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Eating Disorders

Counselling4you has helped many people over the years with difficult food relationships, from young people to people in their late middle years. We assist with the practical steps required in the day to day management. In addition we work with the root causes, which once uncovered and healed, generally lead to long term recovery and good health.

We all have different eating habits. There are a large number of “eating styles” which can allow us to stay healthy. However, there are some which are driven by an intense fear of becoming over weight and damage our health. These are called “eating disorders” and involve eating too much, eating too little and using harmful ways to get rid of calories.

We are only dealing with two eating disorders on this page- Anorexia Nervosa and Bulimia Nervosa.

  • The symptoms of anorexia and bulimia are often mixed - some people say that they have "bulimarexia"

The pattern of symptoms can change over time - someone may start with anorexic symptoms, but later develop the symptoms of bulimia.

Who Gets Eating Disorders?

Girls and women are 10 times more likely than boys or men to suffer from anorexia or bulimia. However, eating disorders do seem to be getting more common with males. They occur more often in people who have been overweight as children.

Anorexia Nervosa

You may:

  • Worry more and more about your weight or appearance.
  • Eat less and less.
  • Exercise more and more, to burn off calories.
  • Cannot stop losing weight, even when you are well below a safe weight for your age and height.
  • Smoke more or chew gum to keep your weight down height.
  • Lose interest in sex.
  • In girls or women - monthly menstrual periods become irregular or stop.
  • In men or boys - erections and wet dreams stop, testicles shrink.

 When Does it Start?

Usually in the teenage years. It affects around:

  • 1 fifteen-year-old girl in every 150.
  • 1 fifteen-year-old boy in every 1000.
  • It can also start in childhood or in later life.

  What Happens?

  • You take in very few calories every day. You eat "healthily" - fruit, vegetables and salads - but they don't give your body enough energy.
  • You may also exercise, use slimming pills, or smoke more to keep your weight down.
  • You do not want to eat yourself, but you buy food and cook for other people.
  • You still get as hungry as ever, in fact you cannot stop thinking about food.
  • You become more afraid of putting on weight, and more determined to keep your weight well below normal.
  • Your family may be the first to notice your thinness and weight loss.
  • You may find yourself lying to other people about the amount you are eating and how much weight you are losing.
  • You may also develop some of the symptoms of bulimia. Unlike someone with Bulimia Nervosa, your weight may continue to be very low.

Bulimia

You may:

  • Worry more and more about your weight.
  • Binge eat.
  • Make yourself vomit and/or use laxatives to get rid of calories.
  • Have irregular menstrual periods.
  • Feel tired.
  • Feel guilty.
  • Stay a normal weight, in spite of your efforts to diet.

When Does it Start?

Bulimia Nervosa often starts in the mid-teens. However, people do not usually seek help for it until their early to mid-twenties because they are able to hide it, even though it affects their work and social life. People most often seek help when their life changes - the start of a new relationship or having to live with other people for the first time.

About 4 out of every 100 women suffers from bulimia at some time in their lives, rather fewer men.

Binging

You may raid the fridge or go out and buy lots of fattening foods normally avoided. You then go back to your room, or home, and eat it all, quickly and in secret. You might get through packets of biscuits, several boxes of chocolates and a number of cakes in just a couple of hours. You may even take someone else’s food, or shoplift, to satisfy the urge to binge.

Afterwards you feel stuffed and bloated – and probably guilty and depressed. You try to get rid of the food you have eaten by making yourself sick, or by purging with laxatives. It is very uncomfortable and tiring, but you find yourself trapped in a routine of binge eating, and vomiting and/or purging.

Binge Eating Disorder

This is a pattern of behaviour that has recently been recognised. It involves dieting and binge eating, but not vomiting. It is distressing, but much less harmful than bulimia. Sufferers are more likely to become overweight.

How can anorexia and bulimia affect you?

If you aren't getting enough calories, you may:

  • Sleep badly.
  • Find it difficult to concentrate or think clearly about anything other than food or calories.
  • Feel depressed.
  • Lose interest in other people.
  • Become obsessive about food and eating (and sometimes other things such as washing, cleaning or tidiness).

