Eating disorders: key facts
What are eating disorders?
Many ‘eating styles’ can help us to stay
healthy - but some are driven by an intense fear of becoming fat.
These can damage our health and are called eating disorders. The
two most common problems are Anorexia Nervosa and Bulimia Nervosa.
We describe them separately here, but the symptoms are often
Who gets eating disorders?
They are 7 to 10 times more common in women
than in men.
What causes eating disorders?
We do not know for certain, but important
- Control - losing weight can make us feel good and in
- Longstanding unhappiness which may show itself through
- Puberty - anorexia reverses some of the physical changes of
puberty. You can see it as putting off some of the challenges of
becoming an adult.
- Family - saying “no” to food may be the only way you can
express your feelings.
- Depression - binges may start off as a way of coping with
- Low self-esteem.
- Social pressure - Western culture, particularly the media,
idealises being thin.
- Genes may play a part.
Types of eating disorders
Anorexia Nervosa - signs and symptoms
- increasingly worrying about your weight
- eating less
- exercising more
- being unable to stop losing weight, even when
you are below a safe weight
- using laxatives or other tablets to help you lose
- smoking and chewing gum to keep your weight
- losing interest in sex.
In women, periods become
irregular or stop.
In men and boys, erections
and wet dreams stop and testicles shrink.
When does it start? Usually
in the teenage years, but it can start at anytime.
Anorexia nervosa is a dangerous condition which can lead to
serious ill health and even death.
Bulimia Nervosa - signs and symptoms
- worrying more about your weight
- binge eating
- make yourself vomit and/or use laxatives
- have irregular periods
- feel guilty about your eating pattern, but
stay a normal weight.
When does it start?
Often in the mid-teens. But people don't usually seek help for it
until their twenties because they are able to hide it.
This involves dieting and binge eating,
but not vomiting. It is distressing,
but not as harmful as bulimia. Sufferers are more
likely to become overweight.
Treatments that can help
Your GP may refer you to a specialist counsellor,
psychiatrist or psychologist. Your eating disorder may
have led to physical problems and some physical illnesses
can mimic anorexia - so get a physical health check.
Psychotherapy or counselling - talking to
a therapist about your thoughts and feelings can help you to
understand how the problem started, and how you can change the ways
you think and feel about things. It can be upsetting to talk like
this, but a good therapist will help you to do this in a way which
helps you to cope better and to feel better. They will also help
you value yourself more, and rebuild your sense of self-esteem.
Advice and help with eating
- a dietician may talk to you about healthy
eating. They are experienced in talking about these experiences
sensitively and will discuss them with you when you are ready. They
may also advise you about vitamin supplements.
Psychiatric support - a
specialist will discuss with you when the problem started and how
it developed. You will have your weight measured and will have a
physical examination. Although this can be difficult for someone
with anorexia, it will only be done with your permission and with
time for you to prepare for it. With your permission, the
specialist might want to talk with your family or a friend to
see what light they can shed on the problem. Medication is not
usually prescribed for anorexia alone, but it may be given for
other symptoms, such as obsessive
compulsive disorder and depression.
Hospital admission - this may
be an option if you have lost so much weight that it is making you
Compulsory treatment - this
only happens if someone is so unwell that their life or health is
in danger or they cannot make proper decisions for themselves and
need to be protected.
How effective is the
treatment? More than half recover well, although it can
take a long time.
Behavioural Therapy (CBT) - this can be done with a
therapist, a self-help book, in group sessions, or with a computer
programme. CBT helps you to look at the links between your
thoughts, feelings and actions.
- Interpersonal Therapy - this
is usually done with an individual therapist. This treatment
focuses on your relationships with other people.
Eating advice - this helps
you to get back to regular eating, without starving or
Medication - antidepressants can reduce the
urge to binge. Unfortunately, without the other forms of help, the
benefits wear off after a while.
How effective is the
treatment? About half of sufferers recover. Recovery
usually takes place slowly over a few months or many years.
How to help yourself
- Keep a diary of what you eat, your thoughts
and feelings. This can help to identify links between how you feel,
think and eat.
- Try to be honest with yourself and with
others. Remind yourself that you don’t always have to be achieving
things – let yourself off the hook sometimes.
- Know what weight is best for you and why that is.
- Challenge eating patterns and look to ways you can improve how
you look at your body.
- Think about joining a self-help group and
contact Beat, the eating
disorders association which helps adults and young people in the UK
beat their eating disorders.
How other people can help you
- Talking with your family and friends can help them to
understand what you are experiencing.
- Having support from people around you will help and you may
want to monitor your behaviour to make you more aware.
For more in-depth information see our main leaflet: Anorexia and Bulimia
This leaflet reflects the most up-to-date evidence at the time
Produced by the RCPsych Public Education Editorial Board.
Series Editor: Dr Philip Timms
Reviewed by Dr Sophie Swinhoe
© March 2016. Due for review: March 2019.
Royal College of Psychiatrists.
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