Eating disorders: what's your relationship with food?
Eating disorders can involve eating too little or too much, and/or becoming obsessed with body weight and body shape. Normally, someone with an eating disorder will exhibit an unhealthy relationship with food, their body and themselves to the point where it has taken over their life and made them ill.
You might be reading this as a person who suffers from an eating disorder, or may know someone close to you who suffers from one. Whatever your situation, in this article, I will briefly describe some of the main types of eating disorders and hope to shed some light onto understanding these conditions better.
Anorexia is a condition where people restrict their diet resulting in low body weight. People who suffer from anorexia may also exercise a lot to burn off food they have eaten. Anorexics will often see themselves as being much bigger physically than they really are, and will often have a deep fear of gaining weight. They may also challenge the idea that they should gain weight. The preoccupation with weight control and fear of gaining weight is the key symptom of anorexia.
Bulimia literally means “ox hunger” in Greek and is also a condition where there is a persistent concern with body shape and weight; the bulimic may also see themselves as bigger than they really are. However, bulimics differ from anorexics, in that they binge eat (a rapid consumption of food within a small space of time), and will then self-induce vomiting which is often very distressing for them. They may also use laxatives or diuretics and will fast or exercise vigorously to prevent weight gain. When bulimics binge they often report feeling out of control of how much or how quickly they eat, and sometimes describe themselves as being disconnected from what they are doing.
Binge Eating Disorder
Binge eating disorder (BED) is an illness where people experience a loss of control and eat large quantities of food on a regular basis over a short period of time (called bingeing) until feeling uncomfortably full, even when they are not physically hungry. Unlike those with bulimia, people with binge eating disorder do not regularly purge after a binge.
Emotional overeating means using food for comfort and escape during times of low mood and stress, and can also be used to manage a range of difficult emotions. When someone overeats emotionally, they are normally attempting to comfort and sooth themselves. Someone who emotionally overeats does not feel satisfied with a full stomach and can feel guilt, shame, and powerlessness when they eat.
Diabulimia is an eating disorder in which people with type 1 diabetes skip taking insulin to lose weight, and may have serious health consequences if left untreated. This condition is not yet recognised by the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Insulin is a hormone in the body that helps cells use glucose as fuel, and people with type 1 diabetes are not able to produce insulin on their own. Without insulin, glucose accumulates in the blood and is flushed out of the body through frequent urination, resulting in rapid weight loss. This symptom is often the intended goal with this eating disorder. Early symptoms of diabulimia are similar to those of poor insulin control.
Why do people develop eating disorders?
Over the years, many explanations have been given for having an eating disorder. One of the most common explanations of eating disorders used to come from the sociological model where “thin is beautiful”. However, with an increased number of people suffering from emotional overeating and binge eating disorder where the focus of the disorder in not necessarily to be thin, this can no longer be a leading explanation. Our relationship with food and ourselves seems to be the most dominant factors in determining whether we have an eating disorder. Food can become a way to cope with emotions and the repetition of this coping mechanism can become a habitual behavioural pattern and an addiction. By using food to deal with anxiety, stress, grief, and many other uncomfortable emotions, the body becomes conditioned to crave that process to feel relief, and avoid these feelings.
Treatment and moving forward
Eating disorders can often be extremely distressing and debilitating. When people do not seek help or support for their eating disorder, this mental illness can cause long term health issues and can even result in death. It is however possible to recover from an eating disorder successfully, and the treatment plan will very much depend on the type of eating disorder being treated. The first step with any mental health issue, and indeed with an eating disorder is to initially recognise that there is a problem, so it can be treated accordingly. Many people benefit from initially seeing their GP, so that an appropriate referral to an eating disorders specialist can be made. Others benefit from attending OA (Overeaters anonymous), a 12-step fellowship program which supports individuals to recover from compulsive under eating or overeating. Long-term psychotherapy and counselling can also be extremely helpful in exploring the underlying issues sustaining eating disorders. Many people with eating disorders recover successfully with a multidisciplinary approach which address both the physical and psychological aspects of this illness. Eating disorders are complex mental illnesses and it is extremely important to access treatment as quickly as possible, as earlier treatment means a greater chance of full recovery.
Overeaters Anonymous - https://www.oagb.org.uk/
NHS - https://www.nhs.uk/conditions/eating-disorders/
Beat Eating Disorders - https://www.beateatingdisorders.org.uk/
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About Neelam Zahid
Neelam is a BACP accredited Integrative Counsellor and Psychotherapist practising since 2003. She offers individual therapy, fast phobia and trauma treatment (rewind technique), mindfulness courses and cultural awareness training. Neelam has also contributed to 'The Handbook of Transcultural Counselling and Psychotherapy', 2011 (eds Colin Lago).