What are eating disorders?
Eating disorders are often described as an outward expression of internal emotional pain and confusion. Obsessive thoughts about, and the behavior associated with, foods are maladaptive means of dealing with emotional distress which cannot be expressed in any other satisfactory way. The emotional distress is often associated with a negative perception of self, a feeling of being unable to change "bad" things about oneself: food is used as an inappropriate way of taking control.
Perhaps due to cultural ideas of what constitutes perfection, people often feel a strong desire to be thinner than their bodies naturally tend to be - "when I am thin everything will be alright". They confuse who they are with what they look like. As a result, they change their eating patterns and may, as a consequence, be at risk for developing an eating disorder.
An eating disorder involves a distorted pattern of thinking about food and size/weight: there is a preoccupation and obsession with food, as well as an issue of control or lack of control around food and its consumption.
There are several recognized eating disorders which can be described as follows:
People with anorexic starve themselves with the aim of losing weight to a point that others would consider to be very thin (although sufferers are unlikely to perceive themselves as such). The longer the condition continues, the more difficult it can be to tackle, and in severe cases can necessitate hospitalization and can even prove fatal. Sufferers are typically in their teens or twenties and most are women, although approximately 10% are male. Symptoms include the following:
- distorted perceptions of one's weight, size and shape
- behavior which results in a marked weight loss
- a morbid fear of gaining weight or becoming fat
- excessive exercising (while starving)
- cessation of menstruation in women.
People with Bulimia may well maintain their normal weight; however, the condition is characterized by the following:
- bouts of eating excessive amounts of food followed by purging
- a distorted perception of own weight, size and shape
- a powerful urge to overeat, leading to binge eating and a resultant feeling of being out of control
- compensatory behavior such as self-induced vomiting; misuse of laxatives, diuretics or other medication; fasting; and/or excessive exercise
- a morbid fear of gaining weight or becoming fat.
Binge eating disorder
- recurrent episodes of binge eating and consequent feeling of being out of control
- marked distress about binge eating and the attempts to control it
- during a binge individuals may: eat more quickly than normal, eat until uncomfortably over-full, eat large amounts when not hungry, tend to "graze" rather than eat meals, eat alone in secret, feel disgusted and guilty with oneself.
- weight-loss accomplished primarily through extreme dieting, fasting or excessive exercise
Other, but related difficulties with food include:
- anorexic behavior though still menstruating
- anorexic behavior where, despite significant weight loss, current weight is still normal
- someone of normal weight inducing vomiting or purging after small amounts of food
- chewing and spitting food rather than swallowing
What characterizes eating disorders?
Apart from the characteristics described above, there are other fairly common features which are often present. Some are more likely to be recognized by friends rather than the person with the problem:
- preoccupation with thoughts of food so that diet and food become the central focus of one's life
- a reliance on behavior associated with food to deal with difficult emotions, stresses and tasks
- a desire for control over at least one aspect of one's life
- low self esteem from failing to meet expectations, which is then reinforced by the behavior associated with the eating disorder, resulting in more self-disgust, shame and guilt, leading to lowered self-esteem
- distorted thinking (e.g., “when I am thin, I will be able to cope with…”)
- secondary disorders caused by the behavior – e.g., dental and digestive system damage, depression
- more women than men are affected
- sometimes, difficulty in adapting to being adult and to being sexual.
How to help yourself
The sooner help is sought, the better chance one has of changing the behavior. People can recover from even very serious difficulties with time. The suggestions below may sound rather simplistic; in practice, it usually helps to discuss these issues with a trained professional and it may take some persistence!
- Acknowledge that the problem exists!
- Rather than just trying to tackle the unhelpful behaviors connected with food, try to identify what the eating disorder is disguising or helping you avoid: for example, are there difficulties in relationships, or within the family, or events in your past that have hurt you and changed how you feel about yourself?
- Challenge the distorted thinking! Although you may still think of yourself as overweight, at least allow yourself to recognize that others may see you quite differently, or even that they may be disinterested in your weight and just see you for who you are.
- Develop a pattern of eating that suits you and keeps you healthy. This isn't the same as saying develop a rigid routine of eating that cannot be varied! Maintaining a generally balanced diet is important, but allowing yourself exceptions is also OK sometimes!
- Accept your body, i.e., respect your body regardless of its current shape or size; set realistic expectations for changing it; recognize and understand its strengths and limitations. Recognize, too, that your body is not the same as your identity; confidence and personal contentment can be present however you look!
- Don't keep an eating disorder a secret any longer. It is unfair to expect a friend to keep secrets for you! Rather, seek support in dealing with the disorder from a professional helper or a self-help group.
How to help a friend whom you suspect has difficulties with food
- Remember that your friend is a person first, and someone who has difficulty with food second. So continue with whatever activities you would normally engage in together, and don't let issues of food dominate the friendship.
- Tell your friend of your suspicions and be prepared for your friend to deny the suspicions.
- Be supportive and encourage your friend to seek professional help. Ultimately, the problem is your friend's; if the friend won't seek help, the consequences will be his or her own. Your responsibility is only to encourage your friend to seek help, or, in more extreme circumstances, to alert others, even against your friend's wishes.
- Don't nag about food, spy on your friend or get enticed into imposing some form of external monitoring or control.
- Be available to listen when your friend can express his/her distress, but don't take on too much. We all have limits of knowledge, ability to help, understanding, time, etc., so offer the level of support you feel able to sustain. If you try to offer more than that, you are likely to feel burdened and in time, perhaps, annoyed or angry, which is unlikely to help either of you or the friendship.
- Look after yourself! Maintain your normal range of friendships and balance in your activities. Don't let this one issue take up all your time.
- If you are unsure whether your style of supporting your friend is actually helpful, or if you are quite concerned for your friend, you can seek out a professional (such as a psychologist) yourself, just to check out these things.
Some useful books
- Coping With Bulimia
- Barbara French (Grafton, 1987)
- Eating Your Heart Out
- Julia Buckroyd (Optima, 1989)
- Breaking Free From Compulsive Eating
- Geneen Roth (Grafton Books, 1986)
- Fat Is A Feminist Issue 1
- Susie Orbach (Arrow Books, 1988)
- Fat Is A Feminist Issue 2
- Susie Orbach (Hamlyn, 1984)
- Fed up and Hungry
- Marylin Lawrence (The Women's Press, 1987)
- The Anorexic Experience
- Marylin Lawrence (The Women's Press, 1984)
- The Golden Cage
- Hilde Bruch (Open Books, 1978)
- The Art of Starvation
- Sheila McLeod (Schocken, 1982)
- Father Hunger
- Margo Maine
- The Body Image Workbook
- Thomas Cash