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An eating disorder is a problem with food and eating, where a person has an unrealistic and unhealthy perception of their own body and weight. Contrary to what a lot of people think, eating disorders aren’t all about food and just signal low self-esteem and mask deep unhappiness. The two eating disorders I am concentrating on in this page are anorexia nervosa and bulimia nervosa.
Anorexics starve themselves to lose weight and have a preoccupation with body image and dieting. Although there are usually seriously underweight, they are not aware they are thin, or if they do they acknowledge it, they believe that certain parts of their body (usually, bottom, thighs and/or stomach) are still fat. Their self-esteem is totally based on their thinness; they congratulate themselves when they lose weight and feel like a failure if they gain any.
The multi-coloured line in the picture (left) is what the girl really looks like... the blue line is what she sees herself as. - The anorexic reality is not truthful!
Bulimics eat large amounts of (usually sweet and high-calorie/high-fat) food in a short amount of time and then compensate for this binge, by purging (self-induced vomiting and/or using laxatives), fasting and/or exercising excessively. Unlike anorexics, they are usually aware of their behaviour but unable to stop and also are usually within an average body weight range (although sometimes slightly overweight/underweight). Their self-esteem too is based on their body weight and image.
The signs of anorexia nervosa are...
- Physical:
- Emaciation (abnormal thinness - weighing 15% or more, below normal)
- Appearing younger than they are
- In females, atrophied (shrunken) breasts
- Dry skin with a yellow tinge
- Lanugo (the growth of fine, downy body hair)
- In females, amenorrhoea (the absence of 3 or more consecutive periods)
- Cold intolerance
- Constipation
- Abdominal discomfort and bloatedness
- Fatigue and lack of energy
- Dizziness and shortness of breath
- Insomnia
- Other:
- Discomfort eating in public
- Despite malnourishment, they are often hyperactive
- Often wearing multiple layers of bulky, oversized clothing
- Intense fear of gaining weight or becoming fat
- Denial of how underweight they are
- An unrealistic perception of their body weight and shape
- Being overly concerned and dissatisfied with weight and shape
- Perfectionism
- Weighing oneself a lot
- Feeling a loss of control when eating
- Experiencing a mood change after eating or after weighing oneself
- Being uncomfortable receiving comments regarding weight or eating
The signs of bulimia nervosa are...
- Physical:
- Scars, abrasions and/or bruises on the backs of fingers/hands and knuckles from teeth and stomach acids
- Erosion of tooth enamel and extreme tooth sensitivity to hot and cold
- Vomiting after eating and/or using medications, laxatives, or diet pills to control weight
- Repeated episodes of binge eating
- In females, amenorrhoea (the absence of at least 3 consecutive periods)
- Cold intolerance
- Dizziness
- Constipation and/or diarrhoea
- Abdominal discomfort and bloatedness
- Fatigue and lack of energy
- Insomnia
- Chest pains and chronic sore throat
- Hair loss
- Other:
- Eating in secret
- Identity and self-esteem being heavily dependent on body weight and image
- Perfectionism
- Weighing oneself a lot
- Experiencing a mood change after eating or after weighing oneself
- Feeling dissatisfied with body weight or shape
- Feeling a loss of control when eating
- Having a fear of gaining weight uncontrollably
- Discomfort eating in front of other people
- Being uncomfortable receiving comments from other people regarding weight or eating
The social pressures (especially for girls and women) to have a body that is thinner than considered healthy, affect everyone to different levels and extremes, but there is no single cause for people to take it further and develop and eating disorder. Eating disorders usually develop during adolescence, but are not a ‘teenage phase’ and may continue for many years, if not dealt with. It’s more common in girls and women too.
People with a sibling who suffers from an eating disorder or who has parents that are unaffectionate, overprotective, perfectionist or controlling are more likely to have an eating disorder, but there are also other factors.
It is estimated by researchers that about 30% of people who have eating disorders have previously been sexually abused (see sexual abuse section) and it is more common for people who also suffer from mood disorders, especially depression (see depression section). There are also strong links between self-harm (see self-harm section) and drug/alcohol abuse (see alcohol abuse and dependance section). Some people even believe that eating disorders are just another form of self-harm. People who participate in activities that focus on weight or appearance also have an increased risk of developing an eating disorder. These activities include ballet, modelling, gymnastics, circus skills, entertaining (acting, dancing, etc.), skating and swimming/diving.
- Malnutrition
- Dehydration
- Vitamin and mineral deficiencies
- Muscle atrophy (wasting away and decrease of muscle)
- Paralysis
- Tearing of oesophagus
- Mallory-Weiss tear (tearing of the gastroesophageal junction)
- Gastric rupture
- Gastrointestinal bleeding (bleeding into the digestive system)
- Oesophageal reflux (partially digested food in the stomach, mixed with acid and enzymes being regurgitated back into the oesophagus)
- Cancer of the throat and Larynx (throat box)
- Insomnia
- Chronic fatigue syndrome (continuous and chronic fatigue)
- Facial swelling
- Scars, abrasions and/or bruises on the backs of fingers/hands and knuckles
- Dry skin and hair, brittle nails and hair Loss
- Low/high blood pressure
- Orthostatic hypotension (sudden drop in blood pressure when sitting up or standing)
- Low platelet count or thrombocytopenia
- Hypoglycemia (low blood sugar)
- Hyperglycemia (elevated blood sugar)
- Diabetes
- Ketoacidosis (high levels of acids that build up in the blood)
- Anaemia (severe iron deficiency)
- Kidney infection and/or failure
- Osteoporosis/osteopenia (low bone mass)
- Degenerative arthritis
- Easily bruised skin
- Dental problems
- Liver damage or failure
- Bad circulation
- Slowed or irregular heartbeat
- Angina (severe pain accompanying heart disease)
- Infertility (inability to have children)
- Problems during pregnancy - including miscarriage, still born babies and death or chronic illness in children born
- Depression (although it may be the cause of the eating disorder, the eating disorder may also be the cause of depression too)
- Lowered body temperature or temperature sensitivity
- Cramps, bloating, constipation, diarrhoea and/or incontinence
- Peptic Ulcers
- Pancreatitis (where digestive enzymes attack the pancreas)
- Seizures
- Death caused by heart attack or heart failure, lung collapse, internal bleeding, stroke, kidney failure, liver failure, pancreatitis, gastric rupture, perforated ulcer and/or suicide
If you suffer from or think you suffer from an eating disorder, then you need to think about what your eating disorder is saying about your feelings and your life, because there is obviously a problem. Talk to a close friend/relative about what you’re doing and why you’re doing it, then seek specialist help (see Uk Contacts under eating disorders). It takes a lot of self-restraint and determination to overcome your eating disorder, but it is possible and will be worth it.
If you have a friend/relative who you suspect has an eating disorder, then the best thing you can do is talk to them about it. Try not to pressure them into talking, lecture them or be really negatively opinionated because this will just make them withdraw from you and be less likely to seek help; just let yourself be available. Then suggest they seek specialist help. Remember that even when they are receiving help, it will still be a struggle and try to offer as much support as possible. Try to avoid talking about their weight and don’t ever compare theirs to yours because although they have an unrealistic perception of their own weight and body image, they see you normally.
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If you have, or have a friend/relative who has an eating disorder, please feel free to email and share your story and feelings. I may want to use quotes from your email, so please state whether I have permission to use to your name. Thankyou!