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An eating disorder can be a very isolating condition and this is one of the feelings that the individual is likely to face from the outset of the issue. Individuals who have a genuine fear of food will avoid places where food might be present. Since this is in most places, individuals will avoid seeing people so they can stay where they can control their exposure to food.
Isolation is a big risk factor for depression, and statistics indicate that for individuals who have anorexia the risk of suicide is 57 times greater than for those who do not.
Eating disorders can make people feel worthless and this is what may lead them to self-harming behaviours. The feeling of being out of control can have a dramatic impact on their ability to function normally because they can never see an end to their problem and their eating disorder.
Many individuals will report that their condition makes them feel trapped because they have been unable to control their issues around food and those issues now control them. The feeling of being trapped can lead to issues with guilt if the person goes a single calorie over the amount that they have allotted to themselves or if they have not completed the gruelling exercise regime that they have self-administered as well.
Guilt then leads to frustration, which may result in the calorie intake being lowered and the exercise minutes being increased so that the individual can punish themselves for what they see as a failure to stick to the perfect schedule that they have drawn up in order to remain thin.
Those people who have eating disorders may feel as though they are selfish because they know the effect that their condition has on the people around them and yet they cannot change their behaviour and so continue to lose weight or believe that they are fat, despite clear evidence to the contrary.
Like other mental illnesses, the effect on other people can be devastating and this often serves not as a motivation to get better or to change habits but to continue the negative behaviours. This is because they act as a comfort mechanism at a time when they feel most vulnerable.
How do eating disorders affect people?
There are many different ways in which the individual will be affected by their eating disorder and these are unlikely to be experienced in isolation from each other, meaning that the individual is ‘attacked’ by their disorder in many different ways.
Some examples of the effect that the condition has on their life include:
- Physical illness.
- Low confidence and self-esteem.
- Completely skewed body image.
- Having to plan their day around food.
- No interest in socializing.
- No hope for the future.
Arguably, physical illness is the most serious impact that an eating disorder can have on an individual’s life. For those individuals who have anorexia, they are prone to many minor illnesses because their immune system is not fully functioning due to the lack of nutrients that the body is subject to.
Since anorexia can have an impact on all internal organs, the ability to fight off illness is reduced and this can have a very serious effect on overall physical health. For example, someone who gets a minor chest infection can usually fight this off with some antibiotics and their own immune system. For someone who has anorexia, their lung function may be inhibited and so a minor infection may become something much more serious.
Also, anorexia can cause muscle wastage and bones to become brittle and this can lead to an unsteady walk and an inability to perform simple physical tasks, such as walking upstairs or getting up easily from a chair. Poor physical health tends to lead to poor mental health and the two can end up becoming a cycle that is very difficult to break.
Those individuals who have bulimia or binge eating disorder are subject to high cholesterol, high blood pressure and possible Type 2 diabetes, which can all be risk factors in the development of coronary heart disease. These two eating conditions can also cause internal bleeding, and many people are thought to die because of complications, especially of bulimia.
Self-esteem and confidence
When someone has low self-esteem and confidence this can have a knock-on effect to many aspects of their life.
For example, the individual may feel as though they are not important enough to be treated, and because of this they do not seek medical assistance for their condition, even when it is obviously having a detrimental effect on their health.
Low self-esteem can lead to individuals feeling as though no one likes them or likes spending time with them, and because of this they are, once again, subject to isolation. Low self-esteem and confidence can also make problems with stress and anxiety worse, and as these are often a cause of eating disorders, the issues can become a vicious circle.
For example, someone who is feeling anxious and stressed tries to take control by severely restricting what they eat. Because of this, they feel guilty and worthless and this leads to low self-esteem. This then causes them to feel anxious about everything and so the control over what they eat becomes even more fastidious.
A skewed body image means that someone sees their body in a negative way, which does not reflect how it actually is. This is linked to a serious medical condition known as body dysmorphic disorder, which is often experienced alongside an eating disorder.
Someone who has anorexia is especially prone to body dysmorphic disorder because when they look at themselves, no matter how thin or underweight they are, they still believe that they are fat. Since many people with an eating disorder have a phobia of being fat or overweight, this can mean that they restrict their food intake even more and yet the mental image they have of their body does not change.
Taking over a person’s life
Those people with eating disorders often find that their condition has taken over their life to the point where their entire day is planned around food. Sometimes, individuals with anorexia will look at pictures of food and count this the same as though they had actually eaten it. Also, they will take great steps in preparing an elaborate tale that ensures that they avoid eating with other people or make it look as though they have already eaten when it comes to mealtimes.
People with bulimia or binge eating disorder may plan their time around when they are going to eat the food that they may have stashed away for that day as their ‘special treat day’. This might involve waiting until others are out of the house or when they know that they will not be disturbed. Any disruption to this plan may cause frustration, meaning that when the binge eating does take place, it may be even more severe to make up for the ‘delay’ in when it was supposed to happen.
Planning a day around food does not necessarily mean that the individual will prepare when they are going to eat and how much, but how they can avoid food at all costs.
This is especially prevalent for those individuals who may have an actual phobia about being fat or of eating food. This may mean that they avoid any situations where there may be food or even where there may be someone who is overweight.
