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What is an Eating Disorder?

What is an Eating Disorder?

Eating disorders are a group of serious and complicated illnesses that affect a small percentage of people, mostly adolescent and young adult women. These disorders present a severe threat to a person’s health and can result in dangerous physical problems and even death. There are many different types of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified.

Anorexia Nervosa
People who develop anorexia nervosa have an intense fear of gaining weight and being “fat”. They have a distorted view of their actual body weight, weight is 85% less of the normal weight for their age and height. They base their self-esteem largely on their own evaluation of their weight. They deny the reality of their physical condition and its physical effects, which includes at least three missed menstrual cycles.

There are two subcategories of anorexia nervosa: the restricting type and the binge-eating/purging type. People with the restricting type control their weight by limiting the amount of food they eat and by increasing their activity, usually by exercising excessively and compulsively. People with the binge-eating/purging type also control their weight by limiting the amount of food they eat but they also binge eat on occasion. They purge by making themselves vomit or by using laxatives, diuretics or enemas. They may become depressed, irritable and withdraw from others.

Bulimia Nervosa
People with bulimia nervosa are overly concerned about their body shape and weight, basing their self-image largely on how they look. Unlike people with anorexia nervosa, people with bulimia may be of normal or above average body weight. They engage in episodes of binge eating in response to powerful cravings and feelings of deprivation which often arise from strict dieting. During these binges, which tend to occur in secret, the person may feel a sense of loss of control or shame. To avoid weight gain, persons with the purging type of bulimia attempt to compensate for binge eating by making themselves vomit, consuming laxatives or diuretics or giving themselves enemas. The nonpurging types compensate for their binge eating by fasting or exercising excessively. Unlike people with anorexia, most people with bulimia are aware that their behaviour is neither normal nor healthy, often feeling depressed, shamed and isolated. They develop a complicated way of life to accommodate the bingeing-and-purging cycle.

Binge Eating Disorder (BED)
Binge eating disorder is similar to bulimia nervosa in that the person eats large amounts of food in a short period of time and feels out of control and unable to stop eating during these binges. However, unlike bulmia nervosa, there is usually no purging behaviour. As a result, people with binge eating disorder usually experience rapid weight gain, weight fluctuations and obesity. They often become secretive with food, hoarding it and eating it alone. They generally feel ashamed of their eating behaviour and may avoid social situations that are likely to involve eating. They may also develop depression and anxiety.

Eating Disorder Not Otherwise Specified (EDNOS)
Eating Disorder Not Otherwise Specified refers to eating disorders that do not fit neatly into the research criteria for anorexia, bulimia or binge eating disorder. For instance, a person may display all the signs of Anorexia Nervosa, but will still have a monthly menstrual cycle or they may meet all the criteria for bulimia but their binging or purging behaviour may occur less than twice a week. They also engage in a typical eating behaviours, such as chewing food but spitting it out prior to swallowing. This type of eating disorder is just as serious as other eating disorders — what the person is doing with regard to food and weight is neither normal nor healthy — so intervention and attention are still required.

Eating Disorders: The Physical Effects

Eating disorders can cause the following physical effects:
  • Acid reflux disorder
  • Anemia
  • Blood sugar changes
  • Blurred vision
  • Brittle nails
  • Calluses on fingers
  • Death
  • Dehydration
  • Depression
  • Diabetes
  • Digestive problems (cramps, bloating, constipation, diahhorea)
  • Dizziness
  • Dry skin and hair
  • Electrolyte imbalance
  • Extreme fatigue
  • Fainting
  • Gum disease
  • Hair loss
  • Headaches
  • High blood pressure
  • Hyperactivity
  • Incontinence
  • Insomnia
  • Kidney infection and failure
  • Lanugo (developing hair on face, back and arms)
  • Liver failure
  • Low blood pressure
  • Lowered body temperature
  • Malnutrition
  • Menstrual problems, pregnancy complications, and infertility
  • Muscle atrophy
  • Oesophagus deterioration
  • Osteoporosis and Osteopenia
  • Pancreatitis
  • Peptic ulcers
  • Seizures
  • Stomach erosion, perforation or rupture
  • Swelling of the face, cheeks, legs and feet
  • Tooth enamel erosion
Who is at risk for developing an eating disorder?

