What is an Eating Disorder?
How do you know if your loved one has an eating disorder?
Eating disorders can impact many aspects of a person’s health and wellbeing.
Whilst these areas are severely impacted during the illness, they are also considered important aspects of recovery.
- Physical health and well-being
- Emotional health and well-being
- Social well-being
Eating disorders are often very private and hidden and can exist for a long time before recognised by someone else.
Why can’t my loved one just stop their eating disorder behaviours?
Eating disorders are not just about food or physical appearance. For many individuals with an eating disorder, the eating disorder has developed over time as a coping mechanism – for circumstances out of their control that may be distressing, difficult, or confusing. The eating disorder is not a choice – and the behaviours have become deeply ingrained. It is important to recognise the complex nature of eating disorders as they are a serious mental and physical health condition that requires specialised treatment and support. It will take time for your loved ones to learn new coping mechanisms, and to reduce their reliance on the eating disorder behaviours.
Indications for Medical Intervention
- Rapid or consistent weight loss
- Slow heart rate or chest pain. Can also include tachycardia (fast heart beat)
- Inability to sustain core body temperature
- Electrolyte imbalance (potassium, phosphate, magnesium)
- Rapidly increasing weakness
- Dizziness, fainting or disorientation
Eating disorders seriously affect all aspects of a person’s life
Eating disorders are complex mental and physical health issues. They can affect people regardless of gender, age, race, ethnicity, body shape and weight, sexual orientation and socio economic status.
Recognising the signs and symptoms of an eating disorder can be difficult as these can be subtle in the early stages of onset.
It is important to understand the signs and symptoms of an eating disorder so that you can access information and support for yourself and your loved one.
EDQ values people being the experts in their lives and we encourage you to trust your instincts if you are concerned or have observed changes in your loved one.
Carers and family members can play a vital role in recovery for a person living with an eating disorder, in conjunction with the treatment team. Optimal treatment is a team/collaborative approach.
Please note that your loved one may still be achieving and functioning at school or university, and/or maintaining employment, but can still be medically and/or psychiatrically compromised.
It is important to remember that no one risk factor, trigger, person, situation or event is responsible for the development of an eating disorder.
Below are some common eating disorder signs and symptoms. If your loved one is displaying any of the below symptoms, please see Eating Disorders in Detail (below) for more detailed information:
- dieting and/or emotionally eating
- over evaluation and/or distressing/critical thoughts about body weight and shape
- intense fear of gaining weight
- sudden unexplained weight loss
- food preoccupation/fixation on “healthy” or “clean” eating to the point of inflexibility
- wearing baggy, layered or inappropriate clothing
- omitting food groups
- restricting food intake
- binge eating
- purging or going to the toilet/bathroom directly after eating
- compulsive and/or excessive exercise
- the abuse of diuretics and/or laxatives
- mood disturbances
Eating Disorders in Detail
People close to someone with an eating disorder may notice some of the following.
At one end of the continuum we have healthy eating and acceptance of body shape and size. At the other end of the continuum is disordered eating, such as anorexia, bulimia and binge/compulsive eating. In between sits fear of fatness, denial of appetite, emotional eating, exaggeration of body size, depression and rigid dieting.
1. Your loved one doesn’t need to look unwell to deserve treatment. Eating disorders are a serious illness, regardless of your body shape or weight.
2. Carers, family & friends can play a vital role in recovery for a person with an eating disorder, in conjunction with their treatment team. Best treatment is a team approach.
3. An eating disorder is a health crisis that disrupts personal, social and relationship functioning.
4. Having an eating disorder is not a ‘lifestyle choice’, it is a complex mental and physical health issue with grave outcomes if left untreated.
5. Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses.
6. People with an eating disorder have the highest morality rate of all mental health illnesses.
7. Suicide is a leading cause of death for people with an eating disorder.
8. Act Now! Early intervention is important and full recovery is possible.
9. It is better to be on the side of caution where an eating disorder concern is present.
That’s why seeking expert advice is recommended.
Does your gut tell you what you are seeing is not ‘normal’? Follow your gut, and see a GP – preferably one with eating disorder expertise.
In need of a second or third opinion? Need more advice?
Contact EDQ for assistance in finding other or additional medical and professional support.
Review our eating disorder pathway for ideas on which part of the process you are at and where else it might be useful to go for assistance.
The National Eating Disorder Collaboration (NEDC) have developed evidence-based and informative fact sheets on types of eating disorders.
