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Eating Disorders, Anorexia, Bulimia.
Many people ask the question “What is an Eating Disorder? and How to treat eating disorders. Eating Disorders, Anorexia & Bulimia are complex serious conditions. Everybody has to eat. We do so both because we need to and because we enjoy it. However, as with all human behaviour, there are huge differences between people. Some eat more, some eat less, some put on weight easily, and others do not. In Bulimia and Anorexia people go to such extremes that they harm themselves, by eating too much or too little.
Cognitive Behavioural Psychotherapist. Eating Disorder Specialist.
The information in this article deals predominantly with Anorexia nervosa and Bulimia nervosa. Although it is easier to talk about them as different conditions, individual patients often suffer from symptoms of both. Indeed, it often happens that bulimia develops after a period of months or years of anorexic symptoms (Garner et al., 1983).
Chances are ten times higher that women will suffer from these disorders than men, although a quarter of Binge eaters are reported to be male (Weltzin et al., 2005). While these disorders may often be considered adult problems, frequently they start during the adolescent years while the sufferer is still at home.
Individuals with eating disorders tend to be intensely concerned with food, weight, appearance, to the degree that their health, relationships and daily activities are affected (Polivy, 1996). Regardless of whether a person restricts food intake, binges, abuses laxatives or compulsively overeats, these behaviours are regarded as symptoms rather than problems. This is because many individuals with eating disorders have often developed their eating disorders to cope with emotional pain, underlying issues of separation, low self-esteem, stress or trauma (Vanderlinden and Vandereyken, 1997).
The interplay of several factors can place an individual at risk for developing an eating disorder.
“We turn skeletons into goddesses & look to them as if they might teach us how not to need.”
―
The following are some of the typical thoughts that many people have when they are suffering from an Eating Disorder.
“No one loves a fat girl”
“I have tried so hard a million times, nothing works”.
“I am so fat”
“I am disgusting”
“I don’t need to go into treatment I’m not even skinny”.
“If you eat that you’ll have to do an extra hour of cardio every day for a week”
“Just play the game and they’ll discharge you faster”
“This problem will never go away.”
“I’m worthless and a total failure I can’t even go 24 hours without eating”.
“I have tried to deal with this in the past, it’s hopeless just put me on anti depressants”
“Throw it all up. I better hurry before it’s stuck there”.
“I hope that apple was worth the calories”.
“Keep pushing your food around your plate so your mum will shut up and leave you alone”
“I’m not even losing weight. Weigh yourself again! There’s laxatives over there. GET IT OUT!”
“No one is at home, I can throw up all I want”
“I’m OK. I’m not that bad at the moment. I’ve been a lot worse”.
“Look at my belly! I’m such a pig.”
“My jeans are too tight. I’m not trying hard enough. Size 2 isn’t good enough. I’m NOT good enough”
Anorexia is said to affect up to 4% of females (Grover et al., 2012). As an illness, anorexia usually first presents itself during the early teen years, and statistics suggest that it will affect 1 teenage girl out of every 100 studied (Mitchell and Carr, 2002). The disease is not, however, limited to females, although the ratio of female to male sufferers is 9:1 (Mitchell and Carr, 2002).
In more rare cases, anorexia could develop at an even younger age or have delayed onset, only presenting when the patient is in their 30s or their 40s. Girls from professional families are perhaps more likely to develop it than girls from working-class backgrounds. It is also likely that there are other members within the family who have displayed similar symptoms (Scherag, 2010). Frequently, an initial element which predicts the onset of anorexic behaviour is dieting: a large number of anorexia sufferers have been overweight at some point in their life and had their disease begin with a diet.
This dieting, however, quickly goes beyond what is considered healthy. Normal dieting stops when a patient reaches a desired weight, but an anorexic will continue dieting until her weight is well below what is suggested to be healthy for her BMI (Body Mass Index). That is to say, she begins to weigh far too little for her height and bone structure. Soon, the dieting will be accompanied by various strategies to aid her in her weight loss. The small number of calories that she may be ingesting can be disguised through the quantities of fruit, vegetables and salads that she eats. She may also begin undertaking a vigorous exercise regime or start taking slimming aids or pills in order to further her weight loss.