We live in a culture that values thinness and physical beauty rather than one’s inner qualities. Indeed, it is difficult to escape our society’s message that one’s values are based, in part, on the shape and beauty of one’s body. Young girls are most susceptible to this message, which is even more powerful when there is a lack of emotional support from family and friends. People who develop eating disorders tend to have the following characteristics:
  • Low self-esteem
  • Need for approval
  • Need for control of their feelings and environment
  • Perfectionism
  • Feelings of not deserving pleasure and happiness
  • Disappointment in oneself and feelings of being a failure
  • Difficulty in controlling impulses
  • Difficulty expressing their feelings
  • Depression, anxiety and loneliness
  • Disturbed body image – obsession with thinness and an extreme fear of gaining weight or of being fat
  • Past experiences of being shamed for being overweight
  • Family members who are or were obsessed with food and weight
  • Parents with unrealistic expectations
  • Transference of emotional problems to obsession with food and weight
  • Past experiences of sexual or physical abuse
What is the treatment for eating disorders?

Eating disorders are extremely serious and dangerous and require treatment by a qualified licensed professional. It is important to obtain treatment as early as possible to maximise chances of a complete recovery. People who allow an eating disorder to progress beyond the early stages risk becoming seriously ill and even dying.

The best treatment for an eating disorder is a combination of methods tailored specifically for the individual patient. The course of treatment depends on the client’s situation and needs, as well as on the severity of the illness. The following treatment methods are the most effective:

Medical treatment for physical symptoms
Eating disorders may cause a number of medical complications. Individuals who have complications caused by extreme weight loss or are suffering from the effects of bingeing and purging must seek the help of a qualified physician. Sufferers may need treatment at a hospital or centre that specialises in treating people with eating disorders.

Psychological Therapy
Psychological therapy can help sufferers to develop healthy ways of taking control of their lives and address important issues such as the thoughts, feelings and behaviours that led to the development and maintenance of their eating disorder. Cognitive behavioral therapy (CBT) has proved to be effective in treating bulimia and binge eating disorder. The appropriate therapy for anorexia is determined by individual and family circumstances.

Support groups
The Eating Disorder Foundation (EDF) offers a number of support groups for people that are struggling with eating disorders. Whilst these groups are not treatment groups, they aim to support, encourage and assist sufferers to find meaning and purpose beyond their eating disorders.

Many people with eating disorders also suffer fro depression, anxiety disorders, and other psychiatric problems. These conditions must be treated in conjunction with the eating disorder. Medication for these disorders can be very effective.

It is critical for sufferers to learn the facts about their eating disorders, as well as proper skills for managing triggers. EDF provides support and information to those affected by eating disorders. The websites and books listed below may also assist sufferers in this way.

Where can I go for more information?

Janet Treasure. (1997). Anorexia Nervosa: A Survival Guide For Families, Friends And Sufferers. Psychology Press.

Ulrike Schmidt and Janet Treasure. Getting better bit(e) by bit(e): A survival guide for sufferers of bulimia nervosa and binge eating disorders.

Michelle Heffner and Georg H. Eifert. (2004). The Anorexia Workbook: How to Accept Yourself, Heal Your Suffering, and Reclaim Your Life. New Harbinger Publications.

Randi E. McCabe, Traci L. McFarlane, and Marion P. Olmstead. (2004). Overcoming Bulimia: Your Comprehensive, Step-By-Step Guide to Recovery. New Harbinger Publications.

Christopher Fairburn. (1995). Overcoming Binge Eating. The Guilford Press. W. Stuart Agras and Robin Apple. (2007). Overcoming Your Eating Disorder: A Cognitive-Behavioral Therapy Approach for Bulimia Nervosa and Binge-Eating Disorder, Guided Self Help Workbook. Oxford University Press, USA.

Laura Goodman and Mona Villapiano. (2001). Eating Disorders: Journey to Recovery Workbook

James Lock and Daniel le Grange. (2005). Help Your Teenager Beat an Eating Disorder. The Guilford Press.

Abigail H. Natenshon. (1999). When Your Child Has an Eating Disorder: A Step-By-Step Workbook for Parents and Other Caregivers. Jossey-Bass.

Rachel Bryant-Waugh and Bryan Lask. (2004). Eating Disorders: A Parent's Guide. Routledge.

Janet Treasure, Grainne Smith and Anna Crane. (2007). Skills-based learning for caring for a loved one with an eating disorder: The new Maudsley method. Routledge.

The Butterfly Foundation
Ph: (02) 9412 4499

NSW Centre for Eating & Dieting Disorders (CEDD)

The Butterfly Foundation
Ph: 03 9421 3923
The Butterfly Foundation is a national organisation that provides support to Australians who suffer from eating disorders and negative body image issues.

Anorexia Nervosa and Related Eating Disorders Inc

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