The Effects of Starvation and Refeeding
Before explaining the nature of eating disorders, it is very useful for everyone to understand the effects of starvation on physical, social and mental health. A well-known starvation study carried out at the University of Minnesota highlights that many symptoms of eating disorders are actually symptoms of starvation, and that anyone who engages in prolonged and severe dietary restriction can suffer serious physical, social and psychological complications.
The study included a six-month period of food restriction for 36 young, healthy, psychologically normal men. The men ate about half of their normal food intake (approximately 1560 calories, or 6552 kilojoules, a day) and lost about 25 per cent of their former weight. The men were then gradually renourished during the following three months (Alex, 2011).
Changes in the men after six months of semi-starvation
- Despite little interest in food or food preparation prior to the experiment, there was a dramatic increase in food preoccupation, including incessant and intrusive thoughts about food, menus, food preparation and eating, including dreaming about food.
- Abnormal and ritualistic behaviours around food increased, including making strange food combinations and concoctions.
- There were often conflicting desires between wanting to gulp food down ravenously and prolonging the time taken to eat food, sometimes for hours.
- A significant increase in the use of salt, spices and gum chewing. Drinking of coffee and tea increased so dramatically they had to be limited to nine cups a day!
- Some had a complete breakdown in control, unable to stick to their restrictive diets and reported episodes of binge eating followed by emotional upset, self-reproach, disgust, self-criticism and vomiting. One man left the experiment after developing a dangerous a starve–binge–purge cycle.
- Stress, anxiety, depression, mood swings, irritability, disorganisation, hysteria, hypochondria, outbursts of anger and severe emotional distress increased.
- Some men became neurotic and psychotic.
- The men became more withdrawn and isolated, with growing feelings of social inadequacy. Humour and mateship diminished. Social contacts became strained and declined, and sexual interests drastically reduced.
- Concentration, comprehension, alertness and judgement became increasingly impaired; however, there seemed to be no signs of diminished intellectual abilities.
- Physical changes included hair loss; dizziness; headaches; hypersensitivity to noise and light; increased sensitivity to cold temperatures; cold
hands and feet; reduced strength; poor motor control; gastrointestinal problems; decreased need for sleep; oedema (excessive fluid causing swelling); visual disturbances, such as an inability to focus; aching eyes or seeing ‘spots’; auditory disturbances, such as ringing in the ears; and tingling or prickling sensations.
- An overall slowing of the body’s physiological processes occurred, such as decreases in body temperature, heart rate, and respiration, as well as in basal metabolic rate, which is the amount of energy burned at rest.
- Most of the men eventually became tired, weak, listless, and apathetic, and complained of lack of energy. Some maintained exercise regimes and some attempted to lose weight by excessive exercise in order to obtain more food, or to stop a reduction in their food rations.
- Apathy also became common, and some men neglected various aspects of personal hygiene when previously they had taken great care.
During the three months of the renourishment, most of the emotional disturbances, abnormal attitudes and behaviours in regard to food continued to be quite severe. Particularly in the first six weeks, some men actually became more depressed, irritable, argumentative and negative than they had been during the semi-starvation. After between five and nine months of renourishment, most men had returned to normal body weight, normal eating patterns and physical, psychological and social functioning was restored. A few were still binge eating; although, the study did not identify why. The fact that serious binge eating developed in a small subgroup of men supports research indicating that people who regularly diet by restricting food, develop binge eating behaviours.
Although the effects of starvation are very clear from this study, the men were voluntary research subjects. If we are to understand why eating disorders develop, we also need to understand why individuals engage in self-imposed starvation.
For further information on the Minnesota study, click HERE
A 57- year follow-up study was then conducted, and can be accessed HERE.
This follow-up study reports on 19 of 36 male participants in the Minnesota Semi-Starvation Experiment. Data were obtained for only 3 months of controlled nutritional rehabilitation following 6 months of semi-starvation, the follow-up aim was to re- examine the acute effects and inquire into possible long term physical and psychosocial effects from undergoing semi-starvation. The experiment has been a source of information for understanding eating disorders, particularly anorexia nervosa (Eckert E.D. et al. 2018).
Eating Disorders Guide
A current publication for Australia and NZ by Royal Australian and New Zealand College of Psychiatrists. An excellent summary of eating disorders and overview of treatment. Worth downloading and keeping for reference.
If you need help, reach out.
If you need assistance, or are interested in any eating disorder services, get in touch.
We can help with more information, referrals and/or arrange an assessment appointment.
You can also contact us through Eating Disorders Queensland
Eating Disorders Queensland 89 Sherwood Road, Toowong Qld 4066