Eating Disorders Awareness Week (26th February – 4th March 2018) is an international awareness event, fighting the myths and misunderstandings that surround Anorexia, Bulimia, Binge Eating Disorder and EDNOS (Eating Disorder Not Otherwise Specified).
In light of Eating Disorders Awareness Week, I’ve finally built up the courage to sit down and write this post. For personal reasons, I’m not ready to share everything I would like to, but its a topic that’s very important to me and I’ve wanted to write something on it for a while now, but wasn’t sure how to go about it. I’ve given it my best shot below, based on information I’ve come across by Southern Health and other key sources, such as BEAT – the UK’s eating disorder charity. I hope by the end of this post, you will have left it knowing more about the main types of eating disorders that exist, common myths and misconceptions, spotting the early signs and going about seeking help.
You might be wondering why I want to write about this topic or why it’s so important to me – without going into too much detail, it’s due to my personal experience, the subsequent battle with my mental health, and the detrimental impact it had on my relationships – family, friends, romantic and even professional – that made me realise the full extent of it’s ability to completely claw into one’s psyche and overtake and affect every aspect of life. I want to raise awareness and promote seeking professional help as soon as possible, as doing so is the first step to recovery. And I want people to know that 100% recovery is possible. My own story is not only a testament to this, but other people that I have met, who have recovered and given me advice, demonstrate that it’s possible too.
It’s hard to describe experiencing an eating disorder – but the best way I can put it is that its effects are all encompassing – physical, psychological, social – it changes the way you think, the way you behave and the way you live – pretty much everything – and all for the worse. Because it affects the way you think, it’s very difficult to think rationally about anything; distorted thinking and behaviour are commonplace due to the extreme lengths an individual goes to to influence their body shape and weight, and it’s near impossible to escape its grip without outside help. In the field of psychology, eating disorders fall under the category of abnormality.
I really want people to understand how serious the condition is, and that if you are worried about yourself, or someone else, to seek help at the first opportunity. Like with all conditions, the earlier it’s caught, the better the chances of recovery.
What is an Eating Disorder?
An eating disorder is a serious and complex mental illness which effects people both physically and psychologically. There are approximately around 1.6 million people in the UK who suffer from an eating disorder according to NICE (National Institute of Clinical Excellence).
There are three main types:
- Anorexia Nervosa: AN is characterised by an intense fear of being overweight and continues even when someone’s actual body weight is extremely low. Anorexics typically weigh less than 85% of their normal body weight and tend to suffer from depression, low self-esteem, low blood pressure, cessation of menstruation, dry, cracking skin and constipation.
- Bulimia Nervosa: BN is characterised by periods of binge eating and then purging, whether by induced vomiting, using laxatives or other means. Bulimics feel guilt about their bingeing/purging episodes, and are aware of their problem. They tend to keep their disorder a secret as the physical effects are not as obvious as AN, but they still share an intense fear of fatness, and are very much preoccupied with their body weight and shape. Physical effects include a swollen face, deterioration of tooth enamel and digestive tract damage.
- Binge Eating Disorder: BED involves the rapid consumption of large amounts of high calorific foods in a short space of time, on a regular basis. Binges are characterised by eating much faster than normal, usually in secret, experiencing a loss of control and finding it difficult to stop during a binge (even if sufferers want to), and having extreme feelings of disgust or guilt after the binge. Far from being enjoyable, binges tend to be distressing; some have even described feeling disconnected to the whole experience, or struggling to remember what they’ve eaten afterwards. Unlike BN, people with BED don’t regularly use purging methods after.
Common across all: spending a lot of time thinking about or obsessing over food, trying to exert control and/or experiencing a loss of control, social isolation, body dysmorphia, low self-esteem/self-loathing, shame, sleep problems, anxiety, depression and suicidal thoughts.
Myths and Misconceptions about Eating Disorders
- Eating disorders are a choice. They just need to snap out of it.
This is probably the worst misconception that exists. Eating disorders are in fact complex medical and psychiatric illnesses that sufferers do not choose to experience and cannot simply just ‘snap’ out of. The causes are complex and still baffle and confuse professionals who have been treating patients for years. Current research and thinking shows that eating disorders are caused by both genetic and environmental factors – they are bio-sociocultural diseases. Societal factors, like pressure to be thin from the media; environmental factors such as bullying or other life stressors, and certain biological predispositions, may all make an individual vulnerable to developing an eating disorder.
In fact, decades of research show that biological factors play a significant role in who develops an eating disorder, and that they commonly occur simultaneously with other mental health conditions like depression, anxiety, social phobia, and OCD. The consequences of eating disorders can be life-threatening, and many individuals find that the stigma against mental illness and eating disorders that exists in society, can obstruct a timely diagnosis and adequate treatment.
- It’s just an eating disorder. It’s not a big deal.
Did you know that eating disorders have the highest mortality rate of any psychiatric illness? Up to 20% of individuals with chronic Anorexia Nervosa die as a result of their illness. Furthermore, studies show that all eating disorders, including Bulimia and EDNOS, have similar mortality rates. Sufferers have a severely impacted quality of life, and besides the medical complications bought on from binge eating, purging, starvation, and over-exercise, suicide is also common.
Moreover, the idea that Anorexia is the only serious eating disorder, is not true. Individuals who abuse laxatives or diuretics or force themselves to vomit are at significantly higher risk of sudden death from heart attacks due to electrolyte imbalances. Excessive exercise can also increase the risk of death in individuals with eating disorders by increasing the amount of stress on the body.
- Eating disorders are a cry for attention.
