What are eating disorders?

The term ‘eating disorders’ is used to describe a range of problems to do with eating and body image. Anyone can develop an eating disorder, although they most often develop when you are a teenager or young adult. If left untreated, serious medical problems can develop, so it’s very important to get help if you think you might have an eating disorder. With treatment, most people can get better, although recovery can take a while.

Types of eating disorders

The three most common types of eating disorders are:

  • anorexia nervosa
  • bulimia nervosa
  • binge eating disorder.

Although each of these illnesses has its own distinctive features, they also share some similar features. These include abnormal patterns of eating, and a tendency to be worried or preoccupied with food and body weight.

Anorexia nervosa

Anorexia nervosa (often called anorexia for short) most often starts in the teenage years, although it can happen earlier. While it is a much more common problem in females, it can also happen in males.

In general, if you have anorexia, you:

  • have an extreme fear about gaining weight or becoming fat
  • believe that being thin is critical to your self-worth or your value as a person
  • have a false impression of your body’s appearance, believing yourself to be fat when you are not
  • try to control your weight using strategies such as severely restricting food intake, making yourself vomit after eating, using laxatives or diuretics, and exercising excessively
  • become very underweight, or fail to put on weight at a time when you should be growing.

Bulimia nervosa

Bulimia nervosa (bulimia) is more common than anorexia nervosa, and usually develops in teenagers and young adults. Many people with bulimia will have had previous episodes of anorexia.

People with bulimia tend to:

  • be preoccupied with body shape and weight
  • go on regular eating ‘binges’, during which they feel out of control and lose self-respect
  • try to compensate for binge eating by fasting, purging, using laxatives, or exercising excessively.

Unlike people with anorexia, those with bulimia are not underweight and their problem may therefore not appear as obvious.

Binge eating disorder

Binge eating disorder is the most common of the eating disorders. While it usually starts in the late teenage or young adult years, it can also affect people in mid-life.

Like bulimia, binge eating disorder involves regular binge eating, and feeling preoccupied about body shape and weight. However, people with binge eating disorder do not try to compensate in extreme ways such as fasting or vomiting. As a result, they tend to be either a normal weight, overweight or obese.

Symptoms of eating disorders

There are many different signs of an eating disorder, and symptoms can vary depending on the type of disorder. Some of common symptoms include:

  • feeling anxious at meal times
  • feeling self-conscious about eating with others
  • thinking about food a lot
  • feeling out of control around food
  • saving food to eat later
  • taking extreme measures to try to lose weight
  • being fearful about putting on weight
  • checking yourself in the mirror or weighing yourself a lot.

You may also feel bad about yourself or depressed.

What causes eating disorders?

Eating disorders have a range of different causes, and there may be a combination of reasons why you develop an eating disorder.

Some of the factors thought to influence your risk of developing an eating disorder include:

  • having a history of dieting
  • having other people in your family with eating disorders
  • being involved in certain activities, such as gymnastics, dancing, or modelling
  • having mental health issues such as low self-esteem, perfectionism or impulsiveness
  • having difficult relationships with friends or family
  • having been physically, emotionally, or sexually abused
  • experiencing stressful life changes
  • feeling depressed or lonely.

Cultural influences are also thought to be important. In Australia and other Western cultures, being thin is seen as the ideal body shape, and some people – especially adolescents – can feel under pressure to achieve this ideal.

What are the effects or complications of eating disorders?

Eating disorders can have serious, and even fatal, consequences.

Physical – if your body is not getting enough nutrition, this can cause problems with normal growth and development. It can also lead to a whole range of medical problems such as kidney failure, heart failure, liver disease, bone loss, infertility and bowel problems. In the case of bulimia, recurrent vomiting can damage your mouth, throat and stomach. Many girls with anorexia find that their periods stop, and fine, downy hair (called lanugo) may grow on all parts of their body.

Mental and emotional – eating disorders can lead to marked personality changes, including depression, anxiety and mood swings. Chemical imbalances in your body may make clear thinking difficult. In severe cases, you may start to have suicidal thoughts.

Social – you may develop relationship problems, withdraw from friendships, and struggle at work or school. You may also develop a problem with drugs or alcohol.

Diagnosing eating disorders

If you think you may have an eating disorder, see your doctor. It’s important to do this as early on as possible, not only because eating disorders can cause serious medical problems, but also because it’s been shown that the earlier treatment starts, the better the outcome is likely to be.

Your doctor may examine you and do some physical and psychological tests. If he or she believes you could have an eating disorder, you may then be referred to a professional who specialises in eating disorders, or a specialist eating disorders service if there is one near where you live.

How are eating disorders treated?

Once an eating disorder is diagnosed, a variety of treatments is available to help recovery. Treatment often involves a whole team of health professionals (including medical doctors and nurses, mental health professionals and dietitians) and may include a ‘treatment plan’ – a written document that outlines your goals and what can be done to reach them.

Depending on your individual situation, which eating disorder you have, and how severe it is, treatment can vary. However, there are usually three basic components.

  • Good nutrition – one of the main goals of treatment is to restore normal body weight for your height and age. You will also be helped to learn new, healthier eating habits and given an eating plan to follow.
  • Medical care – if you have, or are at risk of, serious health problems, you may need to be admitted to hospital; otherwise, treatment can be given in an outpatient setting.
  • Psychological treatment – psychotherapy is an important part of improving how you feel, and learning healthier attitudes and behaviours. Cognitive behavioural therapy (CBT) has been shown to be particularly useful for the treatment of bulimia and binge eating disorder.

Sometimes, medications may be prescribed. Family therapy is often also part of a treatment plan, especially if the person being treated is a child or adolescent.

Self-help for eating disorders

Eating disorders are illnesses that need to be taken seriously, and treated by trained health professionals.

Once you have started getting treatment, there are some things you can do to help yourself stay on the road to recovery.

  • Make sure you stick your treatment plan.
  • Talk to your loved ones about how you are feeling and coping.
  • Ask your doctor if there are any nutritional supplements or types of exercises that may help you.
  • Join a local eating disorder support group, or go online and get information from the Australian eating disorder foundation in your State or territory (see www.nedc.com.au/support-organisations).
  • If there are certain things that trigger your symptoms, make a plan for dealing with them, such as getting extra help at these times.
  • Reduce your stress levels if you can – for example, try yoga, meditation, or massage.

Last Reviewed: 15/07/2016

myDr



References

1. Eating disorders. In: eTG complete. Melbourne: Therapeutic Guidelines Limited, March 2016 edition. http://online.tg.org.au/complete/ (accessed June 2016).
2. Royal Australian and New Zealand College of Psychiatrists. Eating Disorders: Your guide to what they are and how they are treated (published Jan 2016). https://www.ranzcp.org/Files/Publications/Guides/RANZCPEatingDisordersGuide.aspx (accessed June 2016).
3. Australian Psychological Society. Understanding and managing eating disorders. https://www.psychology.org.au/publications/tip_sheets/eating/ (accessed June 2016).
4. Mayo Clinic. Eating Disorders. http://www.mayoclinic.org/diseases-conditions/eating-disorders/home/ovc-20182765 (accessed June 2016).