25th February marks the start of Eating Disorders Awareness Week , so I thought it maybe useful to put together some information about eating disorders, how you can support people, how you can get some help for yourself and what to look out for in those you love and care for.
IF YOU OR SOMEONE YOU KNOW IS STRUGGLING PLEASE GET SOME HELP
Why do we even eat?
Bodies need energy to do everything, including our brains to think so in order to function and to learn we need a good supply of fuel in the form of food. Puberty is a time where extra energy is needed and so extra fuel/food too.
For some people, eating the right amount each day is very difficult for a variety of reasons.
What are Eating Disorders?
Eating disorders are serious illnesses where worry and feelings towards food take over people’s lives. Someone with an ED has a very negative relationship with food and their behaviour towards it is controlled by the disorder.
We still don’t know exactly what causes EDs. They can be linked to other mental health conditions such as depression or anxiety. For other people they can begin as a way of getting some order and control into a chaotic life, they can control food when they can’t control anything else.
There are many explanations that have been researched:
- Experiential factors such as trauma, abuse, bullying, bereavements. It has been shown in studies that around 15% of people with anorexia had a negative life event in the three months to the onset of the illness.
- Cognitive factors such as obsessive thought, rigid thinking patterns, low self-worth. In research it was shown that people with EDs have a higher memory than most for words such as diet, weight, body-shape.
- Personality factors such as perfectionism, body dissatisfaction, low self-esteem
- Sociocultural factors – preoccupation with thinness is only found in cultures where food is abundant and places where thinness is prized the prevalence of EDs is higher
- Family dynamics have been researched with factors such as intrusive parenting, unremained conflicts, parents praising slenderness identified as risk factors in some studies
- Genetic studies have shown a possible link to chromosome 1 in families where there are two or more people with EDs
- Neural biology investigations have shown possible links to damage to the hypothalamus, serotinin levels and problems with the insula
- Evolutionary explanations have been hypothesised such as ED being an evolutionary adaptive mechanism to modern environments with excess food amongst other theories.
Body Dysmorphic Disorder (BDD)
Body dysmorphic disorder (BDD) is a type of anxiety disorder related to body image. Some people assume all people with an eating disorder have BDD too but this isn’t the case. BDD can exist on it’s own as well.
People with BDD don’t see the version of themselves like everyone else does. When they look in the mirror they only see the negatives and often exaggerate this in their own mind and so see problems with their appearance that others may not even notice.
This isn’t the same as someone having a “bad hair day” or feeling own on their appearance from time to time. Puberty changes bodies and so it is common for people going through it to feel some unease about how they look. BDD causes negative thoughts that are almost constant and these thoughts have a big impact on their lives.
Binge Eating Disorder (BED)
Binge eating disorder (BED) is a disorder where people eat a large amount of food very quickly in a binge. They will do this regularly and compulsively not just on the odd occasion.
Binge eating often happens in secret, so the signs can be more difficult to spot. Like other eating disorders, it can be associated with anxiety and depression.
There are risks associated with BED such as high blood pressure, high cholesterol and diabetes.
This is one of the most common eating disorders. People with bulimia go through a cycle of binge eating and then purging (vomiting, extreme exercise or taking laxatives). This cycle usually happens every day and can last months. After binge eating, people with bulimia tend to feel extremely guilty which leads them to purge, feel worse and so binge eat again in a vicious cycle. As people with bulimia eat large quantities in the binges, they can often be average weight and don’t look thin.
Bulimia is incredibly dangerous as nutrients are lost during purges leading to malnutrition and physical illness. Vomiting regularly can lead to electrolyte imbalance causing cardiac problems, kidney damage and other whole body issues.
The act of vomiting brings up acid from the stomach leading to tooth damage, throat irritations, bad breath and stomach irritations.
Anorexia is probably the most well-known eating disorder, even though it isn’t the most common. People with anorexia try to keep their weight as low as possible, restricting food intake and exercising a dangerous amount in order to lose weight.
Anorexia is a controlling illness where people feel the need to monitor everything they consume and ends up affecting every aspect of someone’s life.
It can take a massive toll on someone’s physical health and effects due to lack of nutrition can include: being extremely cold, dizziness or fainting, hair falling out, growing thicker body hair, painful joints and bones.
Anorexia is a serious condition that can be fatal as people’s bodies can become so malnourished that their bodies start to shut down. Out of all the eating disorders, anorexia kills the most people with about 5% fatality rate.
I have mentioned some of the most common eating disorders but there are many many more.
Orthorexia is where people are unhealthily obsessed with healthy living. They cut out certain foods that they believe aren’t “clean” or “pure” and feel very guilty if they eat something they don’t normally allow.
Another serious issue is exercise addiction which can be an issue on its own without having a diagnosed eating disorder. People with exercise addictions are physically active to an unhealthy degree and feel they have to exercise. It can be a method of managing guilt or self-hatred and a symptom of another mental health condition such as depression.
How To Help
It can be very hard to know what to say or how to help someone with an eating disorder. Usually you cannot just help them with your words alone, they are not choosing to be like this and so saying things like “just eat more” can be very unhelpful. In fact on the whole it is usually best to not mention food at all and try not to draw attention to them eating or not eating. Commenting on eating habits can just lead to more negative associations with food and meals. Being relaxed around food is one of the most helpful things you can do.
Encourage the person to seek professional medical help starting with their GP. The GP is the person who can refer to psychiatrists and psychologists who can start treatment plans.
One of the cruellest things about eating disorders is that the person suffering often doesn’t realise they are sick or they can underestimate how sick they are, they may need real help getting the urgent treatment they need. You may need help from family members, school staff to help them get the support.