What is an eating disorder?

Our relationship with food is important, and the way we feel about ourselves can have an impact on what we eat and how much we eat. Eating disorders are mental health conditions that drastically change your relationship with food and eating, and your sense of self. They also have significant effects on your physical, psychological, social and emotional health and functioning. 

Eating disorders are complex mental health conditions, so It can be scary to think that you or someone you care about might have an eating disorder, but they are also treatable conditions where full recovery is always possible. With the right help and support, people can and do recover from eating disorders. 

What are eating disorders?

Eating disorders are complex mental health conditions that have a widespread impact on thoughts, feelings and behaviours, and cause serious and potentially life-threatening changes to eating habits. 

Eating disorders often result in physical changes in the body that can put your life and health at risk. If you are living with an eating disorder, the people around you might struggle to understand what you’re going through because they are only thinking about what they can see; the ways your eating behaviours have changed and how your physical health is being impacted. In reality, eating disorders start in the mind and there are complex emotional and psychological symptoms that influence eating behaviours. This is also why it can be very difficult to explain your eating disorder to others.     

The difference between disordered eating and an eating disorder

Many people engage in disordered eating to a certain extent. Eating habits can change from day to day and thoughts and feelings influence how people feed themselves. A person moves towards eating disorder territory when their thoughts and behaviours around food become compulsive and they find them more difficult to control.

When a person feels like they have to engage in disordered eating behaviours like restricting food intake, bingeing on food, or compensating for their eating by purging or over-exercising, this is a sign that they may be developing an eating disorder. When food and eating causes a person to feel anxious and afraid, or they spend a large portion of their day planning or worrying about eating or gaining weight, this is also a sign that they may need support for an eating disorder. Disordered eating can become more problematic gradually over time, and getting support earlier can make recovery easier, so if your eating habits are beginning to worry you, talking to your GP or calling the bodywhys helpline can help.

Common eating disorders

• ​Anorexia Nervosa
• Bulimia
• Binge Eating Disorder
• Other specified feeding or eating disorder (OSFED)

Why do people develop eating disorders?

No one knows for sure what causes eating disorders. The exact causes of any eating disorder can vary from one person to the next. This means that two people can be diagnosed with the same condition but have different experiences and factors which led to their development of that condition. Eating disorders can seem like they’re all about food and body size on the surface, but the root causes are usually linked to how the person feels about themselves and what they’re going through in their lives. To better understand how an eating disorder affects a person, it can be helpful to think of it as a coping mechanism. An eating disorder causes a person to control food and their body to manage distress and feel in control when something else in their life is making them feel out of control or unsafe. Understanding this makes it easier to understand how scary it can be to stop engaging in eating disorder behaviours.  

Researchers who study eating disorders have identified a range of risk factors that increase your chances of developing an eating disorder. Some of these risk factors are psychological, some are environmental, and others are biological. Eating disorders are not caused by one thing, it is often a coming together of a number of factors in a perfect storm that might set the scene for an eating disorder to develop. Keep in mind that even if you do experience some of these factors, it doesn’t mean that you will definitely go on to develop an eating disorder. People can also develop eating disorders without experiencing any of these risk factors. 

Psychological risk factors for eating disorders

• Negative body image 
• Mental health issues like anxiety and depression
• Trauma
• Low self-esteem
• Perfectionist tendencies 
• Stress

Social risk factors for eating disorders

• Social fat shaming and fatphobia
• Diet culture and pressure to conform to ‘ideal’ body types
• Bullying
• Sexual abuse
• History of dieting
• Gendered expectations
• Comparison with peers
• Periods of transitions
• Feeling like you don’t belong

Biological risk factors for eating disorders

• Having a close relative with an eating disorder 
• Having a close relative with a mental health condition

Who can develop an eating disorder?

