even exhausted when they return. Excessive or obsessive exercise is another behaviour to look out for. A combination of all or any of these factors is more likely to mean cause for concern.
Prevention and treatment
Getting help for an eating disorder – or even preventing one in the first place – isn’t always straightforward. Efforts to reduce risk factors such as body dissatisfaction, and boost self-esteem, may be beneficial. Being a good role model around younger children, and promoting healthy eating and exercising, may also be helpful. Also, encourage others to value themselves on character, talents and accomplishments, rather than body shape.
Eating disorders rarely get better on their own, so the right treatment is vital. And time is of the essence. The sooner there is a diagnosis and treatment can take place, the better the chance of making a full recovery.
However, asking for help – for yourself or someone else – isn’t always easy. The GP is the first place to start. They should then refer the patient to an eating disorder specialist or team. They can also discuss any other support that might be available, and include this in their treatment plan.
The exact type of treatment offered will depend on the different symptoms and diagnosis. There is no one single treatment pathway, and different methods work for different people. The initial response usually involves some kind of talking therapy, combined with regular health checks. Self-help and support groups can also aid recovery. For severe cases, inpatient (residential) treatment programmes within specialist facilities may be the best option.