The Facts

Eating Disorders – The Facts

Eating disorders are complex conditions. Not everyone will experience the same symptoms and you do not need to have all of the symptoms discussed to have an eating disorder. If in doubt, talk to a medical professional.

Anorexia Nervosa (anorexia) is a disorder that sees people lose the ability to allow themselves to satisfy their appetite. Intake of food and drink is restricted, possibly to  dangerous levels, and excessive exercise may also be taken. Food is used as a means to gain control of life and thus the disorder will often stem from low self esteem or the inability to cope with stress or worries. As the illness progresses, the chemical changes in the brain distort thought-patterns, making rational decisions about food almost impossible. Exhaustion and other effects of starvation typically result. Anorexia can be fatal, particularly if not treated.

The effects of anorexia …

On the body: Extreme weight loss; constipation and abdominal pain; dizziness and feeling faint; bloated stomach; puffy face and ankles; growth of downy hair on the body; poor blood circulation and feeling cold; skin becomes dry, rough or discoloured; amenorrhoea (loss of periods); loss of interest in sex; infertility; loss of bone mass.

On the mind: Intense fear of weight gain; distorted perception of body shape and weight; obsessive interest in what others are eating;denying that there is a problem;mood swings; changes in personality;becoming aware of an 'inner voice' which challenges perceptions of eating and exercise.

On behaviour: Excessive exercise; ritual or obsessive behaviours, particularly concerning food; lying about food; secretiveness; mood swings; restlessness and hyperactivity; wearing big baggy clothes; vomiting and taking laxatives; preparing and cooking food for everyone else.

Long term: Women can find it difficult to conceive, although this can be reduced when the body receives proper nourishment. Some women never regain their periods. Male and female sufferers have a high likelihood of developing osteoporosis.

Bulimia Nervosa (bulimia) is thought to be more common than anorexia. While the condition can begin to dominate life, it tends to be hidden from others and weight usually remains at average levels.People with bulimia find themselves caught in a cycle of eating large quantities of food and then seeking to prevent weight gain through purging (by vomiting or taking laxatives), excessive exercise, or fasting. The hunger which causes these binges is not one which is satisfied by food, but is again an emotional need. Food becomes a way to take control, to cope with emotional difficulties. Students are in the age range when people are most likely to develop bulimia.

The effects of bulimia …

On the body: Frequent weight changes; sore throat, mouth infections, tooth decay, and bad breath caused by excess vomiting; rounder face caused by swollen salivary glands; poor and dry skin; lethargy and tiredness; dehydration; fainting; increased risk of problems with heart and other internal organs; women may experience irregular periods.

On the mind: Uncontrollable urges to eat large quantities of food; obsession with food; sense of being out of control around food; depression; isolation; mood swings; low self-esteem; feelings of shame and guilt.

On behaviour: Bingeing and vomiting; disappearing to the toilet after meals; excessive use of laxatives, diuretics, or enemas; fasting; excessive exercising; secrecy and reluctance to socialise; spending abnormal amounts on food or shoplifting; disappearance or secret hoarding of food.

Long-term: Heart failure (in extreme cases); low levels of essential minerals can have a significant (even fatal) affect on vital organs; rupture of the stomach; choking; erosion of tooth enamel; painful swallowing; salivary glands drying up; laxative abuse can cause serious bowel problems.

Binge Eating Disorder (BED) shares some of the characteristics of bulimia with the essential difference that binge eating is not followed by attempts to purge. Large amounts of food will be eaten in short periods of time, during which the person binging may feel out of control. It is believed that far more people suffer from BED than anorexia or bulimia. Compulsive overeating is a variation on binge eating in which people eat when they are not hungry, picking on food all day. As with other eating disorders, food is being used as a means to deal with difficult feelings. Compulsive overeating and binge eating can lead to depression or feelings of inadequacy because eating cannot be controlled.

The effects of binge eating …

On the body: Weight gain; stomach pain; poor or spotty skin; difficulty sleeping; women may experience irregular periods.

On the mind: Depression; feeling out of control; mood swings; obsession with weight; feeling of shame and guilt after binging; feeling very self-conscious.

On behaviour: Bingeing; secrecy and reluctance to socialise; spending abnormal amounts on food or shoplifting; disappearance or secret hoarding of food; eating until feeling uncomfortably full; eating when not  physically hungry; eating more rapidly than usual; eating alone due to embarrassment.

Long term: Many people with BED will become obese; problems with blood pressure; heart disease; general lack of fitness.

Atypical eating disorders (disordered eating) resemble anorexia or bulimia but do not meet their diagnostic criteria. Many people find they are diagnosed with an atypical eating disorder or Eating Disorder Not Otherwise Specified (EDNOS). These are disorders which share some but not all of the diagnostic signs for anorexia or bulimia, or it may be that symptoms fall somewhere between anorexia and bulimia. About 50% of people with disordered eating do not fit the diagnositic criteria for anorexia or bulimia, but they still have a serious problem which requires professional help. More information can be found on the b-eat (formerly the Eating Disorder Association) website: www.b-eat.co.uk.

Diagnostic criteria for anorexia and bulimia

Anorexia nervosa

1. Extreme preoccupation with shape and weight (intense fear of weight gain and fatness, accompanied by pursuit of weight loss and thinness)

2. Maintenance of an unduly low weight (Body Mass Index less than 17.5), achieved mainly by strict dieting and excessive exercising 

3. No periods for at least 3 months

Bulimia nervosa

1. Extreme preoccupation with shape and weight (as in anorexia)

2. Frequent binges (bulimic episodes)

3. Extreme behaviour to prevent weight gain, such as self-induced vomiting, misuse of diuretics and laxatives, and strict dieting