what is an eating disorder
Questions about eating disorders, or whether one might have an eating disorder, are often challenging to ask. It can be even harder to pinpoint when an eating disorder first began. Unlike an accident with a clear date of injury, eating disorders often develop subtly in the background, gradually gaining control over a person’s mental and physical health. Unlike other unhealthy behaviours such as excessive alcohol or gambling, we need to eat to survive, whereas abstinence can be achieved with other coping methods.
Understanding what an eating disorder is and its effects is a highly individual journey. For instance, someone might use food as a maladaptive coping strategy due to trauma from an event or family issues, bullying at school or work. This could involve binging on food to block out or numb uncomfortable emotions or restricting food to lower the body’s production of cortisol (a stress hormone). While each person’s experience will differ, relying on an eating disorder as a coping strategy reinforces the control it can have.
Over time, repeated behaviours associated with anorexia, bulimia, or binge eating disorder can become the primary coping mechanism. When a person tries to move away from these behaviours, it might be the moment they realise they have developed an eating disorder.
Initially, the symptoms of an eating disorder may even appear positive, with comments from friends or family like, “you’re looking great,” or “I wish I had your willpower.” With binge eating, there might be a sense of relief, thinking, “later, in private, I can treat myself for the difficult tasks and situations I’ve dealt with today.” Our thought patterns regarding achievement or reward play a crucial role in our emotions. When we feel a behaviour has led to a positive outcome, we naturally want to repeat that positive experience, which can lead to it becoming a repeated behaviour, often more frequently than initially intended.
The challenges arise when we try to make changes in our lives. What once provided a positive reward now feels alien to do the opposite and can lead to negative feelings, even triggering the adrenal response (the fight-or-flight reflex). Food differs from alcohol or gambling in that we need it to function daily, providing energy to move, repair, and grow, for our physical and mental wellbeing. This creates a significant challenge: the person wants to return to a normal relationship with food, but the eating disorder has established both physical and emotional control.
How common are eating disorders?
A common question people ask is, “how common are eating disorders?” However, a more insightful question might be, “do I know anyone who might have or has had an eating disorder?” This perspective often reveals how prevalent eating disorders are within our communities.
The signs of eating disorders can often be subtle or misinterpreted. For instance, is what appears to be picky eating actually Avoidant/Restrictive Food Intake Disorder (ARFID)? Is excessive exercise seen as a positive display of “super energy,” rather than a potential symptom of over-exercising or orthorexia? Does someone with binge eating disorder restrict themselves in social settings and appear to have a normal relationship with food, only to “lose control” in private during the evenings?
Sometimes, families may not recognise these behaviours until they are together for a holiday, and the alarming nature of the behaviours becomes evident. In cases of anorexia, a person might refuse to eat during the holiday or exhibit physical signs like lanugo hair, which is soft, downy hair growth on the face, back, arms, and legs. The circulation system may be affected e.g., cold hands and feet or feeling cold most of the time, discolouration in their hands, feet or legs may be evident also.
Reflecting on your own experiences and relationships with this new understanding can illuminate how common eating disorders are, often hidden in plain sight within the community. It’s usually when these situations reach a crisis point that they finally become highlighted.
Symptoms of eating disorder
When we observe significant weight changes in someone, it’s often a clear signal that something might be amiss. However, reflecting on past experiences, it becomes evident that there can be more subtle indicators that often go unnoticed until a more serious problem develops. It’s challenging to define what constitutes “normal” behaviour, especially for teenagers or individuals dealing with stress from work or college. Yet, when a person begins to employ maladaptive coping strategies to manage these difficulties, these can serve as early warning signs.
Subtle signs such as avoiding family meals, consistently taking walks during lunchtime at work regardless of the weather, adopting rigid eating patterns (like always consuming the same foods), or fixating on “good” versus “bad” foods can be difficult to discern. These behaviours can often be masked as common, healthy practices, as society often promotes them as positive attributes like being health-conscious or engaging in self-care. Furthermore, as malnutrition begins to impact the body’s ability to maintain normal functions, it conserves energy by reducing certain functions, leading to a natural decrease in energy levels. Our bodies rely on the fuel we provide for much more than just energy; it’s essential for growth and repair. Without the necessary nutrients, individuals suffering from anorexia, for instance, might experience hair loss or thinning. Again, these aren’t always seen as early signs, as we might attribute them to external factors like changing conditioner or blaming swimming pool chemicals.
The crucial question then becomes, do we wait until someone is experiencing severe symptoms like fainting, dizziness, or intense mood swings, or do we attempt to offer support at an earlier stage? Each individual’s journey is unique, and their willingness to discuss their difficulties may be guarded. It’s helpful to understand that food might not be the sole issue; sometimes, the eating disorder itself is a coping mechanism for deeper, underlying problems. Reflecting on the issues that might have been present before an eating disorder was identified can provide valuable insight, as these issues could be reinforcing the current behaviours.
What types of eating disorder
Although the common eating disorders have been defined as anorexia nervosa, bulimia nervosa, binge eating disorder etc. it is possible for a person to have moved through different eating disorder at different times. An example of this could be a person while in school or college had a strong routine and when the summer months come and their routine is removed, they could struggle to maintain their rules around food and exercise. This could cause them to develop additional strategies to maintain their restricting such as using laxatives when they feel like they have eaten more than they were “allowed”. Or alternately the use of bulimia as a coping method or increasing in the amount of exercise to compensate. Engaging with the person as an individual and understanding what behaviours they have can help define if anorexia nervosa, bulimia nervosa, or binge eating disorder etc is the primary diagnoses but the recovery pathway needs to consider the individual’s needs and what has brought them to this point in their life.
Discussing the different types of eating disorders and the complexities involved in their diagnosis and how this has manifested in their life can help build on their recovery. The recovery pathway must always consider the individual’s unique needs and the underlying factors that have contributed to their current situation.
Help for eating disorders.
Sometimes asking for help could be the hardest thing a person has to do and the person wanting to help may have wished to say something but is afraid of saying or doing something wrong. In any recovery journey the first step is recognising that the person needs a help in some areas of their life, this does not always mean they need the highest level of treatment but to start the conversation about how they are feeling and the difficulties they are experiencing. It is important that there is no blame, shame or failure imposed in any of the conversation.
We offer support to individuals struggling with eating disorders and also to their loved ones. It’s understandable that reaching out for help can be incredibly difficult, and those who want to assist might be hesitant, fearing they could say or do the wrong thing. In any recovery journey, the crucial first step is for the individual to recognise they need some form of support. Please do not fear, this doesn’t always mean for the need for the highest level of treatment; often, simply opening a conversation about how they are feeling and the difficulties they are experiencing can be a significant start.
Starting by fostering an environment where these conversations can happen safely, without judgment and with understanding, is vital.
If you would like to discuss the concerns you have about a love one, contact NEDRC in confidence. We are happy to listen and guide you through.
NEDRC can help you and your loved one take that vital step to regain a happy, healthy life. Please use the contact details below to find out about our eating disorder treatment options available to you and your loved one. Contact NEDRC
Telephone: 01 564 4450 or Mobile: 087 7755996 / Email enquiries@nedrc.ie
For referrals from Healthcare/ Therapeutic professionals please contact via : referrals@nedrc.ie or healthlink@nedrc.ie or online via Healthlink
Healthmail users can send referrals to healthmail@nedrc.ie
