Eating disorders are complex mental illnesses that involve different types of disordered behaviour surrounding food consumption. These behaviours might mean that a person either limits the amount of food eaten, eats very large quantities of food at once, purges what they have eaten, misuses laxatives, fasts, engages in excessive exercise or perhaps presents with a combination of all of these behaviours. Anorexia nervosa and bulimia nervosa are likely the most well known forms of disordered eating, however other examples include binge eating disorder, avoidant/restrictive food intake disorder (ARFID) and purging disorder – which presents without binge eating behaviours. Eating disorders are not always easy to identify and can present themselves quite differently from person to person. Although eating disorders tend to be more common among females and teenagers, disordered eating can develop at any age and is becoming increasingly more prevalent among males, perhaps due to growing social pressures.
While there are a variety of factors which can increase the risk of developing an eating disorder, it is vital to remember that an eating disorder is often not about food itself. It is a mental illness. Your psychological and emotional health plays a role, as can cultural pressures and messaging purported by the media. People with eating disorders often also suffer with anxiety, depression, and/or obsessive-compulsive disorders. Disordered eating then develops to cope with underlying stressors and pressures,
such as the perceived need to be ‘thin’. There is some evidence to suggest eating disorders can be hereditary. Higher rates of eating disorders are reported among those with a genetic tendency to perfectionism and sensitivity. Still, ultimately eating disorders can affect anyone of any age, gender, or background and they are NOT the fault of the person suffering.
Quite often a seemingly healthy person could be suffering privately from an eating disorder. There are some changes in behaviour that may be noticeable before you see changes in physical appearance. While some indicators may be specific to a certain eating disorder, generally you should remain on the lookout for the following signs and symptoms which suggest there could be an issue:
• Saying they have eaten earlier or will eat later, or that they have eaten more than they have
• Strict dieting and avoiding food they think is fattening
• Obsessive and/or rigid behaviour, particularly around food, i.e. counting calories, eating each type of food separately on a plate etc.
• Avoiding eating with other people
• Taking appetite suppressants, such as slimming or diet pills
• Excessive exercising – this might also include exercising when not physically well enough to do so or feeling guilty or anxious about not exercising
• Social withdrawal and isolation
• Distorted perception of body shape or weight, e.g. thinking they are much larger than they are
• Underestimating or denying the seriousness of the problem or not believing there is a problem at all, even after diagnosis.
Eating disorders affect a person’s physical and emotional health, and complications can be fatal. Some potentially dangerous developments include:
• Heart issues
• Electrolyte imbalance
• Loss of period (females)
• Decreased testosterone (males)
• Gastrointestinal issues
• Kidney issues
Unfortunately, many people who suffer with disordered eating may initially reject help. If you are at all worried about yourself or someone else, urge him or her to seek professional support as soon as possible.
It is best to first approach your GP about any concerns. Your GP will typically run several tests, including a physical exam, lab tests, and a psychological evaluation. Generally, treatment is managed through a team approach with help from doctors, mental health professionals and dietitians collectively. That said, treatment plans are highly individualised, and a trained professional will advise on what is the best route to take.
In most cases eating disorders can be treated in outpatient facilities. More intensive treatment in an inpatient unit might become necessary if the condition worsens.
The road to recovery from an eating disorder is unique to each person. However, with the right treatment plan and support – recovery, whatever that means to the individual, is possible. There are a few steps that can be taken to try to prevent disordered eating habits taking root, or to avoid a future relapse. Promoting a positive narrative around eating habits and body image is a good place to start. Discuss with your children why fuelling our bodies with food is important; be weary of how you speak about your own body and eating habits around your children; and reject the idea of there being an ‘ideal’ body type. For more information on managing and overcoming eating disorders, please refer to the following resources:
If you or someone you know is suffering with an eating disorder it is important to seek professional help. Contact your GP first for more information. The following websites can also provide further insight and help for eating disorders:
Dr. Alexandra Bodden is a licenced psychologist in both Cayman and Maryland, USA.