Eating Disorders

This week is National Eating Disorders Awareness Week. Eating Disorders are serious mental illnesses which can affect a person physically, psychologically and socially. They can also affect the people around them such as family and friends. There are various types including the more commonly known Anorexia and Bulimia as well as lesser known conditions such as Binge Eating Disorder and Orthorexia. In this blog, I will be talking about the different types of eating disorders.

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Types of Eating Disorders

Anorexia Nervosa is one of the most common types of eating disorders. Anorexia is characterized by a sufferer attempting to keep their body weight low through refusal of food/dieting, vomiting, laxative abuse or excessive exercise. Anorexia can have behavioural and physical signs including:

Behavioural:

  • Fear of putting on weight or “getting fat”
  • Constant thoughts about body weight
  • Body dysmorphia; a distorted body image (i.e. being extremely underweight but believing you are overweight)
  • May lie about why they can’t eat or that they have already eaten earlier
  • Constant thoughts about food
  • Rigid eating behaviours; hiding food, excessive calorie counting, only eating low-calorie food, avoiding food they believe is fattening, cutting food into smaller pieces, squashing food down, using a teaspoon to eat, skipping meals, avoid eating with other people
  • Taking diet pills or appetite suppressants
  • Excessive exercise
  • Purging; vomiting or laxative misuse
  • Social withdrawal and isolation
  • Feeling irritable or moody
  • Being a perfectionist
  • Can be associated with other mental health problems such as depression or Obsessive Compulsive Disorder (OCD)

Physical:

  • Severe weight loss (which may often be hidden under baggy clothes)
  • In girls and women, periods become irregular or stop altogether (amenorrhoea)
  • Lack of sexual interest
  • Difficulty sleeping and tiredness
  • Dizziness
  • Stomach pains, constipation and bloating
  • Feeling cold
  • Growth of downy hair (soft and fine) all over the body (Lanugo)
  • Hair falling out
  • Difficulty concentrating
  • Feeling week and loss of muscle strength
  • Reduced bone strength (can eventually lead to osteoporosis)
  • Effects on the endocrine system (the collection of glands that produce hormones)
  • Low blood pressure

Bulimia Nervosa is another common eating disorder. Bulimia is characterized by a sufferer getting caught in a vicious cycle of eating large quantities of food “binging” then partaking in purging behaviours such as vomiting or taking laxatives to prevent weight gain. This can cause the sufferer to feel like they have “lost control” and can dominate their everyday lives. Unlike Anorexia, a Bulimia sufferer can appear to be a healthier weight so it can be more difficult to spot. Behavioural and physical signs on Bulimia include:

Behavioural:

  • Binging
  • Purging after binging; vomiting, over exercising, using laxatives or diuretics, fasting
  • Constant thoughts of food
  • Usually secretive about bulimic episodes
  • Mood swings
  • Feeling anxious and tense
  • Body dysmorphia
  • Feeling of loss of control over eating
  • Feelings of guilt and shame after bulimic episode
  • Can be associated with other mental health issues such as depression and self-harm
  • Disappearing soon after eating

Physical:

  • Fatigue/lethargy
  • Feeling bloated
  • Stomach pain and constipation
  • Swelling of the hands and feet
  • Amenorrhoea
  • Enlarged salivary glands
  • Calluses on the backs of the hand from forcing down throat to vomit
  • Damage to teeth enamel through vomiting
  • Electrolyte abnormalities/ imbalance
  • Gastric problems
  • Regular changes in weight

Binge-Eating Disorder (BED) is characterized by a sufferer losing control and binging on large quantities of food over a short period of time, even when they aren’t hungry. It is not about eating extra-large portions and binges are usually planned and the sufferer make have special “binge foods”. Binges are usually done in private and the sufferer will often feel guilt and disgust at their lack of control. Unlike Bulimia, BED sufferers do not purge after a binge. BED is associated with a sufferer binging at least once a week over a period of three months or more. Signs of BED include:

  • Eating more rapidly than normal during an episode
  • Eating until uncomfortably full during an episode
  • Eating large amount of food when not hungry during an episode
  • Eating alone through embarrassment
  • Feelings of guilt, shame and disgust
  • Feeling distressed
  • Low self-esteem and lack of confidence
  • May suffer from other mental health conditions such as depression and anxiety
  • Many sufferers are overweight or obese (this can lead to health issues such as type 2 diabetes and heart disease)

Other types of eating disorders include:

  • Orthorexia – A term used for obsessive behaviour in pursuit of a healthy diet. Sufferers will obsessively avoid food which they deem unhealthy such as food with artificial colours, high fat, high sugar or pesticides. Sufferers may experience obsessive concerns over the relationship between food choices and health concerns, limiting themselves to a small amount of acceptable food choices, feelings of guilt if they deviate from their “healthy diet”, constant thoughts about food, social isolation to avoid situations where they deviate from their diet such as eating out at a restaurant and other mental health conditions such as anxiety.
  • Anorexia Athletica – This disorder is characterized by excessive, obsessive exercise. It is more commonly seen in athletes who participate in sports where having a small, lean body is advantageous. Signs include; obsessive exercise, obsession with food, calories and fat, obsession with weight, self-worth being determined by physical performance and guilt over missing a workout.
  • Drunkorexia – This disorder is characterized by a sufferer skipping meals and starving their bodies of food in order to make up for the calories in alcohol.
  • Pregorexia – A condition where sufferers attempt to control weight gain during pregnancy through obsessive dieting or exercise.
  • Diabulimia – This disorder is characterized by a type 1 diabetes sufferer reducing their insulin intake in order to lose weight. Signs include; high blood glucose levels, persistent thirst, frequent urination, unexplained weight loss, increased appetite (especially in sugary food) and secrecy about blood sugars, insulin injections and eating. Sufferers can risk losing their eyesight, diabetic ketoacidosis, diabetic coma and even death.
  • Some disorders combine behaviours from more than one disorder or do not exactly fit the criteria of the “typical” eating disorders. These fall under the umbrella term “Eating Disorder Not Otherwise Specified” (EDNOS)

Getting help

Eating disorders do not discriminate. While it more commonly effects teenage girls, they can also effect boys, men, children, elderly, etc. If you suspect that you have an eating disorder, the first step to recovery is to tell someone. This can be a parent, friend, doctor, teacher or even a support service/charity website such as B-EAT. Treatment differs depending on the diagnosis but can include inpatient care, Cognitive Behavioural Therapy (CBT), diet and nutrition advise or medication.

The important thing to remember is that recovery is possible so if you are worried about your eating behaviours, do not feel ashamed and hide away; talk to someone and take that first step towards recovery.

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