Eating Disorders
What Is An Eating Disorder?
Dieting is not an unusual practice in the western world, particularly amongst women and teenagers. Occasional over-eating or calorie-restriction doesn’t necessarily indicate an eating disorder. However, many people have problematic and complex relationships with food and weight. Eating disorders are fundamentally psychological in origin, and often have serious physical consequences which can continue for many years if untreated. An eating disorder disrupts every aspects of the person’s life, including relationships with close friends and family and can be fatal.
The most commonly referred to eating disorders are anorexia nervosa and bulimia nervosa, but there are a number of variations within these categories including EDNOS (Eating disorder not otherwise specified) and BED (Binge Eating Disorder).
Anorexia is defined by weight loss of 15% of normal bodyweight combined with an extreme fear of weight gain, distorted body image and the cessation of 3 consecutive menstrual cycles.
Bulimia is defined by compulsive eating of large amounts of food (when not necessarily feeling hungry), within short periods of time. Bulimics tend to have a sense of their eating being out of control and compensate for weight loss through purging behaviours such as vomiting, laxative abuse and excessive exercise. Many bulimics are at normal body weight, although some may be either under or overweight. Concerns over body image are common.
EDNOS is another category which covers eating problems which do not fully meet the criteria for either anorexia or bulimia. BED falls under this category. See DSM IV full diagnostic criteria for more information.
Why Do People Develop Eating Disorders?
An eating disorder is likely to occur when a person uses eating, or not eating, to block out painful or uncomfortable thoughts or feelings and when food and eating take on an abnormal significance. Some people who struggle with eating problems may have experienced traumatic events in the past, some may have been abused or neglected, and some may not be able to link eating difficulties to anything in particular. In addition adolescence, even under the best of circumstances, is a time of transition and turbulence. It requires young people to negotiate issues around separation and identity whilst also having to cope with many physical and emotional changes. As a result some young people respond to this emotional turmoil through attempts to control their bodies.
Who Develops Eating Disorders?
Anyone can be affected by an eating disorder, regardless of age, race, gender or background, however for many, body image issues and eating problems begin in adolescence. Eating disorders are complex with no single cause and it is important to consider psychological, interpersonal, socio-cultural and biological factors in order to understand them. Often people who are already suffering with anxiety, depression and low self-esteem are particularly vulnerable.
Anorexia receives more media attention, although bulimia is more common. Anorexia is estimated to affect between 1 and 5 women in every 100,000. Anorexia has the highest mortality rate of any psychiatric illness. Bulimia is easier to disguise as many people suffering from the disorder will be of normal weight. On average there are 10 women with bulimia to one with Anorexia. Eating disorders can also affect boys and young men. Unfortunately far less is known about how it affects this population, due to preconceptions about it being a “female” illness.
Consultation and Training for Professionals
Because eating disorders often start in early adolescence, teachers and other educational professionals may be the first people to notice when there is a problem. Knowing how best to respond to these complex issues can be stressful and anxiety provoking.
At Evolution we work directly with groups, organisations and institutions who look after young people in some capacity, to develop individual training packages to address their specific needs.
Psychotherapy For Individuals
Evolution offers an individual psychotherapy service to people from 16 years upwards who are seeking to change and understand their eating disordered behaviour. Taking the first step towards finding the most appropriate type of therapeutic support can feel daunting. We offer a confidential, non-judgemental assessment and referral service for anyone seeking psychotherapy. Because we use an integrative approach, we address the difficult behaviours themselves as well as the underlying psychological causes, which is crucial to ensure long-term recovery and well-being. For more information see our Individual Consultation page.