Anyone can develop an eating disorder. Eating disorders affect people of any gender, age, sexual orientation, ethnicity, body shape and size. It is a common misconception that eating disorders only affect young white women. These misconceptions about who eating disorders affect have real consequences, leading to fewer diagnoses, treatment options, and pathways to help for those who don’t fit the stereotype. Understanding that eating disorders don’t discriminate helps to make sure everyone has access to the support they need. Men and non-binary people with eating disorders have been under-diagnosed and under-treated in the past. It can take men longer to realise that what they are experiencing is an eating disorder and to reach out for help. People with larger bodies and people from minority ethnic groups who have concerns about their eating behaviours, can also find it difficult to reach out for help. Many people believe that people who have eating disorders are all underweight, but this is often not the case.

Signs and symptoms of eating disorders

Eating disorders cause symptoms that affect how people think, feel and behave. Different eating disorders come with their own list of potential signs and symptoms and while there are some common symptoms that feature across multiple disorders, the different types of eating disorder affect people in very different ways. On top of this, the way that an eating disorder manifests can vary a lot from person to person. This means that two people with the same eating disorder can have different experiences of their condition. People can also experience a combination of disordered eating symptoms that don’t align to any one eating disorder diagnosis. Below is a list of signs and symptoms of eating disorders. This list doesn’t capture all experiences associated with eating disorders and each individual’s experience with an eating disorder is unique. 

Behavioural symptoms of eating disorders

• Missing meals and limiting what you eat and how often you eat
• Weighing yourself all the time
• Not being truthful about when you’ve eaten and your weight
• Exercising too much
• Engaging in eating binges where you eat large amounts of food in a short period of time and feel like you can’t control what you’re eating
• Purging food by vomiting or using medications such as laxatives or diuretics to make you need to go to the toilet
• Obsessively thinking about food and how much you’ve eaten 
• Avoiding meals with other people or gatherings where food is the focus
• Secretly getting rid of food or eating food in secret
• Having strict routines and habits around food
• Withdrawing from friends and family and from normal activities (especially ones that revolve around food), in an effort to hide your eating habits
• Compulsively checking your body in the mirror or your reflection in a window etc.

Psychological symptoms of eating disorders

• Low self-esteem
• Feeling irritable and having mood swings
• Struggling with your body image and believing your body looks different to how others might see it
• Depression may set in and you might develop 
• Having obsessive and/or compulsive thoughts around food
• Feeling like you can’t control what you eat, how much you eat, or when you stop eating
• Experiencing mood swings
• Having a fear of gaining weight
• Seeing weight loss as a good thing
• Not recognising the seriousness of weight loss

Physical impact of eating disorders

Eating disorders begin in the mind, but as they progress, they can often begin to have an impact on your physical health and how your body is functioning. Experiencing physical complications can be frightening, but many of these issues can be reversed and improved with appropriate treatment. Some of the complications that can arise with eating disorders include:

• Feeling tired
• Feeling cold
• Feeling dizzy
• Changes in body weight
• Poor sleep
• If you get periods, they might change, become irregular or stop entirely.
• Stomach pain and digestive issues

How do I know if I have an eating disorder?

If you are worried that you may have an eating disorder, it’s important to make an appointment to speak with your GP or mental health professional. 

Here are some questions to ask yourself about some of your habits. If you find yourself demonstrating one or more of these signs, it doesn’t necessarily mean you have an eating disorder, but if your eating habits are beginning to worry you or are making life more difficult, talking to your GP or calling the Bodywhys helpline can help.

• Do you feel guilty or ashamed about eating? 
• Are you frightened of putting on weight or do you check your weight all the time?
• Do you worry or think about your weight or body shape or about what you’re eating all the time?
• Do you exercise all the time to work off what you eat?
• Do you think about food all the time?
• Are you very critical of yourself? Do you think that you could do things better such as losing more weight or exercising more?
• Do you overeat when you feel depressed or down about yourself?

