Eating Disorders: An Introduction

Image: Michael Woloschinow

There is a lack of data detailing how many people in the UK suffer from an eating disorder. Although the Department of Health provides hospital episode statistics, these only include those affected by eating disorders who are in inpatient NHS treatment. The figures therefore leave out all those who have not come forward (which is significant given that most don’t think they need or want help), those have not been diagnosed, are receiving private treatment, or are being treated as an outpatient or in the community.

Who’s affected?

  • 1.6 million people in Britain affected by an eating disorder (source: B-eat)
  • It is estimated that
    • 10% of sufferers are anorexic,
    • 40% are bulimic, and
    • the rest fall into the EDNOS category, (Eating Disorder Not Otherwise Specified – including  binge eating disorder).
  • up to a quarter of these are male, (NHS Adult Psychiatric Morbidity Survey, 2007)
  • Most common is bulimia (1-2 per cent of pop affected)
  • 140 000 with anorexia
  • They are most common aged in young women – but increasingly affecting children, men and older people too.
  • 20% of anorexia sufferers will die prematurely from their illness. Bulimia is also associated with severe medical complications, and binge eating disorder sufferers often experience the medical complications associated with obesity.
  • In every case, eating disorders severely affect the quality of life of the sufferer and those that care for them.

 

Warning signs:

  • weight loss or unusual weight changes
  • periods being irregular or stopping
  • missing meals, eating very little and avoiding ‘fattening’ foods
  • avoiding eating in public, secret eating
  • large amounts of food disappearing from the cupboards
  • believing they are fat when underweight
  • exercising excessively, often in secret
  • becoming preoccupied with food, cooking for other people, calorie counting and setting target weights
  • going to the bathroom or toilet immediately after meals
  • over-exercising or using laxatives or diet pills and vomiting to control weight
  • feeling excessively cold
  • headaches and dizziness
  • changes in hair and skin
  • tiredness and difficulty with normal activities
  • damage to health, including stunting of growth and damage to bones and internal organs
  • loss of periods and risk of infertility
  • anxiety and depression
  • poor concentration, missing school, college or work
  • lack of confidence, withdrawal from friends

 

Anorexia Nervosa:

Restricting food intake as a way of coping with and controlling life. As the disorder progresses, chemical changes affect the brain and distort the sufferer’s thinking, (the ‘whirlpool’). This makes it more difficult for them to seek help or to think rationally about food and weight.

Who?

1 in 200 women and 1 in 2000 men.

Signs:

  • unable to maintain a minimum body weight (for example, 85% of expected weight)
  • intense fear of becoming fat, despite being underweight
  • if female, loss of periods
  • may frequently skip meals or make excuses to avoid eating—he or she had a big meal earlier, isn’t hungry, or has an upset stomach. The person may also claim to be disgusted by foods that used to be favorites.
  • may take tiny servings, eat only specific low-calorie foods, obsessively count calories, read food labels, and weigh portions.
  • will usually deny any problem
  • constipation and stomach pains, dizzy spells and fainting, swollen stomach face and ankles, downy hair on the body or loss of hair on the head when recovering, poor blood circulation, loss of interest in normal activities.
  • may show personality changes,  become secretive, restless and hyperactive, wear baggy clothes
  • may develop certain rituals when they eat food such as cutting things up into pieces

Bulimia Nervosa:

Uncontrollable urges to eat large quantities of food (bingeing), then trying to get rid of food (purging), e.g; by vomiting, using laxatives or over-exercising. Sufferers may also fast for long periods of time, which restarts the ‘binge-purge’ cycle.

Who?

It usually begins in adolescence, but many don’t seek help until they are in their 30s-40s. Nine times more common in women than men and more likely in those family histories of alcohol and substance abuse, or mood disorders.

Signs:

  • usually of normal weight but this may fluctuate
  • piles of empty food packages and wrappers, cupboards and refrigerators that have been cleaned out, hidden stashes of high-calorie foods such as desserts and junk food.
  • disappearing to the toilet after meals in order to vomit(may run the water to muffle the sound and use mouthwash, breath mints, or perfume to disguise the smell, a sore throat or tooth decay, swollen salivary glands, poor skin, irregular periods and lethargy.
  • obsession with food, a distorted perception of body weight and shape, anxiety and depression, low self-esteem and feelings of isolation.
  • May use laxatives, go through periods of fasting and excessive exercise, become secretive and reluctant to socialise.
  • May be accompanied by other impulsive behaviours e.g; overspending, shoplifting, promiscuity.

 

Binge-eating Disorder (BED)

Sufferer eats an unusually large amount of food very quickly (in less than 2 hours), far more than an average person would eat. Similar to bulimia but those with BED do not purge, fast or exercise after binge eating. Those with BED are more likely to be overweight or obese.

Who?

Affects men and women equally. The condition tends to be more common in older adults than in younger people, but it is often an issue for those recovering from anorexia or bulimia.

 Signs

  • Eats until physically uncomfortable and nauseated or when depressed or bored.
  • Often eats alone during periods of normal eating, because embarrassed about food.
  • Feels disgusted, depressed or guilty after binge eating.
  • Rapid weight gain.
  • Severe depression, easily irritated.

 

Remember:

  • ED don’t necessarily fit into the above categories, e.g; someone can be anorexic but still get their periods or ‘bulimarexic’ (a combination of the two).
  • NOS: When symptoms don’t fit a specific diagnosis; doctors may call this an eating disorder ‘not otherwise specified’ (NOS).  This is hard for sufferers to deal with, so be sensitive. Of those who receive a hospital diagnosis, 50% will receive this diagnosis.
  • All EDs cause enormous emotional and psychological distress and should be taken seriously.

Seek immediate medical help if sufferer experiences: dizziness, fatigue, black-outs, extreme temperature sensitivity, chest pains, tingling in hands or feet, blood in stools or vomit, stomach pains, incontinence or uncontrollable vomiting or diarrhoea, and/or 25% or more weight loss of total average body weight in a short period of time.

 ***
Rates of recovery (see B-eat website for more details):
Reviews of the research into recovery suggest that around 46% of anorexia nervosa patients fully recover, with a third improving, and 20% remaining chronically ill (Steinhausen, 2002). Similar research into bulimia suggests that around 45% of sufferers make a full recovery, 27% improve considerably, and 23% suffer chronically (Steinhausen & Weber, 2009).
For more info:

The Big House: www.thebighouse.org.uk: Organisation providing residential youth programmes on difficult issues young people face from a Christian perspective, as well as training and resourcing youth leaders.  Website includes talks on dealing with self-harm and eating disorders.

ABC: Anorexia and Bulimia Care:  www.anorexiabulimiacare.co.uk

National Centre for Eating Disorders: http://www.eating-disorders.org.uk/

Royal College of Psychiatrists: http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthandgrowingup/24.eatingdisordersinyoung.aspx

Beat: www.b-eat.co.uk

Men:http://mengetedstoo.co.uk/

Parents and carer support: www.feast-ed.org.  See also ‘Eating Disorders: Helping Your Child Recover’, published by beat, £15, www.b-eat.co.uk/Shop/Bookshop

 

 

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