GETTING TO GRIPS WITH EATING DISORDERS

Untangling the complex relationships between self-image, food, and societal expectations can be complicated. But with the help of an expert, we shed some light on eating disorders and how they can be treated.

In a nutshell, an eating disorder (ED) is characterised by a pattern of persistent disordered eating. An eating disorder is an illness that can lead people to overeat, starve themselves, or adopt other unhealthy behaviours surrounding food and body weight. These disorders are not simply bad habits; they interfere with daily life and, without proper treatment, can cause serious health problems.

Recent studies show that although eating disorders can affect people of any gender at any life stage, they’re most often reported in adolescents and young women. In fact, up to 13% of youth may experience at least one eating disorder by the age of 20.

There are many eating disorders out there, but below we’ll focus on the three most prevalent disorders. In addition to anorexia nervosa, bulimia nervosa, and binge eating disorder, individuals may suffer from less common EDs like rumination disorder, pica, avoidant food intake disorder, purging disorder, and night eating syndrome.

 

Anorexia nervosa

Anorexia nervosa is the most well-known eating disorder. It generally develops during adolescence or young adulthood and tends to affect more women than men. People with anorexia generally view themselves as overweight, even if they’re dangerously underweight. They tend to constantly monitor their weight, avoid eating certain types of foods, and severely restrict their calorie intake.

Anorexia can be classified into two sub-types: restricting type, and bingeing and purging type. Individuals with the restricting type lose weight solely through dieting, fasting, or excessive exercise. Whereas individuals with the binge eating and purging type may binge on large amounts of food or eat very little. In both cases, after they eat, they purge by vomiting, taking laxatives or diuretics, or exercising excessively.

This ED can be exceptionally damaging to the body long term. Over time, individuals may experience the thinning of their bones, infertility, dental issues, brittle hair and nails, and the growth of a layer of fine hair all over their body.

 

Recent studies show that although eating disorders can affect people of any gender at any life stage, they’re most often reported in adolescents and young women. In fact, up to 13% of youth may experience at least one eating disorder by the age of 20.

Bulimia nervosa

Like anorexia, bulimia tends to develop during adolescence and early adulthood and appears to be less common among men than women.

People with bulimia frequently eat unusually large amounts of food in a short period of time. Each binge eating episode usually continues until the person becomes painfully full and feels they can no longer control what they are eating. After the binge, individuals with bulimia then attempt to purge to compensate for the calories consumed. Common purging behaviours include forced vomiting, fasting, laxatives, diuretics, enemas, and excessive exercise.

But how does this differ from anorexia nervosa? Symptoms may appear very similar, however, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight.

 

Binge eating disorder

Binge eating disorder is believed to be one of the most common eating disorders. Individuals with this disorder have symptoms similar to those of bulimia or the binge eating subtype of anorexia. For example, they typically eat unusually large amounts of food in short periods of time and feel a lack of control during binges.

However, people suffering from binge eating disorder do not restrict calories or use purging behaviours to compensate for their binges. This often results in obesity and excessive weight gain, which, in turn, increases an individual’s risk of heart disease, stroke, and Type 2 diabetes.

 

Treatment best practices

Staats Van Rooyen, a Pretoria-based psychologist, notes that treatment can be tricky because EDs sometimes occur in conjunction with a history of trauma, borderline personality disorder (BPD), and obsessive-compulsive disorder (OCD).

“It is advisable to trace a very comprehensive history of the patient’s eating disorder. For treatment to be effective, you have to understand when the disordered eating started, as well as the severity of symptoms, past emotional traumas, and family histories. A holistic approach that considers the many factors that influence the ED is recommended,” says Staats.

Treating an ED isn’t as simple as placing a patient on an eating plan. Instead, mental health professionals must explore the root of the disorder and manage that first. Once the trigger is being managed, it becomes easier to rectify disordered eating patterns.

 

Getting help

It is important to note that eating disorders can be managed with the help of a trained professional. There’s no need to feel alone or ashamed – help is out there.

Eating Disorders South Africa (EDSA) hosts weekly support groups for individuals over the age of 18 who are struggling with anorexia nervosa or bulimia nervosa. These free meetings take place every Wednesday from 17:30 to 19:00 at Denmar Psychiatric Hospital in Pretoria. Email [email protected] for more information.

RecoverySpace.org is an online resource for those struggling with eating disorders throughout South Africa. Here you’ll find local articles and referrals to treatment centres throughout the country, including those in Johannesburg, Cape Town, and Pretoria.

Eating disorder warning signs

Look out for the following when worried about a loved one’s eating patterns:

  • Insistent preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting;
  • Appears uncomfortable eating around others;
  • Skipping meals or taking small portions of food at regular meals;
  • Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism);
  • Withdrawal from usual friends and activities;
  • Frequent dieting and extreme concern with body size and shape;
  • Extreme mood swings;
  • Noticeable fluctuations in weight, both up and down;
  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.);
  • Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives;
  • Dizziness and difficulties concentrating.

 

Eating disorders present differently in every person, so the above is not intended as a checklist. Rather, consider the fact that the chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder. Be vigilant, open, and most of all: be kind.

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