Getting help for an eating disorder

Thinking that you might be experiencing an eating disorder can be a scary thought. If you have recognised that you’re experiencing some of the symptoms listed above you might be tempted to ignore them or try to avoid the subject, but you deserve to reach out for help and support. No matter how hard it may seem, it is possible to make a recovery. Recovery is not always linear. It can be one step forward and one step back sometimes, and what recovery means to you might be different to what it means for someone else. Everyone’s recovery journey is different and it may take time, but you can recover from an eating disorder. 

Speaking to your GP

If you have an eating disorder or think you may be developing a problem, you can speak to your GP about getting help. This can be a good place to start- your GP may ask you some questions about your eating habits and attitude towards food, and they can refer you to a service that can help. Sometimes the idea of speaking to your GP about concerns around eating habits can be daunting. If you feel like you’re not ready to take that step just yet, you could call the Bodywhys helpline. Their helpline is open to anyone, and is delivered by a team of trained volunteers. It offers non-judgemental and confidential support and information about eating disorders.

Treatment options for eating disorders

The type of treatment you receive for an eating disorder can depend on the type of eating disorder you have or the type of symptoms you are experiencing. Often, treatment will involve a combination of talking therapy to address the underlying causes of the eating disorder and nutritional therapy to promote physical health recovery. Getting treatment that is evidence-based and specialised for eating disorders makes a substantial difference to a person’s recovery and quality of life. Trying to recover from an eating disorder by yourself can be really isolating and hard. Reaching out for support from professionals, family, and friends can make all the difference and help to get you through. 

Talking therapy and family therapy

Talking therapy is usually a part of treatment for eating disorders. Some people will take part in individual talking therapy or group therapy, while others (especially young people) might do family-based treatment with members of their family.

The aim of talking therapy is to help you understand the root causes of your eating disorder, to address eating disorder behaviours, and to work towards feeling more comfortable with food. 

A form of Cognitive Behavioural Therapy (CBT) called CBT-E is often used to support recovery from eating disorders. CBT-E has been enhanced in certain areas, and particular strategies have been added to specifically address eating disorders and their core symptoms. CBT-E looks at the ways that our thoughts affect our behaviours and feelings. Through CBT-E, you can develop strategies to help you build self-awareness and identify triggers, create helpful routines, and manage compulsive thoughts and unhelpful behaviours.  All of these are important steps towards a future free from your eating disorder. 

If you’re younger, you take part in family-based treatment (FBT), involving you and your family talking with a therapist. FBT will look at how you have been affected by your eating disorder, and what your family can do to support you in getting better. 

The aim of talking therapy is to help you understand the root causes of your eating disorder so that you can improve your relationship with food and with yourself. 

In-patient treatment

It is often possible to stay at home during treatment. However, in some cases when someone with an eating disorder has serious physical symptoms associated with low weight and malnutrition, they may need in-patient treatment in a hospital where specially trained health professionals give them the care and support they need at the beginning of their recovery journey. At extremes of low weight, restoring weight should be monitored by doctors and dietitians to make sure it’s managed safely.

In some cases, a period of inpatient psychiatric treatment may also be recommended to support weight restoration and to make sure that all relevant professionals are part of a person’s recovery process.

Other sources of support for eating disorders

People have different support needs at different points during their recovery from an eating disorder. This may be from a medical team, outpatient appointments, community services and informally from family and friends.

You can reach out to Bodywhys for advice or information on eating disorders. Bodywhys is the Eating Disorders Association of Ireland and provides confidential support, information, understanding and a listening ear to those affected by eating disorders. You do not need a diagnosis to talk to Bodywhys.

How friends and family can help

Setting out on a recovery journey can be daunting, but you don’t have to do it alone. Recovering from an eating disorder can be made easier if the people around you take the time to learn about the condition, how it impacts you, and how they can show understanding and support you. 

Friends and family can help by not commenting on a person’s appearance and details of specific food behaviours because this can feel confusing and unhelpful. Even when a person’s physical health improves, there still may be a lot going on for them emotionally. If you found the information in this article helpful, it could be a good idea to share it with some of the people in your life. 

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