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Eating disorders
What are eating disorders and difficulties?
Eating is essential to life. In western societies, most of us have enough to eat and so our relationship with
food is no longer just about survival. Our own relationship with food begins when we are babies and often
family and social interactions occur in the context of eating. Food takes on a wealth of social, familial,
cultural and personal meanings.
Eating, for most people, is enjoyable. However, in today’s society we are faced with constant social media
images of food, eating and ideal body shapes that complicate our relationship with food and with our
bodies. Consequently, it is not surprising that many people, both men and women, and increasingly at an
earlier age, develop issues and problems around food. Eating too little or too much, feeling unhappy about
their bodies, adopting some compensatory behaviours, such as over exercising or purging.
It seems that both women and men in today’s society are rarely satisfied with their body shape or weight
and most people will diet at some time.
Anyone, from all types of background and ethnic groups can suffer from eating disorders. Eating disorders
may be a way of coping with feelings that are making you unhappy or depressed. It may be difficult to face
up to and talk about, feelings like anger, sadness, guilt, loss or fear. An eating disorder is often a sign that
you need help in coping with life, and sorting personal problems.
Conditions as complex as eating disorders mean that there are variations in the typical signs, and not all
symptoms will apply to all people. You may feel that you have a mixture of anorexia and bulimia, or
alternate between them. You may find that you are focused on food and exercise and cannot think of
much else. Some people also find they are affected by an urge to harm themselves or abuse alcohol or
drugs.
Eating Disorders do not include food allergies, selective eating issues or disorders of the digestive system.
However, a G.P should be the first point of call for these issues as well as for eating disorders. Counselling
might be an additional or a first point of contact to talk through these issues further.Grief
Grief may take a long time to work through. It is an inevitable and human response.
Below are some of the feelings and behaviour that are often experienced, sometimes in quick succession:
o Shock and disbelief: you may feel numb and be unable to take in what has happened
o Anxious and panic: sometimes in situations that wouldn’t normally bother you
o Guilt and regret: whether for things you wish you had said and done (or not done) or for just
being alive; these feelings are particularly strong when someone has completed suicide.
o An overwhelming sense of loss and sadness: sometimes we may feel as though a part of
ourselves has been lost.
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o Depressed: feelings of wanting to withdraw from family and friends; at times you may feel
despairing, that there is no point in going on.
o Anger and rage: some of this may relate to feeling out of control, that everything is chaotic.
o A sense of injustice and envy: of those who aren’t suffering in this way.
o Relief: particularly if the person who has died was suffering a great deal.
In addition we may find ourselves affected in some of the following ways: sleep disturbance, loss of appetite,
restless, agitated, preoccupied, unable to concentrate, irritable, tearful and exhausted
Sometimes there seems to be an expectation that a bereaved person should have recovered after a certain
time has elapsed, but everyone has their own recovery time.
Some definitions and distinctions
Eating disorders can be an external expression of internal emotional pain and confusion. Obsessive thoughts
about, and the behaviour associated with food (e.g over exercise, over or under eating, vomiting and
purging, social withdrawal etc) may be ‘maladaptive’ attempts at processing emotional distress that cannot
be otherwise expressed. Often, this emotional distress may be linked to a very negative self-perception, a
feeling of being unable to change ‘bad’ things about one self.
Feelings of being ‘out of control’ may be overwhelming- and food is then often used as a way of taking back
some control, until this too becomes an area of ‘out of control’ ness.
An eating disorder involves a distorted pattern of thinking about food and size and weight, to the extent that
there is a preoccupation and obsessive quality to thinking about food, together with an issue of control or
lack of control around food and its consumption.
There are several recognised eating disorders and areas of disordered eating.
Anorexia
Anorexia is a disorder (or illness) which stems from low self-esteem and an inability to cope safely with
worries and problems. It involves lowering food intake by skipping meals and cutting down the types and
amounts of foods eaten; some people over-exercise as well. Beliefs such as :’losing weight will make life
happier’ may be typical as well as ‘people will like you more’ , ‘you will be more successful’ or even perhaps
that ‘you may be noticed less’.
Individuals may punish themselves if weight loss is not significant enough, or eat something not usually
‘allowed’. Losing weight is not the answer to everything. It is important that one tries to focus on oneself
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Physical symptoms of Anorexia Nervosa
 Severe weight loss
 Difficulty sleeping and tiredness
 Dizziness
 Stomach pains
 Constipation
 Feeling cold
 Growth of downy (soft and fine) hair all over one’s body (called Lanugo)
 (girls) Periods stop or don’t start (amenorrhoea)
 Hair loss
 Feeling fat when underweight
 Getting irritable and moody
 Setting high standards and being a perfectionist
 Social isolation/ withdrawal
 Shutting oneself off from the world
 Thinking things are either right or wrong, there is no in between
 Difficulty concentrating
Behavioural symptoms of Anorexia Nervosa
 Excessive exercising
 Having ritual or obsessive behaviours
 Being secretive
 Lying about eating
 Trying to please everyone
 Cooking or preparing food for everyone else
 Wearing baggy clothes
Bulimia/ Bulimia Nervosa
Bulimia is also a disorder linked with self-esteem, emotional problems and stress. One may constantly think
about calories, dieting and ways of getting rid of the food eaten. Bulimia is actually more common than
anorexia, but is more of a hidden illness, because people with bulimia usually remain an average or just over
average body weight. Bulimia can go unnoticed for a long time, although one may feel ill and very unhappy.
