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An eating disorder is a mental illness, which means that an individual will have a very complex relationship with food that is likely to be out of control. Eating disorders can lead to other mental illnesses such as stress, anxiety, depression and phobias. People will commonly experience at least one of these alongside a diagnosis of an eating disorder.
Unlike some mental illnesses, eating disorders can have a serious effect on an individual’s physical health as well as their mental health, and for this reason early identification of the signs of an eating disorder is beneficial in being able to treat it successfully. It is estimated that in the UK, approximately 1.6 million people live with an eating disorder. Of these, it is estimated that up to 75% are female and 25% are male. However, this figure is likely to be higher because many cases of eating disorders will go undetected and therefore undiagnosed.
The Diagnostic and Statistical Manual for Mental Disorders (DSM) defines each individual type of eating disorder separately and, as such, does not provide a general definition for this type of mental illness.
Types of eating disorder
There are three common types of eating disorder that people often know of. These are:
- Anorexia nervosa.
- Bulimia nervosa.
- Binge eating disorder (BED).
Although these are the most common types of eating disorder, they are not the only ones. Many people are often diagnosed with an ‘Other specified feeding or eating disorder (OSFED)’ which means that their specific eating disorder matches a number of different definitions. This often happens because an individuals eating disorder will be unique to them.
Believed to be the most common of eating disorders, anorexia nervosa (literally meaning ‘loss of appetite through nervous origins’) is characterised by an individual trying to keep their body weight as low as possible by dieting, vomiting, exercising excessively or using laxatives.
How they see their own body is often in contrast to what it actually looks like; people who have anorexia will commonly complain that they are too fat when, in fact, their weight is dangerously low.
Individuals who have been diagnosed with bulimia (literally meaning ‘ox-like hunger through nervous origins’) will experience frequently recurring episodes where they eat very large quantities of food and feel as though they have no control over themselves whilst they are doing this.
Those who have the condition report that they get little pleasure from eating a lot yet cannot stop themselves from doing so. Foods typically eaten during a binge episode will be highly calorific and tend to include:
- Multiple slices of toast with butter.
- Packets of biscuits.
- Tubs of ice cream.
- Bars of chocolate.
- Multiple bowls of cereal.
Binge Eating Disorder (BED)
Binge eating disorder is similar to bulimia nervosa in that there are frequent episodes of binge eating, however, unlike bulimia, there are no episodes of purging, excessive exercising or fasting afterwards. As a result of this, individuals who have this disorder are often overweight or obese (where their BMI is between 25 and 30 and over 30, respectively).
A characteristic of this disorder is that the binges that take place are usually planned and carried out as a form of ritualistic behaviour. The individual may buy specific foods that are ‘special’ for binges and then take them to a place where they will not be disturbed and consume them all in one sitting.
Causes of eating disorders
Like many mental illnesses, the cause of eating disorders is largely unknown but it is thought to be connected to one or more of several potential factors. These factors are a mixture of physical and social and it is unlikely that one single factor would result in an eating disorder that takes over an individual’s ability to lead a normal life.
It is thought that eating disorders may develop because of specific factors that can be categorised as:
- Biological: Hormone dysfunction and genetics.
- Psychological: Poor body image, low self-esteem and confidence, anxiety and stress, striving for perfectionism and a phobia of being overweight.
- Environmental: Trauma, lack of control, problems in development transitions, peer pressure, media pressure, bereavement and abuse.
Physical symptoms of eating disorders are of a primary concern.
Restrictions on eating or overeating will result in major physical effects on a person. These can be a loss or gain in weight which will have an impact on the chances of becoming malnourished or developing illnesses later in life. Other physical issues can occur as well which will have a clear impact on the self-esteem of the person with the eating disorder.
The behaviour of someone with an eating disorder is often ritualistic and can change dramatically when an obsession with food is seen.
Not allowing certain foods to touch each other, faddy diets and extreme concern with body size or shape are all common behavioural symptoms of eating disorders. Seeing flaws in their own body image and a preoccupation with weight, calories and dieting is also often seen.
Psychological symptoms can have a lasting effect on a person who has an eating disorder.
Many eating disorders develop into further psychological issues such as depression. A preoccupation with food can lead to ritualistic behaviour and, when these rituals are changed, irritability and anger can be felt.