Considering that there is the possibility that food may be anywhere, such as on advertising boards, being passed by someone walking down the street eating and in abundance in any place where there are a lot of shops, this may mean that the person restricts themselves to going to places where they know that encountering food is less likely. Eventually though, this may mean that the person doesn’t leave their house much, and certainly does not attend social events where the likelihood of food being present is much higher.
Avoiding social events also increases the possibility that someone’s eating disorder may go undetected. When the person is with family and friends who know them well, signs and symptoms may be impossible to hide, so avoiding all of the people who may know that something is wrong is another way of ensuring that their condition is kept secret.
Loss of hope
There may come a point when the individual becomes so obsessed with food and eating that they see no hope for the future and a way of living their life as they did prior to their condition.
Feelings such as this are made worse by social isolation and by the fact that they may also be experiencing physical illnesses which have a negative impact on their overall well-being. When someone has no hope for the future, this becomes a risk factor for self-harm and, sadly in some cases, for someone feeling as though they have no other option but to end their life.
How eating disorders affect others
The parents of a child who has an eating disorder may deny that there is anything wrong with them and this can lead to a delay in getting treatment and support for them. If the eating disorder is acknowledged, this may result in the parents feeling powerless, angry and worried about their child, as well as feeling guilty that they have ‘allowed’ this to happen and have not been able to do anything to stop it.
Family members may find that they are continually arguing about what to do in order to help the person who has the eating disorder. They may be unsure whether to confront them about it so that they can get support or whether this will make the situation worse because the individual will realise that everyone knows about the condition that they have been trying to hide.
The disorder can have an effect on normal family functioning if the individual will not go to any place where they have to encounter food or where they feel that they cannot partake in rituals. This means that days out, holidays and other family activities will be reduced or cancelled whilst the individual is feeling the effects of their condition.
Siblings of the individual who has an eating disorder may feel as though their needs are not being met, because of the attention that is given to the individual. This can lead to resentment within the family, which may be the foundation of further arguments. Friends of the individual may find that they continually have to defend their friend’s behaviour, and when this becomes too much they may reject the friend because they are overwhelmed by the effect that the friend’s condition is having on them.
Parents or other family members may become unofficial carers to the individual who has the eating disorder and this can lead to further resentment, especially if the individual continues to insist that they do not need help, even though it is clear to all that they do. Caring can be an extremely stressful occupation and those who take on the role are subject to a reduction in their own physical and emotional well-being because of the time they invest on caring for someone else.
It is important for carers that they have support for themselves and are encouraged to take care of their own health as well. A support group for carers can provide an excellent place for carers to discuss any of the issues that they are having in their role and it helps them to talk with others who are in the same position that they are as well. Many support groups offer advice and guidance about caring and this can be very comforting to someone who feels as though they are struggling to cope in their caring role.
Signs and symptoms
Sometimes the signs and symptoms of an eating disorder are hard to identify because the individual will go to great lengths to keep their condition secret from other people. However, when they are identified, it is important to encourage the individual to seek help for their condition before it takes over their life – if this hasn’t happened already.
Signs and symptoms that should be monitored can be classified as either:
Physical symptoms of eating disorders are very 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.
Physical symptoms include:
- Sudden weight loss.
- Frequent changes in weight.
- Disturbed sleep patterns.
- Osteoporosis – bones become very brittle.
- Extreme sensitivity to cold (even in warm weather).
- Swollen jawlines and teeth damage caused by frequent vomiting.
- Excess body hair growth.
- Skin problems.
- Frequent minor illnesses.
- Weakened muscles.
- Amenorrhea – periods stopping for women, which can lead to infertility.
- Stomach pains.
- Low blood pressure (anorexia).
- High blood pressure (bulimia and binge eating).
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.
Psychological symptoms include:
- Increased preoccupation in body shape, weight and food calorie values.
- Intense fear of gaining weight.
- Negative body image.
- Anxiety at meal times.
- Sensitivity to comments about appearance.
- Low self-esteem.
- Impaired cognitive functioning.
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.
Behavioural symptoms include:
- Signs of vomiting, using laxatives or binge eating.
- Constantly checking body weight.
- Wearing baggy clothes to hide weight loss or gain.
- Lying about eating habits to cover up behaviour.
- Making constant lists of ‘good’ and ‘bad’ foods.
- Shopping and cooking alone.
- Excessive calories counting for even the smallest food items.
- Avoiding eating with other people.
- Obsessive and ritualistic behaviours, such as cutting food into tiny pieces.
- Eating very slowly to make it appear as though more food has been consumed than it actually has.
- Hiding food or feeding it to a pet.
- Excessive exercising.
- Refusing to admit there is a problem or the seriousness of the problem.
The seriousness of symptoms
Clearly, the extensive list of signs and symptoms indicates how serious the problem of an eating disorder can be.
Like with many mental illnesses, the categories of signs and symptoms are extremely unlikely to be experienced individually and there will almost certainly be a crossover between them. For example, someone who has developed anorexia may suffer from depression due to the fact that they feel they cannot control their life.
Their depression may lead them to believe that they are not a socially desirable person to be with and so they try to lose more weight to counter these feelings. Eating disorders can be very complex and, as such, they are very difficult to treat in many cases.