Eating disorders affect approximately four in every 100 people in Australia (about 1 million people). They can affect people of any age, weight, size, shape, gender identity, sexuality, cultural background or socioeconomic group. Our dominant culture normalises dieting, demonises certain foods, reveres slim bodies and celebrates weight loss. In this way, many patterns of disordered eating are normalised and reinforced. So what is disordered eating? And when does it become a problem?
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Eating disorder vs disordered eating
Disordered eating refers to a disturbed and unhealthy eating pattern that can include restrictive dieting, compulsive eating, skipping meals, and purging. While disordered eating can include behaviours that reflect symptoms of eating disorders such as anorexia nervosa or bulimia nervosa, the difference between 'disordered eating' and an 'eating disorder' is the level of severity and frequency of behaviours.
An eating disorder, as defined by a psychiatric diagnosis, is a mental health condition characterised by unhealthy thoughts, behaviours and attitudes towards food and eating. This can manifest itself in a number of ways, including (but not limited to):
Preoccupation with body weight/shape.
Using compensatory strategies to control weight/shape (e.g. exercise, restricting food intake, purging).
Dissatisfaction with one's own body or a negatively distorted body image (body dysmorphia).
Feelings of anxiety and/or guilt around eating.
It's important to know that eating disorders are not a "lifestyle choice", a "diet gone too far", or a "cry for attention". It is a serious mental illness that's complex and potentially life-threatening, and can have detrimental impacts on one's life and health.
What are the different kinds of eating disorders?
There are several types of eating disorders, each with a distinctive set of symptoms.
Anorexia nervosa is characterised by an intense fear of gaining weight or becoming overweight regardless of current appearance or weight. A person suffering from this disorder will experience severe weight loss due to starvation, and may create extreme rules about their diet and exercise schedules.
Avoidant/restrictive food intake disorder (ARFID)
ARFID, commonly known as 'extreme picky eating', is characterised by an avoidance or aversion to eating. However, this isn't due to a body image disturbance, but rather a phobia or anxiety of food and/or eating itself, a lack of interest in food/eating which leads to low appetite, and heightened sensitivity to food texture, taste or smell.
Binge eating disorder
Binge eating disorder is the most common eating disorder in Australia (comprising of almost half of all eating disorder cases in the country) and is characterised by the consumption of very large amounts of food in a very short period of time, even when they're not hungry, which is then followed by feelings of guilt and shame. Unlike bulimia nervosa, people suffering from binge eating disorder don't compensate with their behaviour afterwards by purging their food or overexercising.
Bulimia nervosa is a serious psychiatric illness characterised by repeated episodes of binge eating followed by feelings of guilt and shame. This in turn leads to compensatory behaviours: something done to compensate for food intake, such as exercise, vomiting, laxatives, or diet pills (also known as 'purging').
For more in-depth information into the different types of eating disorders, head over to the Butterfly Foundation here.
Is my eating disordered and why is this a problem?
Some of the common behaviours and psychological warning signs are presented below:
Constant or repetitive dieting - This can include calorie counting, fasting, skipping meals, avoiding certain foods, or replacing meals with fluids or diet pills
Compulsive or excessive exercise
Avoidance of social situations involving food
Change in food preferences
Secretive behaviour around food (stemming from shame)
Increased focus on body shape and weight
Punishing self after eating
Increased preoccupation with food, eating, body shape and weight
Increased anxiety and/or irritability around meal times
Negative emotions or distress related to body image
Rigid 'black and white' thinking about food being 'bad' or 'good'
Feeling 'out of control' around food
Needing to have rigid control over diet to regulate emotions
There may also be physical symptoms, such as excessive weight loss, however this is not a diagnostic indicator of an eating disorder, simply a consequence of some eating disorders.
Don't I have to be "too thin" to have an eating disorder?
This is a common myth, often reinforced by society, which assumes that if someone has an eating disorder, they must be underweight. This is not the case, and is a dangerous assumption to make. Many people who meet criteria for an eating disorder diagnosis are in the normal. overweight or obese weight range. Rather than having their disordered eating flagged as problematic and treated effectively, however, they are often encouraged to continue eating in a disordered way to to pursue weight loss, which is often seen as a positive, healthy goal, regardless of the means.
Disordered eating and body dysmorphia are unhealthy and require treatment, regardless of your weight and shape!
What causes an eating disorder?
The causes behind an eating disorder are complex and usually involve a combination of genetic, psychological, and sociocultural factors. Generally speaking, there's usually never "one" cause that triggers an eating disorder.
Studies have shown that eating disorders have a genetic basis and can be passed down in families with a history of eating disorders or other mental health conditions, though there's still work that needs to be done regarding the biological causes of this illness.
Psychological factors that may contribute or be present before, during and after recovery from an eating disorder include:
Core low self-esteem
Traits associated with avoidant personality disorder.
There is evidence that sociocultural factors play a role in the development of eating disorders and can include:
Adopting and aspiring to cultural ideals of beauty
Pressure to achieve and succeed
Bullying, especially when focused on weight or body shape
Troubled family or personal relationships
Why seek treatment?
People with eating disorders are often hesitant to come forward for treatment because the disorder has become a central coping strategy for the person in managing their emotions and behaviours, giving them a false sense of security, power and control. It can be extremely difficult to see the negative impacts of an eating disorder when there are many perceived "benefits". Imagine that you have a walking stick you've been using for years, and have come to believe that you cannot walk without it. Would you be willing let go of it?
Eating disorders are always an unhealthy and ultimately unhelpful coping strategy. Seeking help is important because while you have an eating disorder, you are never fully in control of your own life. Even though it may feel like you couldn't cope without the disorder - you can! Therapy is available to show you how.
Treatment pathways and recovery journeys
Eating disorders are complex mental illnesses and it's important to start treatment as early as possible due to the long-term health consequences. There is good evidence that the sooner someone starts treatment for their eating disorder, the shorter the time will be for recovery.
Recovery from an eating disorder varies from person to person and will be different for everyone. What's important is taking the first step in acknowledging that something is wrong and to reach out for help. While feelings of guilt, shame, fear, and anger may arise at this point, it's perfectly okay to have mixed feelings about getting treatment and it's part of the recovery journey.
There are a number of treatment options available, including:
Counselling or psychological therapy
Nutrition education and management from a dietitian.
Family approaches for children, adolescents and young adults that involve the person's whole family or support network.
Combining professional help with self-help approaches.
In Australia under Medicare, people with a diagnosis of an eating disorder are eligible for an Eating Disorder Plan (EDP). The plan can include up to 20 Medicare-subsidised sessions with a dietitian and 40 sessions with a mental health clinician over a 12-month period
If you need support, make an appointment with your GP or chat to someone from Sonder. Sonder is here for you 24/7 and can answer any of your questions.
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All content is created and published for informational purposes only. It is not intended to be a substitute for professional advice.