What is disordered eating?
Do you spend all of your time thinking about calories, fat, exercise or body image? Do you feel guilty or bad when you eat certain foods? Or do you feel such an overwhelming urge to comfort eat sometimes that you can’t stop? In that case, you may have some form of disordered eating.
The NHS defines eating disorders as being characterised by an abnormal attitude to food that makes someone change their attitude to eating habits and behaviour.
The main eating disorders are:
Anorexia Nervosa: trying to keep your weight as low as possible, by food restriction and sometimes also by exercising.
Bulimia Nervosa: feeling the compulsion to binge eat, but then attempting to keep weight down by vomiting or excessive exercise afterwards to compensate for this.
Binge Eating: Feeling compelled to overeat.
Eating Disorders Not Elsewhere Classified: Many people do not satisfy all the medical criteria for eating disorders; however they may be preoccupied with food, try to balance out eating “bad” foods by not eating the next day, or overeat or undereat to manage difficult feelings. If this is you, it’s time to get help as you have disordered eating.
What are the symptoms?
Anorexia: includes excessive weight loss, periods stopping, feeling cold, lying about eating, wearing baggy clothes to cover weight loss, depression, mood swings, obsession with dieting, thinking about food all the time.
Bulimia: includes being sick after eating, sore throat and damaged teeth due to frequent vomiting, irregular periods, using laxatives, feeling ashamed or guilty, depression, feeling out of control.
Binge Eating Disorder: Weight gain, being secretive, eating large quantities of, or inappropriate food, feeling out of control, mood swings.
Why do people get eating disorders?
There is a widespread perception that eating disorders are “caused” by unrealistic images of people (particularly, but not exclusively, women) in the media. It’s certainly not helpful to live in a culture where we are surrounded by such images and where there is such a focus on the importance of physical appearance over personality. However, eating disorders, or disordered eating behaviours, generally arise from difficulties in relating to aspects of the self or to others. These difficulties can include: low self esteem, a desire for control and/or an intolerance of uncertainty, a way of managing or dissociating from feelings, a form of self harm/punishment, a form of self-soothing, among others.
As eating disorders arise for a variety of reasons, it’s important to think about what function the disordered eating performs for the individual client. Counselling is a place to explore this and to think about what fears might have to be faced if the eating disorder was not there. Therapy might initially involve thinking about the origins of the problem, links to emotional/relational difficulties going on at the time it started and thinking about why managing eating became important; this might then move on to thinking about how the disordered eating behaviour is maintained, and challenging that. The eating disorder may feel initially like an old friend, familiar and comforting. But one day you may wake up and realise that this “friend” is now your gaoler. Is someone who tells you what to do, think and feel all day every day really your friend?
If your disordered eating has caused you either to lose or gain significant amounts of weight or you have any specific health concerns, the first port of call should be your GP, who will be able to assess your nutritional and other health needs; you may need to access support via your local hospital.
For many people, disordered eating causes immense psychological distress without reaching the physical levels described above; if this is the case, counselling can really help. If you’re now feeling inspired to get help for disordered eating, you are taking a step in the right direction. However, I recognise that this step may feel like a big one and you will want to feel safe and understood. For this reason, the counselling process starts with an initial meeting where we get to know each other; your counsellor can find out about what you feel is the problem you want to address and you can find out about how they work therapeutically.
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