Eating Disorders

What are eating disorders?

Eating disorders describe a range of problems associated with eating, food and body image. Unfortunately, in our society it is common for individuals to feel unhappy about their bodies and to be dieting or worrying about food. When these problems are extreme or interfere with an individual's normal activities and quality of life, these concerns are considered to be psychological disorders.

The most serious eating disorder is anorexia nervosa, which is characterised by dangerously low body weight. Bulimia nervosa is not so frequently life-threatening, but seriously affects the wellbeing of sufferers and can have serious medical complications. This condition is characterised by binge eating and subsequent behaviours that are engaged in to compensate for the binge.

Many individuals suffer from other equally unhealthy and disturbing patterns of eating, which are not easily classified. These are known as Eating Disorders Not Otherwise Specified (EDNOS).

Eating disorders mainly affect females but approximately one in ten individuals with an eating disorder is male. It is difficult to accurately estimate the frequency of occurrence of eating disorders due in part to the secretive nature of the disorder. In Australia, anorexia nervosa affects approximately 0.5 per cent of females, bulimia nervosa 2-3 per cent and EDNOS 2-3 per cent. Individuals with an eating disorder have significant problems with eating habits, weight management practices and attitudes about weight and body shape. These eating related attitudes and behaviours can have numerous negative consequences including:

Low self-esteem, depression, shame/guilt
Obsession and anxiety
Interference with normal daily activities
Social withdrawal
Life threatening physiological symptoms

What causes eating disorders?

There are many suggested theories of the factors involved in the development of eating disorders, but there is no single consensus on a cause. Most research acknowledges that the development of eating disorders involves a complex set of interactions between cultural, social, family, personality and physical factors (including genetic factors). Our culture has an unrelenting idealisation of thinness and the ‘perfect' body is synonymous with beauty and success. Research suggests that this social environment encourages dieting, and dieting predisposes an individual towards eating problems. In the case of bulimia nervosa particularly, the physiological effects of dietary restriction may trigger binge eating. In addition, feelings of inadequacy, depression, anxiety and loneliness, as well as problematic family and personal relationships, may also contribute to the development of eating disorders. Once the pattern has started, eating disorders may become self-perpetuating. Dieting, bingeing and purging help some people to cope with painful emotions and to gain a degree of control of their lives. However, at the same time, these behaviours undermine physical health, self-esteem and a sense of competence and control. In anorexia nervosa, starvation frequently contributes to a lack of flexible thinking, which may make change difficult.

Treatment of eating disorders

Many people with eating disorders do not seek treatment for their problems. There are numerous reasons for this. In the case of anorexia nervosa, the individual may not perceive that they have a problem, or may be deeply afraid of the weight gain that will be encouraged or enforced in treatment. In bulimia nervosa, individuals may not seek help as they are ashamed and fear the stigma attached to eating disorders, they may not believe they can be helped, they may not be able to afford treatment, or appropriate treatment may not be readily available. In males, eating disorders may be overlooked because these conditions are more unusual in males.

However, finding appropriate help and treatment for eating disorders is essential - the sooner, the better. The longer abnormal eating behaviours persist, the more difficult it is to overcome the disorder and its effects on the body. Psychologists are frequently crucial sources of psychological intervention and can play a vital role in helping people with eating disorders to identify and challenge the negative beliefs about themselves that are maintaining the disorder.