Eating Disorders

What Are Eating Disorders?

There are three main eating disorders:

  • anorexia nervosa
  • bulimia
  • compulsive overeating

All have quite distinct and separate characteristics. However, they all involve problems with food – limiting the types of food eaten, losing control and eating too much or having to get rid of the food soon after eating. Eating disorders are not just about eatingthey are also about being unhappy with body shape size or weight and the impact this has on self esteem, relationships and ability to cope with life in general. It is thought 10% of the population has an eating disorder. Most people with an eating disorder are female; however increasing numbers of males are being diagnosed with eating disorders.

Excessive exercise may also occur in order to lose weight. Males, in particular may work out in order to gain more muscle and no matter how muscular they become, never feel they are big enough. This can lead to abuse of steroids and an obsession with muscle development can become dangerous if it goes unchecked.

Anorexia Nervosa - Anorexia nervosa is a complex psychological eating disorder characterised by severe amounts of weight loss due to self-imposed starvation in an endless pursuit of thinness. To live with an eating disorder like anorexia nervosa, is to live in constant fear of becoming fat. 

Bulimia - Bulimia is a psychological disorder characterised by uncontrollable consumption of large amounts of food. The binge eating is often followed by self-induced vomiting or laxative abuse to counter the excess food ingested.

Compulsive Overeating - Compulsive overeating is marked by impulsive binge eating without purging and results in rapid weight gain.

Eating Disorder Not Otherwise Specified (EDNOS) – This diagnosis may be reached when a person has several symptoms of an eating disorder but these do not fulfil the diagnostic criteria for anorexia, bulimia or compulsive overeating. Many people have disordered eating patterns (for example, very ritualised or limited) that do not amount to a diagnosis, but are still harmful to physical and mental health. It is a myth that a person must look very thin or emaciated before an eating disorder can be considered.

Signs and Symptoms

The various eating disorders have distinct and separate symptoms. When someone is experiencing an eating disorder, the following signs or symptoms may be evident.

Anorexia Nervosa

  • sudden unexplained weight loss, leading to a body weight less than 85% of that expected for the person's age, build and height
  • total preoccupation with body shape and weight
  • hiding of food
  • social withdrawal
  • skipping of meals or eating alone
  • high achievements and expectations of self
  • overactivity and excessive dieting
  • depression

Bulimia Nervosa

  • frequent weight fluctuations
  • depression
  • eating large amounts of food followed by vomiting/laxative abuse
  • social withdrawal

Compulsive Overeating

  • eating large amounts of food without purging
  • repeated attempts to lose weight
  • inability to control food intake
  • lethargy

Causes of Eating Disorders

In spite of research and numerous publications over the past decade, there remains uncertainty about the exact causes of eating disorders. To date, evidence exists in support of a variety of risk factors that may contribute to the development of an eating disorder.

The cause and influence of certain risk factors will differ from one person to another.

Psychological factors

It is possible that feelings of anxiety, low self esteem, self criticism, feelings of inadequacy, perfectionism, the need to achieve highly and to seek other people’s approval can make people vulnerable to developing an eating disorder.

Socio Cultural factors

There is substantial pressure on women within western society to conform to the ideal of the 'waif' look. Thinness is highly valued in our society. The beauty and fashion industries constantly persuade women to think that there is only one acceptable body image, despite the fact that the majority of women are not healthy at this size. The 'muscle man' image from cinema and magazines also influences boys to feel they need to build up their muscles to be attractive to women and to feel better about themselves.

Personal factors

Often changes in life circumstances such as the breakdown of a relationship, changes in adolescence, or having been the victim of child abuse or rape can contribute to the development of an eating disorder. An eating disorder may be the person’s subconscious attempt to exert control over their life, when external things seem uncontrollable. Some people have speculated that anorexia is an attempt to avoid the physical changes associated with adulthood, particularly those related to sexuality. People with eating disorders are individuals and causes may be very specific to each person diagnosed. 

Biological factors

Some research suggests that hormonal or chemical imbalances in the body can play a role in developing an eating disorder. Depression is commonly diagnosed as well as the eating disorder and anti-depressant medication may be useful.

Emotional and Psychological Effects of Eating Disorders

  • depression
  • feeling out of control
  • suspiciousness and resistance to people trying to intervene
  • obsessive thoughts and pre-occupations
  • feelings of alienation and hopelessness
  • compulsive behaviours and rituals around food
  • suicidal feelings
  • secretiveness
  • loss of motivation

Physical Effects

  • Anorexia Nervosa
  • Compulsive Overeating
  • Bulimia Nervosa
  • chronic indigestion high blood pressure chronic sore throat
  • chemical imbalances lethargy burning or rupturing of oesophagus
  • severe sensitivity to the cold
  • heart strain cessation of menstruation
  • loss or thinning of hair rapid weight gain strain on body organs
  • skin and nail problems diseases related to
  • being overweight
  • delay in puberty
  • growth of fine body hair called 'lanugo'
  • decreased bone mineral density
  • severe weight loss
  • swollen salivary glands
  • erasure of tooth enamel due to contact with stomach acid

What Treatment is Available?

Various forms of treatment are available such as psychotherapy, counselling and self help groups. Sometimes hospitalisation and medication are required. The first step is for the person to realise they have a serious problem and they need encouragement to take responsibility for getting help. They need to learn to accept their strengths, weaknesses, successes and failures as part of a balanced existence.

If you think that you, or someone you know, might have an eating disorder, telling someone about it is okay and important. Talking about issues that you perceive to be embarrassing or shameful is hard. Despite how difficult some issues are to talk about, getting treatment for an eating disorder is one of the most important things you can do. You don’t have to do it alone. Various forms of treatment are available, such as psychotherapy, support groups, medical or non-medical practices.

Where to Get Help

  • Your local General Practitioner
  • Community Health Centre (see listing under 'Community Health Centres' in White Pages)
  • The Centre for Eating and Dieting Disorders on info@cedd.org.au, by phoning (02) 9515 5843 or by visiting the website at www.cedd.org.au
  • The Eating Disorders Foundation on (02) 9412 4499 or visit their website at www.edf.org.au
  • Australian Psychological Society (APS) 1800 333 497 for referral to a psychologist in your area
  • Mental Health Information Service (02) 9816 5688 or 1800 674 200 (outside Sydney metro)