OR

  • Find it harder to eat because your stomach has shrunk.
  • Feel tired, weak and cold as your body's metabolism slows down.
  • Become constipated.
  • Not grow to your full height.
  • Get brittle bones which break easily.
  • Be unable to get pregnant.
  • Damage your liver, particularly if you drink alcohol.
  • In extreme cases, you may die. Anorexia Nervosa has the highest death rate of any psychological disorder.

If You Vomit, You May:

  • Lose the enamel on your teeth (it is dissolved by the stomach acid in your vomit)
  • Get a puffy face (the salivary glands in your cheeks swell up)
  • Notice your heart beating irregularly - palpitations (vomiting disturbs the balance of salts in your blood)
  • Feel weak
  • Feel tired all the time
  • Damage your kidneys
  • Have epileptic fits
  • Be unable to get pregnant.

If You Use Laxatives Regularly, You May:

  • Have persistent stomach pain
  • Get swollen fingers
  • Find that you can not go to the toilet any more without using laxatives (using laxatives all the time can damage the muscles in your bowel)
  • Have huge weight swings. You lose lots of fluid when you purge, but take it all in again when you drink water afterwards (no calories are lost using laxatives).

What Causes Eating Disorders?

There is no simple answer, but these ideas have all been suggested as explanations:

Social Pressure
Our social surroundings powerfully influence our behaviour. Societies which don’t value thinness have fewer eating disorders. Places where thinness is valued, such as ballet schools, have more eating disorders. ‘Thin is beautiful’ in Western culture. Television, newspapers and magazines show pictures of idealised, artificially slim people. So, at some time or other, most of us try to diet. Some of us diet too much, and slip into anorexia.

Lack of an “off” Switch
Most of us can only diet so much before our
body tells us that it is time to start eating again. Some people with anorexia may not have this same body "switch" and can keep their body weight dangerously low for a long time.

Control

It can be very satisfying to diet. Most of us know the feeling of achievement when the scales tell us that we have lost a couple of pounds. It is good to feel that we can control ourselves in a clear, visible way. It may be that your weight is the only part of your life over which you feel you do have any control.

Puberty
Anorexia can reverse some of the physical changes of becoming an adult – pubic and facial hair in men, breasts and menstrual periods in women. This may help to put off the demands of getting older, particularly sexual ones.

Family
Eating is an important part of our lives with other people. Accepting food gives pleasure and refusing it will often upset someone. This is particularly true within families. Saying “no” to food may be the only way you can express your feelings, or have any say in family affairs.

Depression
Most of us have eaten for comfort when we have been upset, or even just bored. People with bulimia are often depressed, and it may be that binges start off as a way of coping with feelings of unhappiness. Unfortunately, vomiting and using laxatives can leave you feeling just as bad.

Low Self-Esteem
People with anorexia and bulimia often do not think much of themselves, and compare themselves unfavourably to other people. Losing weight can be a way of trying to get a sense of respect and self-worth.

Emotional Distress

We all react differently when bad things happen, or when our lives change. Anorexia and bulimia have been related to:

  • Life difficulties
  • Sexual abuse
  • Physical illness
  • Upsetting events - a death or the break-up of a relationship
  • Important events - marriage or leaving home.

The Vicious Circle

An eating disorder can continue even when the original stress or reason for it has passed. Once your stomach has shrunk, it can feel uncomfortable and frightening to eat.

 Is it Different For Men?

  • Eating disorders do seem to have become more common in boys and men.
  • Eating disorders are more common in occupations which demand a low body weight (or low body fat). These include body building, wrestling, dancing, swimming, and athletics.
  • It may be that men are now seeking help for eating disorders rather than keeping quiet about them.

Professional Help

This involves talking with us for 1 hour every week, about your thoughts and feelings. It can help you to understand how the problem started, and how you can change some of the ways you think and feel about things. It can be upsetting to talk about some things, but we will help you to do this in a way which helps you to cope better with your difficulties. We will also help you value yourself more, and rebuild your sense of self-esteem.

  • It is wise to have a good physical health check, your eating disorder may have caused physical problems. Less commonly, you may have an unrecognised medical condition.
  • The most helpful treatments for you will probably depend on your particular symptoms, your age and situation.