Tackling eating disorders

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February 22-28 is Eating Disorders Awareness Week. More than 725,000 men and women in the UK are affected by eating disorders – a range of conditions, including anorexia, bulimia and binge eating disorders that can affect someone physically, psychologically and socially.

Although serious, eating disorders are treatable conditions and a full recovery is possible. The sooner someone gets the treatment they need, the more likely they are to make a full recovery. Anyone can develop an eating disorder, regardless of their age, sex or cultural background. Young women are most likely to develop an eating disorder, particularly those aged 12 to 20, but older women and men of all ages can also suffer with the disorder.

Eating disorders claim more lives than any other mental illness – one in five of the most seriously affected will die prematurely from the physical consequences or suicide. These afflictions are complex and there is no one single reason why someone develops an eating disorder. A whole range of different factors combine such as genetic, psychological, environmental, social and biological influences. A number of risk factors need to combine to increase the likelihood that any one person develops the condition.

Eating disorders are sophisticated and not everyone will experience the same symptoms. People will respond differently to treatment and can take different amounts of time to recover. Some people can be affected by more than one type of hypheragia or may find their symptoms changing type as they recover.

Anorexia

Anorexia is a serious mental illness where people keep their body weight low by dieting, vomiting, using laxatives or excessively exercising. The way people with anorexia see themselves is often at odds with how they are seen by others and they will usually challenge the idea that they should gain weight. For example, they often have a distorted image of themselves, thinking that they're fat when they're not. People affected by anorexia often go to great attempts to hide their behaviour from family and friends.

People with anorexia often have low confidence and poor self esteem. They see their weight loss as a positive achievement which helps increase their confidence. It can also contribute to a feeling of gaining control over body weight and shape.

As with other eating disorders, anorexia can be associated with depression, low self-esteem, slef-harm and alcohol misuse.

Anorexia is a serious condition that can cause severe physical problems because of the effects of starvation on the body. This can lead to loss of muscle strength and reduced bone strength in women and girls; in older girls and women their periods often stop. Men can suffer from a lack of interest in sex or impotency.

The illness affects people’s relationship with family and friends, causing them to withdraw; it can also have an impact on how they perform in education or at work. The seriousness of the physical and emotional consequences of the condition is often not acknowledged or recognised, meaning people with anorexia often do not seek help. Anorexia in children and young people is similar to that in adults in terms of its psychological characteristics. But children and young people might, in addition to being of low weight, also be smaller than other people their age, and slower to develop. 

Bulimia

Bulimia is a serious mental illness where people feel that they have lost control over their eating and assess themselves according to their body shape and weight. People with bulimia are caught in a cycle of eating large quantities of food (called ‘bingeing’), and then vomiting, taking laxatives or diuretics (called purging), in order to prevent gaining weight. This dominates daily life and leads to difficulties with relationships and social situations. Usually people hide this behaviour pattern from others and their weight is often in a healthy range. People with bulimia tend not to seek help or support very readily and can experience mood swings as well as feeling anxious and tense.

They may also have very low self-esteem leading to self harming. They may experience symptoms such as tiredness, feeling bloated, constipation, abdominal pain, irregular periods, or occasional swelling of the hands and feet. Excessive vomiting can cause problems with the teeth, while laxative misuse can seriously affect the heart. Bulimia in children and young people is rare, although young people may have some of the symptoms of the condition. Bulimia usually develops at a slightly older age than anorexia. In some instances, although not all, bulimia develops from anorexia.

Binge eating

Binge eating is an eating disorder where a person feels compelled to overeat on a regular basis through regular binges. People who binge eat consume very large quantities of food over a short period of time, even when they are not hungry. Binges are often planned in advance and can involve the person buying "special" binge foods. In rare cases, people describe themselves as being in a "dazed state" during a binge – particularly binges during the night – and they are not able to recall what they ate.

Binge eaters eat feel they have no control over their eating. They often binge in private because they feel embarrassed, guilty or disgusted with their behaviour after they have finished eating. Episodes of binge eating sometimes alternate with periods where the person cuts down on the amount of food they eat. This can lead to a vicious cycle that is difficult to break – where blood sugar levels rise and fall rapidly, and false messages are sent to the brain, which result in cravings for food when your body doesn't need it.

Anyone can be affected by binge eating. While the condition is slightly more common in women than men, the numbers of men and women affected are more equal than in other eating disorders. The condition tends to first develop in young adults, although many people do not seek help until they are in their 30s or 40s.

Treating eating disorders

If an eating disorder isn't treated, it can have a negative impact on everyday life such as someone's job or schoolwork, and can disrupt relationships with family members and friends. The physical effects of an eating disorder can sometimes be fatal. Treatment for these disorders is available, although recovery can take a long time. It's important that the person affected wants to get better, and the support of family and friends is invaluable.

Treatment usually involves monitoring a person's physical health while helping them deal with the underlying psychological causes. This may involve:

  • using self-help manuals and books, possibly under guidance from a therapist or another healthcare professional
  • cognitive behavioural therapy (CBT) – therapy that focuses on changing how a person thinks about a situation, which in turn will affect how they act
  • interpersonal psychotherapy – a talking therapy that focuses on relationship-based issues
  • dietary counselling – a talking therapy to help a person maintain a healthy diet
  • psychodynamic therapy or cognitive analytic therapy (CAT) – therapy that focuses on how a person's personality and life experiences influence their current thoughts, feelings, relationships and behaviour
  • family therapy – therapy involving the family discussing how the eating disorder has affected them and their relationships
  • medication – for example, a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia nervosa or binge eating

If you’d like further advice on eating disorders, visit www.b-eat.co.uk 

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