What are Eating Disorders?
Eating disorders are conditions where the way you are feeling starts to become tangled up with the way you eat, and the way you feel about your weight and/or body. People may try not to eat, or feel like they need to lose weight or be thinner. If they do eat they may struggle with feelings like guilt or panic. Eating disorders can become really serious because they affect your physical health as well as your emotions.
What different Eating Disorders are there?
There are three main eating disorders, though you might hear some other words used as well to talk about eating disorders.
Almost all eating disorders begin when someone starts to feel life would be better if they were thinner. This may be about wanting to look different, but it’s usually more about an instinctive ‘need’ to be thinner, or feel more in control.
Sufferers start to try to control their eating, skipping meals or avoiding certain foods. Some try to follow very strict diets or eat really limited things. Eating disorders can start as following popular diets or eating plans when people find they cannot stop, or that they feel guilty if they release that attempt to control or limit what they eat.
Anorexia Nervosa describes people who continue to really severely limit what they eat, so lose a lot of weight. This can be gradual or happen more rapidly. Losing weight doesn't’ solve the underlying problems, so they keep on losing weight, trying to fix things, and feel better. They can become convinced they’re still overweight or find it hard to see how thin they are even when it's becoming dangerous.
Some people find their control breaks down and they experience binges – where they feel a sense of losing control and overeat foods they would normally forbid themselves, sometimes in large quantities. Some gain weight rapidly – this is known as binge eating disorder.
Others feel overwhelmed by panic at the thought of gaining weight, so end up doing something to try to avoid putting on weight due to their binges - this can be making themselves sick or taking medications like laxatives or diet pills. It’s called purging and in fact, most of these things don’t really work - but because people feel they do, they make the binge eating worse because it feels like there’s something you can do after eating - meaning control breaks down even more. This pattern of restricting, then binging and purging becomes a vicious cycle that is part of another eating disorder called bulimia nervosa.
What causes Eating Disorders?
Eating disorders are an attempt to cope with emotional pain and distress which can have a whole variety of causes. They are complex illnesses and often accompany other mental health problems, such as depression, anxiety, and self-harm.
Sometimes there’s a really obvious cause but most often people don’t really know where it came from or why they feel the way they do - this can add to feelings of fear or shame. Understanding why your eating disorder started is an important part of getting on the road to recovery for many people.
Can they be treated?
Yes! Recovery from eating disorders is possible, but it’s a gradual process and takes time. Treatment is generally out of hospital, although very physically unwell patients (especially those with anorexia nervosa, or those under 18) may need some time in hospital - either to treat physical effects of starvation or in a specialist unit where they can get more intensive support.
Eating disorders are usually treated with a combination of talking therapies and practical help with eating, supporting people to get back into a healthier pattern.
Getting back in (real) control
One of the hardest parts of treatment for an eating disorder an be the need to regain weight. If you are very underweight it actually affects the way your mind works, because your brain goes into a kind of emergency starvation mode. It makes you think about food all the time which can feel very frightening as it feels like if you let yourself eat you might lose control. A lot of people start to experience periods where they do lose control and eat even when they don’t want to which can add to this fear. Treatment helps you get out of this starvation state so you can feel more in control again.
This is one of the most horrid parts of an eating disorder because they often start as part of someone needing to feel more in control - but in the end they take control and leave people feeling worse than they did before. Treatment helps - but it isn’t easy to take the first steps, so most people need a lot of support.