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What are eating disorders?

Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are mental disorders that involve extreme disturbances in eating behaviour and the persons perception of their body and weight. Eating disorders often co-occur with other mental disorders, such as obsessive-compulsive disorder, anxiety disorder, depression, substance abuse, or the person may engage in self-harming behavior.  It is important to identify and address these co-occurring disorders if they are present. Eating disorders can affect both men and women, and it is important that young men also receive screening and care for eating disorders if necessary.

Anorexia nervosa is an eating disorder where you worry about your weight, want to lose weight and eat less and less food in an attempt to lose weight. If untreated, anorexia has the potential to become life-threatening. Anorexia has the highest death rate of any mental disorder, and without treatment, up to 20% of people with a serious eating disorder will die.

General symptoms of anorexia:

  • Eating very little, or nothing at all
  • Compulsively exercising
  • Constantly worrying about the amount of calories in your meal
  • Feeling anxious about eating in front of others or having a big meal
  • Always feeling fat despite current weight or weight-loss
  • Obsession with body image and comparing your body to others
  • Low mood and irritability
  • Losing lots of weight over a short period of time
  • Monthly periods stopping or being unable to have an erection
  • Feeling cold all the time
  • Growing new downy hair on your body
  • Insomnia
  • Constipation
  • Skin rash or dry skin

Bulimia nervosa is an eating disorder where you get into a cycle of overeating and then making yourself sick to try to control your weight. People who have bulimia typically appear to be of normal weight or overweight, rather than being extremely thin.

General symptoms of bulimia:

  • Obsessive thoughts about your weight
  • Binge eating (eating a large amount of food in a very short period of time)
  • Exercising compulsivly
  • Isolating yourself
  • Poor sleep
  • Low mood
  • Sore throat (from vomiting)
  • Dehydration
  • Feeling weak and tired
  • Damaged teeth (from vomiting)
  • Heart problems
  • Muscle spasms
  • Swollen glands
  • Change in monthly periods
  • Stomach cramps

Binge eating disorder is a common eating disorder where you frequently eat large amounts of food while feeling powerless to stop and extremely distressed during or after eating. During a binge, you may eat even when you’re not hungry and continue eating long after you’re full. Unlike in bulimia, however, there are no regular attempts to “correct” for the binges through vomiting, fasting, or over-exercising.

General symptoms of binge eating disorder:

  • The inability to stop eating or control what you’re eating
  • Eating large amounts of food very quickly
  • Eating even when you’re full
  • Hiding or stockpiling food to eat later in secret
  • Eating normally around others, but bingeing when you’re alone
  • Eating continuously throughout the day, without any planned mealtimes
  • Feeling stress or tension that is only relieved by eating
  • Feeling embarrassment over how much you’re eating
  • Feeling like you’re not really there or you’re on auto-pilot while bingeing
  • Never feeling satisfied, no matter how much you eat
  • Feeling guilty, disgusted, or depressed after overeating
  • Desperation to control weight and eating habits

How do eating disorders affect young people? 

According to the Healthy Teen Project:

95% of people with eating disorders are between the ages of 12 and 25

40-60% of girls between ages 6-12 are concerned about their weight or about becoming overweight

Among high-school students, 44% of females and 15% of males attempt to lose weight

Over one half of teenage girls and nearly one third of teenage boys use unhealthy weight control behaviours, such as skipping meals, fasting, smoking cigarettes, or  purging

Eating disorders can affect people of all ages; however the onset of eating disorders typically occurs during pre-adolescence or adolescence. Puberty is a time when many young people feel self conscious about their physical appearance, and studies have shown that for many teenagers the onset of their eating disorder involved comments or teasing by peers or family members, usually about appearance.

Feeling shame, or being shamed, based on size or physical appearance can be powerful contributors to a teenager developing an eating disorder. Eating disorders affect millions of adolescents and young adults around the world. Given the serious medical complications that may result from eating disorders, it is very important to identify, diagnose and treat them as early as possible. If untreated, eating disorders may lead to serious health complications, hospitalisation, and even death.

What causes eating disorders? 

Eating disorders are complex disorders, and their development is usually influenced by a number of factors. These include:

Genetics. Some people may have genes that leave them more vulnerable to eating disorders. Your chances of having an eating disorder are higher if you have a close relative who has or had the same condition.

Mental health problems. Emotional and psychological problems, such as low self-esteem, depression, anxiety, and obsessive compulsive disorder may all contribute to the development of an eating disorder.

Trauma. People who have experienced sexual or physical abuse or who have suffered some other form of trauma, may be more likely to develop an eating disorder.

Societal causes.  Images in the media and peer pressure will often reinforce a negative body image, making young people more vulnerable to eating disorders.

Can eating disorders be treated? 

Eating disorders can be treated. The first step is to see a mental health professional who will be able to make a formal diagnosis. Based on the diagnosis and your individual needs, a treatment plan will then be developed.

Treatment for eating disorders usually involves a multidisciplinary approach, and could include medical supervision, individual therapy, family therapy, and nutritional rehabilitation to restore health and body weight and change behaviours related to eating and exercise.

Medication may be required if certain mental disorders are also present; most commonly depression and anxiety disorders. The young person may have obsessive-compulsive disorder or tendencies, and may also suffer from trauma or substance abuse, or engage in self-harming behavior.  It is important that eating disorder treatment works to identify and address these co-occurring disorders. Treatment helps the person recovering from an eating disorder create a healthier relationship with food and their bodies.

If you or someone you know has an eating disorder, you can contact Eating Disorders South Africa for more information and help in finding treatment.