In this article:
What are eating disorders?
Definitions & distinctions
Do I have an eating disorder?
What are eating disorders? Eating is essential to life. In western societies, most of us have enough to eat and so our relationship with food is no longer just about survival. Our own relationship with food begins when we are babies and often family and social interactions occur in the context of eating. Food takes on a wealth of social, familial, cultural and personal meanings.
Eating, for most people, is enjoyable. However, in today’s society we are faced with constant social media images of food, eating and ideal body shapes that complicate our relationship with food and with our bodies.
Consequently, it is not surprising that many people, both men and women, and increasingly at an earlier age, develop issues and problems around food. Eating too little or too much, feeling unhappy about their bodies, adopting some compensatory behaviours such as over exercising or purging.
It seems that both women and men in today’s society, are rarely satisfied with their body shape or weight and most people will diet at some time.
Anyone, from all types of background and ethnic groups can suffer from eating disorders. Eating disorders may be a way of coping with feelings that are making you unhappy or depressed. It may be difficult to face up to and talk about feelings like anger, sadness, guilt, loss or fear. An eating disorder is often a sign that you need help in coping with life and sorting personal problems.
Do men get eating disorders too?
Typically eating disorders are perceived to be conditions that affect only women – this is far from the case. Between 10% and 25% of those people experiencing eating disorders are male.
We know that the majority of men who have eating disorders struggle to get access to appropriate support and treatment. Therefore, it is difficult to know how many men are affected by these conditions.
Signs and symptoms may vary
Conditions as complex as eating disorders mean that there are variations in the typical signs, and not all symptoms will apply to all people. You may feel that you have a mixture of anorexia and bulimia, or alternate between them. You may find that you are focused on food and exercise and cannot think of much else. Some people also find they are affected by an urge to harm themselves or abuse alcohol or drugs.
Eating disorders don’t include food allergies, selective eating issues or disorders of the digestive system. However, a GP should be the first point of call for these issues, as well as for eating disorders. Counselling might be an additional or a first point of contact to talk through these issues further.
Definitions & distinctions Eating disorders can be an external expression of internal emotional pain and confusion. Obsessive thoughts about, and the behaviour associated with food (e.g. over exercise, over or under eating, vomiting and purging, social withdrawal etc.) may be ‘maladaptive’ attempts at processing emotional distress that cannot be otherwise expressed. Often, this emotional distress may be linked to a very negative self-perception, a feeling of being unable to change ‘bad’ things about oneself.
Feelings of being ‘out of control’ may be overwhelming and food is then often used as a way of taking back some control, until this too becomes an area which is ‘out of control’.
An eating disorder involves a distorted pattern of thinking about food and size and weight, to the extent that there is a preoccupation and obsessive quality to thinking about food, together with an issue of control or lack of control around food and its consumption.
There are several recognised eating disorders and areas of disordered eating.
Anorexia/Anorexia Nervosa
Anorexia is a disorder (or illness) which stems from low self-esteem and an inability to cope safely with worries and problems. It involves lowering food intake by skipping meals and cutting down the types and amounts of foods eaten; some people over-exercise as well.
Beliefs such as: ’losing weight will make life happier’ may be typical, as well as ‘people will like me more’, ‘I will be more successful’ or even perhaps that ‘I may be noticed less’.
Individuals may punish themselves if weight loss is not significant enough, or eat something not usually ‘allowed’. Losing weight is not the answer to everything. It is important that you try to focus on yourself.
Physical symptoms of Anorexia Nervosa
- Severe weight loss
- Difficulty sleeping and tiredness
- Dizziness
- Stomach pains
- Constipation
- Feeling cold
- Growth of downy (soft and fine) hair all over one’s body (called Lanugo)
- (girls) Periods stop or don’t start (amenorrhoea)
- Hair loss
- Feeling fat when underweight
- Getting irritable and moody
- Setting high standards and being a perfectionist
- Social isolation/ withdrawal
- Shutting oneself off from the world
- Thinking things are either right or wrong, there is no in between
- Difficulty concentrating
Behavioural symptoms of Anorexia Nervosa
- Excessive exercising
- Having ritual or obsessive behaviours
- Being secretive
- Lying about eating
- Trying to please everyone
- Cooking or preparing food for everyone else
- Wearing baggy clothes
Bulimia is also a disorder linked with self-esteem, emotional problems and stress. One may constantly think about calories, dieting and ways of getting rid of the food eaten. Bulimia is actually more common than anorexia, but is more of a hidden illness, because people with bulimia usually remain an average or just over average body weight. Bulimia can go unnoticed for a long time, although one may feel ill and very unhappy.
