What is an Eating Disorder?
An eating disorder is characterised by unhelpful beliefs and over concern about shape and weight, which in turn leads to weight-control behaviours that are detrimental to the person. Eating disorders are complex and can significantly impact all areas of a person’s life, such as physical health, emotional wellbeing, and social life. Giving these challenges a label such as Bulimia or Anorexia can be useful, bringing meaning and understanding to these distressing experiences and aiding access to specialised help that can be tailored to a person’s needs, enabling the person to become unstuck.
Anorexia Nervosa
The first criteria for a diagnosis of Anorexia is that a person eats less than is needed to maintain a “normal” weight for their height and size. The second is an intense fear of weight gain or attempts to prevent weight gain, and the third a distorted perspective of body image which intensifies as weight is lost, resulting in the person being unable to acknowledge the risks of being underweight. Weight is lost by eating less or avoiding foods that are deemed as fattening. What starts as a way to fit into societies view of what is deemed acceptable, evolves into fear of food and becomes a way of blocking difficult emotions that are experienced as “feeling fat”.
Bulimia Nervosa
Those struggling with Bulimia have powerful urges to overeat. These urges are associated with food restraint followed by some form of purging behaviour such as vomiting, taking laxatives, excessive exercise or taking diuretics. These behaviours are believed to prevent weigh gain after what is perceived as excessive food intake. Like with Anorexia, those with Bulimia have a terror of gaining weight but tend in general to hold a higher body weight. Bulimic behaviours (even in Anorexia) carry the risk of weight gain, since an average of 1200 calories are absorbed before vomiting occurs and 90% of calories are retained where laxatives are used.
Binge Eating
Those that struggle with this presentation, struggle with a sense of loss of control, alongside secrecy and eating beyond fullness until the food is gone. These behaviours lead to feelings of guilt and shame and leave the person feeling their behaviour is “abnormal”. Food eaten in a binge may be labelled by the person as forbidden or fattening and is likely to be a food high in fats and sugars such as cakes, sweets, biscuits, deserts, ice cream, or bread and butter. Binge eating differs from Bulimia in that there is no compensation for the amount eaten by purging or starving and is therefore associated with larger bodied people.
Feeding/eating Disorder not otherwise specified (FEDNEC)
This involves those food related struggles that do not fit the strict criteria for Anorexia, Bulimia or Binge eating such as night eating or those that restrict but class themselves as clean eaters (Orthorexia). Those that struggle with Orthorexia begin by eating well and become fixated on goodness, excluding things they see as impure.
