4 Eating disorders

Eating disorders most commonly start in the mid-teens and can become serious illnesses.

In economically advanced countries, it is estimated that the proportion of adolescents and young adults experiencing eating disorders is approximately 3% (30 in a thousand) females and 0.1% (one in a thousand) males. It is easy to underestimate the amount, however, because not everyone seeks help and it can be difficult to conduct surveys that are truly representative of a community (AYPH, 2019).

Figure 5: Eating disorder

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A piece of artwork of a person at a dining table with a cross over their mouth. The artwork is illustrating an eating disorder.

Figure 5: Eating disorder

According to the National Institute for Health and Care Excellence (NICE), an eating disorder is when you have an unhealthy relationship with food which can take over your life and make you ill. It might involve eating too much or too little, or becoming obsessed with controlling your weight (NICE, 2017, p. 2).

Eating disorders can be a way of coping and/or expressing emotional distress. Causes of eating disorders are varied and are thought to include:

• low self-esteem, depression or anxiety
• family history of eating disorder and inherited genes
• relationship difficulties, peer pressure to be thin or bullying (Bould et al., 2017).

A young person with anorexia nervosa, for example, becomes preoccupied with weight and body shape and tries to lose weight by restricting food intake, exercising, inducing vomiting or using laxatives. Limiting food intake can be a way of feeling in control and coping with life but the young person can also feel as though the illness controls them. It is common to deny weight loss, have an extreme fear of gaining weight and resist offers of help.

In the next activity, you’ll hear about three types of eating disorder.

Activity 4: Dealing with an eating disorder

Timing: Allow about 10 minutes

Watch this video, a cartoon-style explanation of different eating disorders.

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Transcript: Video 2: Different eating disorders

SPEAKER

Eating disorders can develop for a number of complex reasons. People have an eating disorder when they have a difficult relationship with food and their bodies, which has a significant negative impact on their lives. It can involve eating too much or too little. And often becoming obsessed with weight and body shape, causing intense distress. But there are treatments that can help, and you can recover from an eating disorder.

People of all genders, ages, ethnicities, sexualities, and populations can develop an eating disorder. There are different types of eating disorders. The most common eating disorders are anorexia nervosa, when you try to keep your weight as low as possible, by not eating enough food and sometimes exercising too much.

Bulimia nervosa, when you sometimes lose control and eat a lot of food in a very short amount of time. And then try and get rid of the food by purging, such as making yourself sick, using laxatives, restricting what you eat or doing too much exercise. Binge eating disorder, when you regularly lose control of your eating. Eat large portions of food all at once, until you feel uncomfortably full and are often then guilty or upset.

It can often be very difficult to identify that one of our friend has developed an eating disorder. Warning signs to look out for include, dramatic weight loss, being secretive about how much and when they’ve eaten, or how much they weigh. Eating a lot of food very fast, going to the bathroom a lot after eating, often returning looking flushed. Excessively or obsessively exercising, avoiding eating with others, cutting food into small pieces or eating very slowly.

And wearing loose or baggy clothes, to hide their weight loss. Physical signs can include feeling cold, tired, or dizzy. Problems with digestion, weights being very high or very low compared to others of a similar age and height, and problems with menstrual cycle. It can be difficult to know what to do, if you’re concerned that someone you know has an eating disorder.

People with an eating disorder often keep their difficulties a secret. Sometimes not realizing that there is a problem, or feeling too embarrassed to seek help. Let them know you’re worried about them, and encourage them to see their GP. You could offer to go along with them. Remember, you can recover from an eating disorder, but it may take time and recovery will be different for everyone.

End transcript: Video 2: Different eating disorders

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Video 2: Different eating disorders

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Pick out three common themes relevant to all the types of eating disorder mentioned in the video: Anorexia nervosa, Bulimia nervosa, and Binge eating disorder.

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Discussion

Here are three themes that can be picked out:

• Obsession with body shape and food intake.
• A sense of control or lack of control over eating.
• Being secretive about eating.

You may also have noticed the warning signs to look out for, such as noticeable weight loss, feeling tired and cold, eating very fast or very slowly, frequently going to the bathroom after eating, and excessive exercising.