Individuals with Bulimia become involved in a cycle of eating a very large amount of food, making themselves sick (purging), cutting down or starving for a few days or trying to find other ways to make up for the food eaten.
Starving causes extreme hunger that then leads to excessively large amounts of food being craved, because your body is craving nourishment. Some people will not vomit but will take laxatives; both behaviours may be described as ‘purging’ by medical professionals, but taking laxatives is particularly dangerous.
Just because bulimia does not cause the extreme weight loss that anorexia does, it does not mean that it is less serious. Help and support is needed. The side effects and consequences of bulimia can be very serious.
Physical symptoms of Bulimia Nervosa
- Sore throat
- Bad breath and mouth infections
- Stomach pains
- Irregular periods (in girls/women)
- Dry or poor skin
- Difficulty sleeping
- Constipation
- Puffy cheeks
- Dehydration
- Fainting
- Kidney and bowel problems
Thoughts and feelings: psychological symptoms of Bulimia Nervosa
- Feeling emotional and depressed
- Feeling out of control
- Mood swings
- Obsessed with dieting
- Eating large quantities of food
- Being sick after meals or binges
- Taking laxatives or diet pills
- Being secretive and lying
Binge Eating Disorder/Compulsive Overeating
If you binge eat, this usually means that you would eat large amounts of food in a short period of time (perhaps not at a normal mealtime) and have associated feelings of lack of control during these binges.
However, unlike someone with Bulimia Nervosa, you may not try to get rid of the food. You may feel out of control around eating, eat what may be thought of as an unusually large amount of food, eat much more quickly in these binges, eat until feeling uncomfortably full, eat large amounts of food when not hungry, or eat alone.
You may well do this for similar reasons to someone with bulimia. Compulsive overeating involves ‘picking’ at food all day. There may be different reasons why you may do this, but as with eating disorders, food and eating is used as a way of dealing with difficult feelings. If you compulsively overeat or binge eat, you may feel depressed or inadequate because of a lack of control around eating, which can lead to further eating and weight gain.
Other Feeding and Eating Disorders (OFED) or Undiagnosed Feeding and Eating Disorders (UFED)
Eating disorders are very complex which means that there can be variations in the typical signs and symptoms and that not all of the signs and symptoms will apply to all people. There are many people that may fall into the category of Other Feeding and Eating Disorders (OFED) or Undiagnosed Feeding and Eating Disorders (UFED).
These are disorders where one may have some but not all, of the diagnostic signs for Anorexia or Bulimia. You may also be diagnosed with a ‘partial syndrome’ eating disorder if, for example, a woman with Anorexia has irregular or normal periods, or perhaps, Bulimic episodes are very infrequent.
How are Other Feeding and Eating Disorders (OFED) are diagnosed?
There are many different behaviours which can help a professional to diagnose OFED. Here are some examples of what some typical diagnoses might include:
- All the criteria for Anorexia Nervosa are met, except the individual has regular menses or despite significant weight loss, the individual's current weight is within the normal range.
- All the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a week or a duration of less than three months.
- An individual of normal body weight who regularly engages in inappropriate compensatory behaviour after eating small amounts of food (e.g. self-induced vomiting after the consumption of two biscuits).
- An individual who repeatedly chews and spits out, but does not swallow, large amounts of food.
Do I have an eating disorder? Conditions as complex as eating disorders mean that there are variations in the typical signs, and not all symptoms will apply to all people. You may feel that you have a mixture of Anorexia and Bulimia, or alternate between them. Some people also find they are affected by an urge to harm themselves or abuse alcohol or drugs.
Even if you don’t have these symptoms, if you’re worried and upset by something, anything, it is important to find appropriate support and someone to talk to.
- Understanding Your Eating, Julia Buckroyd (Open University, 2011)
- Overcoming Anorexia Nervosa - a self-help guide using Cognitive Behavioural techniques, Freeman, (Constable and Robinson, 2002)
- On Eating, Susie Orbach (Penguin, 2002)
- Getting Better Bit(e) by Bit(e) - a survival kit for sufferers of bulimia nervosa and binge eating disorders, Schmidt & Treasure (Psychology Press, 1993)
- Anorexia Nervosa: a survival guide for families, friends & sufferers, Janet Treasure (Psychology Press, 2013)
- The University of Cambridge also offer a further list of books you may find helpful: Self-help books on Eating Disorders