People with eating disorders are not seeking attention. In fact, sufferers go out of their way to hide symptoms of their illness, disguise or deny their behaviour, either out of shame or because they are afraid someone will make them stop.
Linked to this is the idea that people with eating disorders are just self-absorbed and vain – this is not true either. They are serious mental health conditions and usually transcends beauty and becomes a way to cope with other issues.
- Strict rules about eating or fad diets aren’t a problem.
What appears to be a strict diet on the surface may actually be the beginning of an eating disorder. Chronic dieting or serious disordered eating can have serious medical consequences, such as anemia and bone loss, and has been associated with the later development of an eating disorder, so addressing these issues right away is critical.
- As long as someone is not emaciated, they are not that sick.
An individual can experience a severe eating disorder at any weight.
Most people with an eating disorder are not underweight. Although sufferers are commonly portrayed by the media as being emaciated – the truth is, you can’t tell whether someone has an eating disorder just by looking at them. This is concerning, because perceptions like this only help to perpetuate the problem, and can cause distress in sufferers for fear of not being “sick enough” or “good enough” at their disorder to deserve treatment.
- The main eating disorder symptom I have to worry about in someone is weight loss.
Although Anorexia Nervosa and other restrictive eating disorders are characterized by weight loss, many people with eating disorders don’t lose weight and may even gain weight.
- Eating disorder behaviors only focus on food.
The funny thing about suffering from an eating disorder is that it’s got absolutely nothing to do with food, but it’s got everything to do with it at the same time.
Yes, sufferers have an unhealthy focus on food and weight, but the symptoms of an eating disorder go far, far beyond this. Numerous scientific studies have shown links between eating disorders, perfectionism, and obsessionality, which can lead to a fixation on grades, sports performance etc.
Although many sufferers report that eating disorder behaviors initially help them decrease or deal with depression and anxiety, as the disorder progresses, it can ultimately increase their levels of depression and anxiety, going on to affect all aspects of their life.
- Doesn’t everyone have Binge Eating Disorder these days?
Binge Eating Disorder (BED) only affects 3.5% of women, 2% of men and up to 1.6% of adolescents, and it is not the same thing as occasionally overeating or eating more than is comfortable. Those who struggle with BED engage in recurring episodes – at least once per week over three months – where they eat significantly more food in a short space of time than most people would, and experience a sense of loss of control over their eating behavior. The frequency and severity of the disorder can significantly impact the individual’s life negatively, with many sufferers experiencing co-occurring conditions such as depression and anxiety.
- My daughter/son has Bulimia, so she/he won’t develop another type of eating disorder.
Many people with eating disorders will suffer from more than one disorder before they ultimately recover. Roughly half of all people with Anorexia will go on to develop Bulimia. Some individuals show signs of both Anorexia and Bulimia simultaneously, regularly binge eating; they may also purge while at a low weight. Others transition from one diagnosis to another (diagnostic cross-over). All can involve life-threatening consequences.
- Bulimia Nervosa is about self-induced vomiting.
People diagnosed with BN may not necessarily make themselves sick. They may take laxatives, exercise excessively or try and restrict their food intake between binge episodes. People with BN and EDNOS may share the same beliefs and psychological problems as people with AN, even though their diagnosis and behaviours may be different.
- Eating disorders only affect white, middle class, young adolescent girls.
Anyone can develop an eating disorder at any time. They occur across all cultural and socio-economic backgrounds, amongst people of all ages, from children to the elderly, and in both men and women.
The first signs?
In a recent YouGov survey, 34% of UK adults could not name a single sign or symptom of an eating disorder. For me this is really worrying, as someone could be suffering from a life-threatening illness right under your nose, and you may not even have a clue.
Here are some key warning behaviours – people suffering from an eating disorder may not realise they are initially, but as someone close to them you may be able to identify the first signs:
- LIPS – Are they obsessive about food?
- FLIPS – Is their behaviour changing?
- HIPS – Do they have distorted beliefs about their body size?
- KIPS – Are they often tired or struggling to concentrate?
- NIPS – Do they disappear to the toilet after meals?
- SKIPS – Have they started exercising excessively?
If you’re worried someone you care about is showing signs of an eating disorder – or if you think you might be suffering from it yourself – you must act quickly. Speak to your GP and reach out to BEAT – the UK’s eating disorder charity, which can help provide advice and support on the road to recovery. I can’t express the importance of seeking help as early as possible enough. Evidence shows that early diagnosis and intervention can greatly reduce the duration and severity of an eating disorder, especially as there is a considerable period of time between onset and treatment.
My advice will always be to seek treatment and take medication alongside this (if recommended) to help with treatment and recovery. It is possible to recover 100%, even though it might not seem like it initially, you just have to be willing to try everyday, and seeking help is the first step to getting better.
The following are links to key resources and references I used to write this post. I hope you found it informative:
- BEAT is the UK’s eating disorder charity – they are a champion, guide and friend to anyone suffering from an eating disorder.
- NHS on Eating Disorders
- National Eating Disorders Collaboration
- NEDA – National Eating Disorders Association
- Overcoming Binge Eating Disorder
- Princess Diana on Bulimia and Depression
- Louis Theroux: Talking to Anorexia
Eating disorders affect more people than you know. Sufferers suffer in silence, in shame and from the guilt and stigma that is attached to it and experience a significantly poorer quality of life because of it. I’m so glad Eating Disorders Awareness Week exists, as at worst, eating disorders are ignored; and at best, they are significantly misunderstood.
Please share this post if you found it useful and to raise awareness, or with someone who you think it would be of value to.
Featured photographs obtained from Google Images