Eating Disorders, the facts

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Written by Sally Vicent

Some eating disorders, particularly bulimia and overeating, can also be treated in a similar environment to drug and alcohol addictions. There is a striking similarity between the relationship some have with food with the relationship others have with drugs or alcohol.

It is not the amount that you eat, drink or use that causes the problem but the underlying reasons why. It could be low self esteem, anxiety or stress, fear, relationship difficulties or as a coping mechanism for dealing with the memories of past traumas. In addition with food there are peer pressures to be the right size and shape in order to fit in or get the ‘right’ partner. This pressure increases the inner turmoil and the misery.

Diagnosing an eating disorder should be left to the experts but there are a number of typical behaviours that are common:

Obsessive thinking about food
Eating excessive amounts particularly on a low mood (Comfort Eating)
Making yourself sick or using laxatives
Lying to your family and friends about how much you eat
Anxiety about eating in social situations
Rigid calorie counting
Buying food from different shops so the assistants don't notice how much you're eating
Narrowing your social life so you don't have to eat in front of other people
Refusing to eat in unfamiliar environments
Severe mood swings and physical weakness brought on by lack of nourishment
Exhibiting perfectionist behaviour to show people how well your life is under control
Distorted perceptions of other people's lives (“she's got slimmer thighs than me so she must be happy - I hate her”)
Feeling trapped by the hold that food has over you
Thinking that there's no point in taking charge of your life “until I lose all this weight”
Fearing that no one will ever love you because of your size.

Bulimia, anorexia, overeating

Here's a brief overview of the three main types of eating disorders:

Bulimia - Bulimia nervosa, often called bulimia, is a type of eating disorder. A person with bulimia characteristically eats a lot of food in a short amount of time (binging) and then tries to prevent weight gain by getting rid of the food (purging). Purging might be done by:

Making yourself throw up
Taking laxatives (pills or liquids that speed up the movement of food through your body and lead to a bowel movement)

A person with bulimia feels he or she cannot control the amount of food eaten. Also, bulimics might exercise a lot, eat very little or not at all, or take pills to pass urine often to prevent weight gain.

People with bulimia can fall within the normal range for their age and weight. But bulimics:

Fear gaining weight
Want desperately to lose weight
Are very unhappy with their body size and shape

Bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part.

Culture. Women today are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies.
Families. If you have a mother or sister with bulimia, you are more likely to also have bulimia. Parents who think looks are important, diet themselves, or criticise their children's bodies are more likely to have a child with bulimia.
Life changes or stressful events. Traumatic events (like rape), as well as stressful things (like starting a new job), can lead to bulimia.
Personality traits. A person with bulimia may not like herself, hate the way she looks, or feel hopeless. She may be very moody, have problems expressing anger, or have a hard time controlling impulsive behaviours.
Biology. Genes, hormones, and chemicals in the brain may be factors in developing bulimia.

Anorexia - A terror of weight gain is fuelled by a self-imposed starvation regime. Teenage anorexia in girls is widely publicised but it can also afflict young children, older adults, boys and men. Anorexia is best dealt with in a specialised environment as the pattern of food use is markedly different from that of drugs or alcohol. Often specialised medical care is needed in the early days as well as supervision during meal times and the period immediate after. A person with anorexia nervosa, often called anorexia, has an intense fear of gaining weight. Someone with anorexia thinks about food a lot and limits the food she or he eats, even though she or he is too thin. Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of life and to ease tension, anger, and anxiety. Most people with anorexia are female. An anorexic:

Has a low body weight for her or his height
Resists keeping a normal body weight
Has an intense fear of gaining weight
Thinks she or he is fat even when very thin
Misses 3 menstrual periods in a row (for girls/women who have started having their periods)

While anorexia mostly affects girls and women (85 - 95 percent of anorexics are female), it can also affect boys and men. It was once thought that women of colour were shielded from eating disorders by their cultures, which tend to be more accepting of different body sizes. It is not known for sure whether African , Asian, Latina, Asian/Pacific Islander, and other ethnic groups develop eating disorders because western culture values thin people. People with different cultural backgrounds may develop eating disorders because it’s hard to adapt to a new culture (a theory called “culture clash”). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.

There is no single known cause of anorexia. Eating disorders are real, treatable medical illnesses with causes in both the body and the mind. Some of these things may play a part:

Culture. Women are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies. More and more, men are also feeling pressure to have a perfect body.
Families. If you have a mother or sister with anorexia, you are more likely to develop the disorder. Parents who think looks are important, diet themselves, or criticise their children's bodies are more likely to have a child with anorexia.
Life changes or stressful events. Traumatic events (like rape) as well as stressful things (like starting a new job), can lead to the onset of anorexia.
Personality traits. Someone with anorexia may not like her or himself, hate the way she or he looks, or feel hopeless. She or he often sets hard-to-reach goals for her or himself and tries to be perfect in every way.
Biology. Genes, hormones, and chemicals in the brain may be factors in developing anorexia.

Overeating - You may find eating a great comfort. Many people are reassured by “nursery food” such as custard, stodgy puddings, mashed potato, when they're feeling down. But overeating can also be a way of literally trying to fill an empty space deep inside you, a space which is desperate for love, approval, success, happiness. However, the feeling of an uncomfortably full stomach and the self-loathing which can accompany it only increases the emptiness.

People with compulsive overeating disorder often eat an unusually large amount of food and feel out of control during the binges. Unlike bulimia or anorexia, binge eaters do not throw up their food, exercise a lot, or eat only small amounts of only certain foods. Because of this, binge eaters are often overweight or obese. People with binge eating disorder also may:

Eat more quickly than usual during binge episodes
Eat until they are uncomfortably full
Eat when they are not hungry
Eat alone because of embarrassment
Feel disgusted, depressed, or guilty after overeating

About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. Binge eating disorder affects women slightly more often than men. In Europe the figure is less but growing.

What causes binge eating disorder?

Researchers are unsure of the causes and nature of binge eating and other eating disorders. Eating disorders likely involve abnormal activity in several different areas of the brain. Researchers are looking at the following factors that may affect binge eating:

Depression. As many as half of all people with compulsive overeating are depressed or have been depressed in the past.
Dieting. Some people binge after skipping meals, not eating enough food each day, or avoiding certain kinds of food.
Coping skills. Studies suggest that people with overeating problems may have trouble handling some of their emotions. Many people who are binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat.
Biology. Researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect compulsive overeating. Research also suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family. Neuroimaging, or pictures of the brain, may also lead to a better understanding of binge eating disorder.

Certain behaviours and emotional problems are more common in people with compulsive overeating. These include abusing alcohol, acting quickly without thinking (impulsive behavior), not feeling in charge of themselves, and not feeling a part of their communities.

People eat in a compulsive way are usually very upset by their binge eating and may become depressed. Research has shown that people compulsive overeating report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder.

People with compulsive overeating often feel badly about themselves and may miss work, school, or social activities to binge eat. People with compulsive overeting may gain weight. Weight gain can lead to obesity, and obesity raises the risk for these health problems: