Eating Disorders

Helen Dellow-Findlay, Senior Specialist Dietitian at Roodlane Medical, explains the different types of eating disorders, the symptoms and causes, and how to get help if you have become concerned.

Eating disorders are a group of complex psychological disorders, which have life-threatening physical consequences and are associated with extreme emotional distress and reduced quality of life. They have the highest mortality rate of all psychiatric illnesses due to associated medical complications and suicides.

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What can trigger an eating disorder?

Eating disorders have a genetic component but are often triggered by social and environmental factors such as stress, bereavement, family break-ups, physical illness, bullying, abuse or difficulties at school or work.

For example, somebody who is struggling with their life may begin to believe things would be better if they were thinner (a belief which is often embedded in low self-esteem and body confidence). Being in control of their weight may help them to feel they have more control over their life.

Who can be affected by an eating disorder?

Most eating disorders typically develop in people during their late teens to mid-twenties, although they can develop at any time of life and a significant proportion of those affected are male. It is difficult to know exactly how many people in the UK are affected by an eating disorder as many people go undiagnosed. 

Eating disorders include:

Anorexia nervosa – whereby an individual is fixated on achieving a low body weight, despite the costs to their health. This includes severely restricting food, often alongside exercising excessively or purging by vomiting and laxative use. It is also usually accompanied by a distorted body image and the belief they are overweight or too big.

Bulimia nervosa – whereby an individual is caught up in a vicious cycle of uncontrolled binge eating, followed by compensatory purging behaviours often involving vomiting and/or laxatives.

Binge eating- whereby an individual has repeated episodes of excessive eating over a short period of time, accompanied by feelings of loss of control and shame.

What are the signs and symptoms?

Symptoms of eating disorders vary significantly between individuals and if symptoms do not correspond exactly with the official eating disorder descriptions, the eating disorder may be classified as “Other Specified Feeding or Eating Disorders” (OSFED).

Although not formally recognised as an eating disorder, the prevalence of orthorexia is increasing and is likely being fuelled by our dangerous “clean eating” and dieting culture. This condition is not necessarily driven by poor body image and desire to lose weight but is governed by the obsession to eat healthily. Signs and symptoms include an unhealthy pre-occupation with the quality of food, inflexible and rigid meal patterns, compulsive checking of ingredients lists and labels, cutting out an increasing number of food groups/ingredients (carbs, dairy, gluten, fat, sugar), an obsessive need to only consume foods considered to be healthy and exhibiting high levels of distress when perceived healthy foods are unavailable.

Impact of the pandemic

There are increasing concerns regarding the impact of the COVID-19 pandemic on eating disorders. It is a time of high stress and anxiety, and lockdown rules mean people are much more isolated from friends and family than usual. Eating disorders thrive in isolation and there is increased risk of suicide. 

If you suspect you have an eating disorder, please confide in somebody close to you and seek advice from your GP. If you think somebody you know is affected, encourage them to seek help and offer to attend a GP appointment with them. Reassure them that you care about them and will not judge or criticise them. Although GPs are not eating disorders experts, they will be able to assess any urgent medical concerns and refer you on to a specialist eating disorders service. Specialist eating disorders teams are highly successful at treating eating disorders and are made up of psychiatrists, psychologists, specialist nurses, and dietitians.

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