Individuals with bulimia become involved in a cycle of eating a very large amount of food, making oneself
sick (purging) , cutting down or starving for a few days or trying to find other ways to make up for the food
eaten. Starving causes extreme hunger that then leads to excessively large amounts of food being craved
because one’s body is craving nourishment. Some people will not vomit but will take laxatives: both
behaviours may be described as ‘purging’ by medical professionals but taking laxatives is particularly
dangerous.
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Just because bulimia does not cause the extreme weight loss that anorexia does, it does not mean that it is
less serious. Help and support is needed. The side effects and consequences of bulimia can be very serious.
The Body: Physical symptoms of Bulimia Nervosa
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Sore throat
Bad breath and mouth infections
Stomach pains
(girls) Irregular periods
Dry or poor skin
Difficulty sleeping
Constipation
Puffy cheeks
Dehydration
Fainting
Kidney and bowel problems.
Thoughts and feelings: Psychological symptoms of Bulimia Nervosa
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Feeling emotional and depressed
Feeling out of control
Mood swings
Obsessed with dieting
Behaviour
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Eating large quantities of food
Being sick after meals or binges
Taking laxatives or diet pills
Being secretive and lying.
Binge Eating Disorder / Compulsive Overeating
If one binge eats, this usually means that large amounts of food is eaten in a short period of time (perhaps
not at a normal mealtime) and associated feelings of lack of control during these binges, but unlike
someone with bulimia nervosa, one may not try to get rid of the food. An individual may feel out of control
around eating, eat what may be thought of as an unusually large amount of food, eat much more quickly in
these binges, eat until feeling uncomfortably full, eat large amounts of food when not hungry or eat alone.
An individual may well do this for similar reasons to someone with bulimia.
Compulsive overeating involves ‘picking’ at food all day. There may be different reasons why one does this,
but as with eating disorders, food and eating is used as a way of dealing with difficult feelings. If one
compulsively overeats or binge eats, one may feel depressed or inadequate because of a lack of control
around eating, which can lead to further eating and weight gain.
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OFED and UFED (Other and Undiagnosed Feeding and Eating Disorders)
Eating disorders are very complex which means that there can be variations in the typical signs and
symptoms and that not all of the signs and symptoms will apply to all people. There are many people that
may fall into the category of OFED or UFED.
These are disorders where one may have some but not all of the diagnostic signs for anorexia or bulimia.
One may also be diagnosed with a ‘partial syndrome’ eating disorder if for example a woman with
Anorexia has irregular or normal periods, or perhaps bulimic episodes are very infrequent.
How OFED is diagnosed
There are many different behaviours which can help a professional to diagnose OFED. Here are some
examples of what some typical diagnoses might include:
 All the criteria for Anorexia Nervosa are met, except the individual has regular menses or despite
significant weight loss, the individual's current weight is within the normal range.
 All the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a
week or a duration of less than three months.
 An individual of normal body weight who regularly engages in inappropriate compensatory
behaviour after eating small amounts of food (e.g. self-induced vomiting after the consumption of
two biscuits).
 An individual who repeatedly chews and spits out, but does not swallow, large amounts of food
Do men get eating disorders too?
Typically eating disorders are perceived to be conditions that affect only women – this is far from the case.
Between 10 and 25 per cent of those people experiencing eating disorders are male. We know that the
majority of men who have eating disorders struggle to get access to appropriate support and treatment.
Therefore it is difficult to know how many men are actually affected by the conditions.
Do I have an eating disorder?
Conditions as complex as eating disorders mean that there are variations in the typical signs, and not all
symptoms will apply to all people. You may feel that one has a mixture of anorexia and bulimia, or
alternate between them. Some people also find they are affected by an urge to harm themselves or abuse
alcohol or drugs.
Even if one does not have these symptoms if worried and upset by something, anything, it is important to
find appropriate support and someone to talk to. Coming to the counselling service hopefully is an
important and helpful resource.
Sources of support
National sources of help
Beating Eating Disorders
Wensum House
103 Prince of Wales Road
Norwich NR1 1DW
Helpline: 0845 634 1414
Web: www.b-eat.co.uk
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**Men Get Eating Disorders Too
(Raising awareness of eating disorders in men so men can seek support)
www. http://mengetedstoo.co.uk/
Some Useful Books
Understanding Your Eating, Julia Buckroyd (Open University, 2011)
Overcoming Anorexia Nervosoa - a self-help guide using Cognitive Behavioural techniques, Freeman,
(Constable and Robinson, 2002)
On Eating, Susie Orbach (Penguin, 2002)
Getting Better Bit(e) by Bit(e) - a survival kit for sufferers of bulimia nervosa and binge eating disorders,
Schmidt & Treasure (Pscyhology Press, 1993)
Anorexia Nervosa: a survival guide for families, friends & sufferers, Janet Treasure (Psychology Press, 2013)
Also see: http://www.counselling.cam.ac.uk/selfhelp/books/eating