Eating disorders only entered psychological studies in the 1980s, making it a fairly recent diagnosis. Because of this, I often feel as though there are either misunderstandings or a lack of awareness as to how broad the spectrum of eating disorders can be.
Here I just want to outline some of the different manifestations of eating disorders in an attempt to alleviate any confusion.
According to the NHS, an eating disorder is specified as having an unhealthy attitude to food which can take over your life and as a consequence make you incredibly unwell. This can be eating too little or too much and often developing an unhealthy obsession with body shape and weight.
I suffer from Anorexia Nervosa in which the sufferer will try to keep their weight as low as possible by eating as little as they can and potentially over exercising to further create a calorie deficit.
At its core it is often connected to very low self-esteem, negative self-image and feelings of intense distress.
For me this manifested in extreme behaviours such as taking laxatives and purging by exercising to such a degree that my fitness instructor eventually banned me from the gym as he was afraid my heart would give out.
As a result, one can feel cold constantly, stop menstruation, hair may thin and fall out and is replaced with fuzzy down hair. Additionally, your sex drive drops, you lose concentration and one can develop osteoporosis (as I unfortunately have).
Another common eating disorder is Bulimia Nervosa, characterised by uncontrollable binging sessions then followed by purging behaviour such as the use of laxatives or making oneself deliberately sick, accompanied by restrictive eating.
Bulimia is a depressing cycle of shame and guilt in which negative thoughts about yourself and your body wreak havoc. Furthermore, bulimia can often go unnoticed because the sufferers BMI might only fluctuate a small amount and therefore they are not seen as being at a risk.
The use of laxatives can be detrimental, with the potential of developing IBS and the acid from one's stomach due to constant purging can damage your oesophagus, stain one's teeth and leave one with a sore throat.
Another eating disorder, which is starting to be taken more seriously is Binge Eating Disorder (BED). This is characterised as regularly losing control of your eating, eating large portions of food all at once until you feel uncomfortably full, followed by feeling upset or guilty. It is also described as compulsive eating and sufferers often say they rely on food to make them feel better or to hide difficult feelings.
Binges are often planned in advance and the person may buy "special" binge foods, eating them alone to hide how much they are eating from others. Warning signs may also include storing up supplies of food and putting on weight (although this isn't the case for all sufferers). As a result one may experience health problems that coincide with being overweight, developing problems such as acid reflux or IBS and feeling sick a lot.
Due to BEDs hidden nature, it is often difficult to diagnose because the sufferer will become incredibly reclusive due to the shame of their uncontrollable eating. Furthermore, because of the stigma surrounding obesity in our society (as I have highlighted in previous posts) BED is often viewed as disgusting and immoral consequently hindering the provision adequate help and support.
Surprisingly, the most common eating disorder is OSFED or other specified feeding or eating disorder. This is when your symptoms do not exactly match those of bulimia, anorexia or BED but this does not mean it is any less serious. You might experience any of the behaviours, feelings and body changes associated with other eating disorders.
The NHS states that OSFED is the most common, then binge eating disorder and bulimia with anorexia being the least common.
Other diagnosis related to eating disorders (and are often left out of public knowledge):
Rumination disorder characterised by regularly regurgitating your food (but you do not have a physical health problem to explain it). You might re-chew, re-swallow or spit out the food you regurgitate. It often occurs effortlessly and painlessly, and is not associated with nausea or disgust.
Pica, whereby you will regularly eat things that are not food and have no nutritional value (for example chalk, metal or paint). This can potentially be very harmful.
Avoidant/restrictive food intake disorder (ARFID) characterised by a very strong need to avoid food in general or certain foods because of their smell, taste or texture. The idea of eating can fill you with anxiety. ARFID does not tend to be connected to issues with body image – it is an anxiety about the process of eating itself. It is very important to recognise that any one person can have one or more of these reasons behind their avoidance or restriction of food and eating at any one time. Therefore, ARFID might look completely in one case to another.
The most well known, recent case of this was 2019 in which a teenager went blind due to a lack of B-12 in his diet as he would only eat chips and crisps because of an aversion to certain textures of food which he could not tolerate.
I have also mentioned Orthorexia in a previous post, which refers to an unhealthy obsession with pure food, but what this consists of can vary from person to person. It can also cause physical problems, because someone’s beliefs about what is healthy may lead to them cutting out essential nutrients or whole food groups.
However, It is not currently recognised in a clinical setting as a separate eating disorder, so someone who visited the doctor with the symptoms would not be officially diagnosed with “orthorexia”, although the term may be brought up when discussing their illness. Orthorexia bears some similarities to anorexia, therefore someone who has symptoms of orthorexia might be diagnosed with anorexia if they fit with those symptoms as well.
From this post, please do not start self diagnosing yourself just because you might recognise one or two symptoms of a disorder. This is what leads to lack of understanding and less support for those who might actually be struggling. If you are concerned, please look at the NHS website, Beat support line and contact your GP. They will be able to provide you with an accurate diagnosis and better support.
I have written this so as to provide better understanding and hopefully show people what the signs are for different disorders so that we can support our friends and loved ones who we may notice is struggling.
Of course manifestations of eating disorders will be different for everyone and the root causes are incredibly complex but hopefully this can function as a starting point for everyone's understanding about the basics of eating disorders.
If you are worried about yourself or a loved one, contact Beat on: 0808 801 0677 or 0808 801 0711
Beat (2019) “Rumination disorder” Beat Eating Disorders https://www.beateatingdisorders.org.uk/types/rumination-disorder
Beat (2017) "Orthorexia" Beat Eating Disorders
Mind (2017) “Eating Problems” Mind https://www.mind.org.uk/information-support/types-of-mental-health-problems/eating-problems/types-of-eating-disorders/
NHS (2018) “Eating disorders” NHS https://www.nhs.uk/conditions/eating-disorders/
Roberts, M (2019) “Teenager 'blind' from living off crisps and chips.” BBC News.
Comments