What is an Eating Disorder?

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.

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).