What is an eating disorder ?
Anorexia and bulimia are the two most recognised and most serious eating disorders. Each disorder involves a preoccupation with control over eating, body weight and foods; but whereas people with anorexia are determined to control the amounts of food they eat, people with bulimia tend to feel out of control where food is concerned. Eating disorders are more common in females but males can also suffer from them. Both illnesses can be overcome. The sooner a person seeks advice about the condition the better.
What are the symptoms of Anorexia and Bulimia?
Anorexia is characterised by:
A loss of at least 15% of body weight resulting from refusal to consume sufficient food, despite extreme hunger.
Usually a disturbance of perceptions of body image - the person may regard themselves as fat, overestimating body size the thinner they become.
An intense fear of becoming "fat" and of losing control
Often the tendency to exercise obsessively.
A preoccupation with the preparation of food for others to eat. Collections of recipe books, slimming magazines and health "facts" resulting in lists of "good" and "bad" foods.
About 40% of people with anorexia will later develop bulimia.
Bulimia is characterised by:
Eating binges which involve consumption of large amounts of calorie rich foods, during which the person feels a loss of personal control and self-disgust.
Attempts to compensate for binges, and to avoid weight gain by self-induced vomiting, and/or abuse of laxatives/fluid tablets.
A combination of restricted eating and compulsive exercise; so that control of weight dominates the person's life.
The person with bulimia is usually average or slightly above average weight for height and so if often less recognisable than the person with anorexia.
What causes Anorexia and Bulimia?
Usually, anorexia begins with a weight loss either resulting from a physical illness or from dieting. Favourable comments cause the person to believe that if thin is good, then thinner is better. The body does not react well to starvation, and erratic behaviour begins to dominate the person's life.
Often bulimia starts with rigid weight reduction dieting. Inadequate nutrition causes tiredness and powerful urges to binge eat. Vomiting after a binge seems to bring a sense of relief, but this is temporary and soon turns to depression and guilt. Other people use laxatives, apparently unaware that laxatives do not reduce kilojoules/fat content, and serve only to eliminate vital trace elements and to dehydrate the body.
There can be frantic efforts to break from the pattern, but the vicious binge/purge/exercise cycle, and the feelings associated with it, may have become compulsive and uncontrollable. The person with bulimia may experience chemical imbalances in the body which bring about lethargy, depression and clouded thinking.
Nevertheless, actual causes remain disputed, with biological, psychological and social factors involved. There appear to be factors, which for some people, compound low self-esteem and contribute to the onset of anorexia or bulimia including:
Social influences such as:
Media and other presentations of the "ideal" shape of western societies as slim and fit, and a tendency to stereotype fat people in a negative manner.
Personal factors such as:
Changes in life circumstances such as changes during adolescence, breakdown of relationships, childbirth or the death of a loved one.
Fear of the responsibilities of adulthood
Poor communication between family members or parental reluctance to allow independence as children mature
A belief that love from the family and friends is dependent on high achievement
Biological factor such as:
Chemical or hormonal imbalances (perhaps associated with adolescence) in the body.
What are the effects of Anorexia and Bulimia?
Physical Effects:
The physical effects can be very serious, but are generally reversible if the illnesses are tackled in the early stages. However, if left untreated, severe anorexia and bulimia can be fatal. Responding to early warning signs and obtaining early treatment is essential.
Both illnesses, when severe, can cause:
Kidney dysfunction
Urinary tract infections and damage to the colon
Dehydration, constipation and diarrhoea
Seizures, muscle spasms or cramps (resulting from chemical imbalances)
Chronic indigestion
Loss of menstruation or irregular periods for females
Strain on most of the body organs
Many of the effects of anorexia are related to malnutrition, including:
Absence of menstrual periods, in females
Severe sensitivity to the cold
Growth of down-like hair all over the body
Inability to think rationally and to concentrate
Severe bulimia is likely to cause:
Erosion to dental enamel from vomiting practices
Swollen salivary glands
The possibility of a ruptured stomach
Chronic sore throat and gullet
Emotional and Psychological Effects:
These are likely to include:
Difficulties with activities which involve food
Loneliness, due to self-imposed isolation and a reluctance to develop personal relationships
Deceptive behaviours relating to food
Fear of the disapproval of others should the illness become known, tinged with the hope that family and friends might intervene and provide assistance
Outbursts or depression
What treatment is available?
Changes in eating behaviour may be caused by a number of illnesses other than anorexia or bulimia so a thorough physical examination is the first step.
Once the illness has been diagnosed, a range of health practitioners might be involved in the treatment as the illnesses affect people both physically and mentally. Psychiatrists, psychologists, physicians, dieticians, social workers, occupational therapists, nurses and dentists may play a role in assisting a person to recover.
Hospitalisation - sometimes for prolonged periods - may be necessary for people severely malnourished through anorexia, while out-patient treatment is generally preferred for people with bulimia.
Treatment may also include psychological treatment, medication to assist severe depression and to correct hormonal and chemical imbalances, and dietary education may assist in retraining in healthy eating habits.
Where to go for help
You could visit your:
General practitioner
School or university counsellor
Community Health Centre
Some organisations which can help include:
Eating Disorders Association
1st Floor, Wensum House, 103 Prince of Wales Road, Norwich NR1 1DW
Tel: 01603 619090; Helpline: 01603 621414 Monday to Friday 9.00 am-6.30 pm;
Youth helpline: 01603 765050 (for under 19s) 4.00 pm-6.00 pm weekdays
Overeaters Anonymous (local groups)
Tel: 01454 857158 recorded message
Anorexia Bulimia Careline
84 University Street, Belfast BT7 1HE.
Tel: 02890 614440
Eating Disorders Association Support Group
Eating Disorders Project
Rikenel
Montpellier Gloucester GLI 1LY
Sam Clark-Stone - Clinical Co-ordinator 01452 891142 (Mon-Thur 9.00 am - 12.00 noon)
