Eating Disorders

What is an Eating Disorder?

There are different types of eating disorders and while they are all different, in many ways they also have a lot in common. An eating disorder may develop out of  a simple diet. Some people, to relieve tension or depression will go on a binge. A binge is eating a lot of food in a very short time until uncomfortably full. Although the binges relieve some tension, they also cause disgust, guilt, and concern about weight gain which will lead a person to purge after their binges. A purge is a way to compensate for all the extra calories by vomiting, excessive exercise, fasting, or using laxatives. It causes rapid gain and loss of weight, feelings of inadequacy, and an obsession with food. Binge Eating Disorder, Bulimia Nervosa and Anorexia Nervosa are the most common forms of eating disorders. Binge-Eating Disorder and Bulimia Nervosa are considered mental disorders because people with these disorders do not feel like they are in control of their eating behaviour. If a person binges more than twice a week, it is considered Binge-Eating Disorder. The combination of bingeing and purging is called Bulimia Nervosa.

Anorexia, although still considered a mental disorder is more controlled, with the person either taking very small amounts of food or starving themselves to remain thin.

It is estimated that 0.5 to 1% of women in late adolescence develop anorexia. It is most common between the ages of 10 and 30 and 90% of the cases are women. However, cases are increasing for men, minorities, older women and pre-teens. There are children as young as 8 showing concerns and behaviours around food, and up to 50% of these youngsters are boys.

Anorexia is associated with feelings and behaviours related to the fear of “fatness”.  These feelings include poor body image, a phobia about food and its ability to create fatness, and an intense fear of being a normal body weight. People with anorexia have not lost their appetite.  They are very hungry indeed.  They think about food all the time, want to be close to it - give it to others. What they don’t do is allow themselves to succumb to their desire for food. Like all compulsive disorders, the roots of anorexia lie in deep anxiety, the sense that not only is life out of control, running away too fast, but that their ability to cope with life and all its demands is poor.  Given these fears, it is all too easy for an individual to turn to the control of food and weight to gain some kind of control over their existence.

Typically anorexia starts when a young person feels overweight.  This may be because they have gained a little more weight than average at  puberty, or have slim friends with whom they compare themselves. A decision to go on a diet may be triggered by a specific event such as a comment or remark from a peer. The diet is most usually the first ever tried and it is initially quite successful, giving the young person  a real sense of achievement at an otherwise insecure time of life. There may initially be approval from friends or members of the family which is a positive form of attention. The anorexic never starts off intending to starve themself into emaciation. They just feels that life will be better if they lost a few pounds - which it is for a while.  At some point in the diet there is a subtle psychological change  - which is not experienced by normal dieters - and dieting actually becomes more intense as the diet progresses and the target weight is near.

The dieting behaviour goes underground so that it can become a private secret rather than a public activity and strategies are developed to convince “others” that eating is taking place when in fact it is not.   This requires a great deal of craftiness such as throwing food away, finding ways to get rid of it off a plate at mealtimes, or pretending to already have eaten. Hence by the time that weight loss is noticeable to the family, the anorexia is already well under way.

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In their own private eating world, the person developing anorexia will become very “ritualised” around food.  This may take the form of eating fractions of portions of food at specific times of the day, - like one third of an apple - or eating the crusts around a sandwich but not the middle. They will toy with their food, cut it up into tiny pieces and eat them very slowly. Even non-fattening foods will be feared. Many anorexics weigh themselves several times each day. An anorexic can panic if they show a small change in weight after eating one lettuce. ...

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