Other aspects of anorexia taking over an individual‟s life can be seen in her interaction with food. Not only will it affect her own attitude to how and what she eats, but she could begin taking a strong interest in food shopping or cooking for others – displacing her own hunger by feeding others. Thus, while the definition of the word “anorexia” might be “a loss of appetite”, the truth is that, usually sufferers still persist with a regular appetite, but begin to take a drastic approach to how they eat – and this is something which boils down to control. As time wears on, however, the teenage girl with anorexia may also develop some of the symptoms of bulimia.
As a result, she may begin to employ strategies such as purging, by making herself sick, or ingesting laxatives, as a means of maintaining control over her weight.
“I am forever engaged in a silent battle in my head over whether or not to lift the fork to my mouth, and when I talk myself into doing so, I taste only shame. I have an eating disorder.”
― Hollow: An Unpolished Tale
Hilde Bruch describes anorexia in the now-popularised term,
“The relentless pursuit of thinness”.
Patients have a morbid fear of fatness and lose considerable amounts of weight. This is achieved by dieting, vomiting, laxative abuse and over-exercising. Patients are preoccupied by weight, food, calories, and dieting. As weight decreases this obsession with food intensifies and body image distortion becomes more marked.
A severe anorexic spends her entire existence tormented by her desire to eat and her inability to do so. There are many known predisposing factors in the development of eating disorders. The illness tends to come on for the first time in young women between the ages of 15 and 25. A genetic predisposition to obesity is common. The fear of rapid weight gain often leads to strict rigid dieting.
While the disease is most likely to develop at some point during adolescence, the average age of anorexia onset is somewhere around 16 (Favaro, et al, 2009).
“…compulsive eating is basically a refusal to be fully alive. No matter what we weigh, those of us who are compulsive eaters have anorexia of the soul. We refuse to take in what sustains us. We live lives of deprivation. And when we can’t stand it any longer, we binge. The way we are able to accomplish all of this is by the simple act of bolting — of leaving ourselves — hundreds of times a day.”
―Women, Food and God: An Unexpected Path to Almost Everything
Up to 3% of the population could suffer from Bulimia Nervosa (Mitchell and Carr, 2002). There are many similarities between anorexia and bulimia, but in general, it is considered that this illness tends to be found in an older age group – most typically woman in their 20’s. Like anorexics, people with bulimia suffer from an exaggerated fear of becoming fat. Unlike women with anorexia, someone with bulimia may be able to keep her weight closer to normal.
This is achieved because, even though she aims to lose weight by purging or ingesting laxatives, she is also actively “binge eating”.
This is a process which entails, during a short period of time, eating large quantities of fattening or “forbidden” foods, which the bulimic normally does permit herself to eat.
Later, she makes herself sick, purging all the food from her system. This is usually accompanied by feelings of guilt and depression (Barnes et al., 2010). Ultimately, their chaotic pattern of eating comes to dominate their lives.
In bulimia the normal eating pattern of three or four meals a day is replaced by regular binge eating. Binge eating is compulsive and usually takes place in a frenzied and furtive manner. The first half of the binge is often pleasurable and exciting. The second half of the binge is experienced as being unpleasant and self-punishing. Because bingeing reduces anxiety in the short term it is highly addictive.
Commonly begins in late adolescence or early adulthood.
The binge eating frequently begins during or after an episode of dieting.
Psychological problems
There is a terrible conundrum inherent in eating disorders, and that is, although many young people begin with diets hoping that weight loss will lead to improving their self-esteem, they unfortunately only end up doing permanent damage to their systems – and cause lasting damage to their self-image in the process. The following are just a few of the psychological problems which often plague those battling with eating disorders:
Eating disorders are treatable, and people do recover from them. The above complications, or threat of them developing, should not discourage people from seeking treatment. Together, we can create a healthy, balanced lifestyle worth living.
Diploma in Eating Disorders is designed to provide you with the knowledge and skills required to effectively understand individuals who are struggling with anorexia, bulimia nervosa, binge eating disorder and other eating problems.
The course is also excellent for people suffering with an Eating Disorder to gain insight into the underpinning reasons for their Eating Disorder and also to gain the skills necessary to recover.