Eating Disorders

An eating disorder is a serious and potentially life-threatening mental illness characterised by irregular eating habits, and severe distress or concern about body weight and shape, becoming an unhealthy preoccupation in someone's life. This distress can often then lead to the addition of compensatory behaviours including driven exercise, vomiting, laxatives, diuretics and diet pills. The most common eating disorders include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Other Specified Feeding and Eating Disorders (see pages below for more information).

Eating disorders are associated with major wide-ranging and serious medical complications which can affect every major organ in the body, with the mortality rate for people with eating disorders being the highest of all psychiatric illnesses, and over 12 times higher than that for people without eating disorders.

Eating disorders occur in approximately 9% of the Australian population, occurring across all cultural and socio-economic backgrounds, amongst people of all ages, in both men and women. The factors that contribute to the development of an eating disorder are complex, with no single cause identified, however known contributing risk factors include:

• Disordered eating or dieting is the single most important indicator of onset of an eating disorder. Young people who diet moderately are 6 times more likely to develop an eating disorder; those who are severe dieters have an 18-fold risk.
• Genetic Vulnerability: People who have family members with an eating disorder may be at higher risk of developing an eating disorder.
• Psychological Factors: including perfectionism, obsessive-compulsiveness, core low self-esteem and harm avoidance.
• Internalisation of the thin socio-cultural ideal: People who internalise and adopt the Western beauty ideal of thinness as a personal standard have a higher risk of developing an eating disorder, as it can lead to strong body dissatisfaction. Body Dissatisfaction, or feelings of shame, sadness or anger associated with the body, can lead to extreme weight control behaviours and is a leading risk factor for the development of eating disorders.

• Adolescents: Teenagers are at higher risk due not only because of the significant biological, psychological and physical changes that occur during puberty; but also as they are often vulnerable to societal pressures, which can lead to feelings of insecurity and self conscious-ness which can increase the risk of engaging in extreme dieting behaviours.
• People who engage in particular sports e.g. gymnastics, athletics, rowing, dancers and models.
• People who have previously or are currently experiencing high levels of stress.
• People who have other mental illnesses such as anxiety and depression.
• People who have other physical illnesses, such as diabetes and polycystic ovary syndrome.

Eating disorders are, by their very nature, secretive and shame inducing, making acknowledging that you or someone you love might have one, incredibly difficult.
Some of the signs of an eating may include:

• Dieting behaviour (restricting food groups, skipping meals)
• Eating alone or avoiding sharing meals with others
• Binge eating behaviours, such as hoarding food, or food disappearing from the cupboard or fridge
• Visiting the bathroom during or shortly after meals
• Exercising excessively, even when sick or injured, or becomes very distressed if prevented from exercising

The short answer to this question is YES, even if you have been living with an eating disorder for many years! Seeking help as early as possible is strongly recommended, as it greatly reduces the severity, duration and impact of an eating disorder. 

If you suspect that you or someone you know might have an eating disorder, talking with your GP about it is a great first step. They will be able to provide you with a referral to specialised health professionals who are specifically trained in the management of eating disorders. Your GP will also be a vital member of your treatment team monitoring your medical stability.

The process of recovery can be long and challenging as treatment will need to address the underlying psychological issues as well as the eating disorder's impact on physical health. Despite the seriousness of an eating disorder, with the right treatment and support, there is hope for recovery and improved quality of life at all stages of illness.

Anorexia Nervosa (AN) is characterised by persistent energy intake restriction, intense fear of gaining weight, and disturbance in self perceived weight or shape.

• Restricted energy intake: a person with AN is unable to maintain a healthy body weight, and have lost a considerable amount of weight in a very short period of time.
• A fear of gaining weight: even when someone with AN is underweight they still possess an intense fear of gaining weight / becoming overweight.
• Disturbed body image: seeing your body as overweight when in reality it is dangerously underweight. Someone with AN will place an enormous amount of attention and importance on their body image.

There are two sub-types of AN and both are very serious mental illnesses that require treatment:

1. Restricting Subtype: Severe restriction of the amount and type of food consumed by cutting out food groups, counting calories, skipping meals.
2. Binge Eating / Purging Subtype: Severe restriction as above, but also presents with binge eating and / or purging. Binge eating involves eating a large amount of food and feeling a 'loss of control'. Purging involves self-induced vomiting, misusing laxatives, diuretics or enemas to compensate for eating.

Although Anorexia Nervosa is a mental illness, due to it's nature it also has very serious medical consequences compromising brain function, bone growth and all major organs. If you or anyone you know is engaging in the behaviours above, it is strongly recommended that their medical stability is assessed by their GP as soon as possible.

For a list of physical, psychological and behavioural warning signs, please click on the link below to the National Eating Disorders Collaboration Factsheet.

Bulimia Nervosa (BN) is characterised by repeated episodes of binge eating followed by compensatory behaviours, and an excessive emphasis on body shape or weight in their self evaluation. 

Binge eating is defined as eating a very large amount of food within a relatively short period of time, whilst feeling a sense of loss of control while eating.

Compensatory behaviours are any behaviours used as a way of trying to control weight after binge episodes. 

These may include vomiting, misusing laxatives or diuretics, fasting, excessive exercise or either illicit or legal drugs used for weight control.

There are often strong feelings of shame, guilt and disgust associated with binge eating which is what drives the attempts to compensate, eventually leading to an obsession with food, thoughts about eating, weight loss, dieting and body image. Because of the shame experienced, those with Bulimia go to great lengths to keep their behaviours a secret and can therefore go undetected for a long period of time.

Although Bulimia Nervosa is a mental illness, due to it's nature it can also have very serious medical consequences including increased risk of heart failure, gastrointestinal complications, weakened bones and infertility issues. If you or anyone you know is engaging in the behaviours above, it is strongly recommended that their medical stability is assessed by their GP as soon as possible.

For a list of physical, psychological and behavioural warning signs, please click on the link below to the National Eating Disorders Collaboration Factsheet.

Binge Eating Disorder (BED) is characterised by regular episodes of binge eating. Binge eating is defined as eating a very large amount of food within a relatively short period of time, whilst feeling a sense of loss of control while eating.

People with Binge Eating Disorder may eat very quickly, eat when they are not physically hungry and continue eating  even when they are full to the point that they feel uncomfortable. This often results in shame and guilt, often resulting in secrecy around the behaviour, but it will not result in the use of compensatory behaviours.

Binge eating often occurs at times of stress, anger boredom or distress, numbing those emotions temporarily.

For a list of physical, psychological and behavioural warning signs, please click on the link below to the National Eating Disorders Collaboration Factsheet.

People with Other Specified Feeding and Eating Disorders commonly present with disturbed eating habits, and/or a distorted body image, and/or overvaluation of weight and shape, and/or an intense fear of gaining weight. In fact they present with many of the symptoms of the other eating disorders but will not meet the full criteria for diagnosis of these other disorders. It is the most commonly diagnosed eating disorder.

This doesn't mean it is a less serious eating disorder. It is also a serious mental illness with medical complications including increased risk of heart failure, loss or disturbance of menstrual periods, osteoporosis and kidney failure. 

For a list of physical, psychological and behavioural warning signs, please click on the link below to the National Eating Disorders Collaboration Factsheet.