Getting Help For Someone Else
It can be difficult to know what to do if you’re worried that someone has an eating disorder.
They may not realise they have an eating disorder. They may also deny it, or be secretive and defensive about their eating or weight.
Let them know you’re worried about them and encourage them to see a GP. You could offer to go along with them.
What Are Eating Disorders
Eating disorders are serious medical illnesses marked by severe disturbances to a persons eating behaviors. Obsessions with food, body weight, and shape may be signs of an eating disorder. These disorders can affect a persons physical and mental health in some cases, they can be life-threatening. But eating disorders can be treated. Learning more about them can help you spot the warning signs and seek treatment early.
Remember: Eating disorders are not a lifestyle choice. They are biologically-influenced medical illnesses.
How Are Eating Disorders Diagnosed
Health care providers and mental health professionals diagnose eating disorders based on history, symptoms, thought patterns, eating behaviors, and an exam.
The doctor will check weight and height and compare these to previous measurements on growth charts. The doctor may order tests to see if there is another reason for the eating problems and to check for problems caused by the eating disorder.
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Could I Have An Eating Disorder
I’m always thinking about food, dieting and my weight
I feel guilty and ashamed after I eat
I often feel out of control when I eat
I feel better when I don’t eat
I will never be happy unless I reach my ideal weight
I often try to “get rid” of food by purging
I experience physical signs that my body isnt getting enough nutrients, such as hair loss, dry skin, dizziness or lack of energy
If you answered yes to any of these questions, it’s best to talk to your doctor.
Tip : Develop A Balanced Relationship With Food
Even though food itself is not the problem, developing a healthier relationship with it is essential to your recovery. Most people with eating disorders struggle with issues of control when it comes to foodoften fluctuating between strict rules and chaos. The goal is to find a balance.
Let go of rigid eating rules. Strict rules about food and eating fuel eating disorders, so its important to replace them with healthier ones. For example, if you have a rule forbidding all desserts, change it into a less rigid guideline such as, I wont eat dessert every day. You wont gain weight by enjoying an occasional ice cream or cookie.
Dont diet. The more you restrict food, the more likely it is that youll become preoccupied, and even obsessed, with it. So instead of focusing on what you shouldnt eat, focus on nutritious foods that will energize you and make your body strong. Think of food as fuel for your body. Your body knows when the tank is low, so listen to it. Eat when youre truly hungry, then stop when youre full.
Stick to a regular eating schedule. You may be used to skipping meals or fasting for long stretches. But when you starve yourself, food becomes all you think about. To avoid this preoccupation, try to eat every three hours. Plan ahead for meals and snacks, and dont skip!
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Parents Must Discourage Their Children From Dieting
One of the best ways to prevent your child from getting affected by eating disorders like anorexia nervosa is to discourage them from going ahead with dieting. If in case, your child is concerned about his/her weight, you should never allow him/her to pick dieting as an option to deal with the problem. You should rather try to find out other options to cope up with the problem.
What Can I Do About It
It’s very important to get help for an eating disorder because bingeing, purging and/or severely limiting how much food you eat can cause a lot of serious health problems such as bone loss, kidney problems, or heart problems, which can be life threatening. But eating disorders are treatable and many people recover with treatment. Treatment for an eating disorder often includes support from a few different professionals. Regular medical check-ups are also important to treat physical health problems. The earlier someone seeks help for their eating disorder, the better the outcomes.
The following are common treatments for eating disorders:
PsychotherapyPsychotherapy is a very important part of treatment. Psychotherapies for eating disorders include:
Nutritional helpA registered dietitian can help you learn about food and help you create healthy meal plans.
Support groupsSupport groups for yourself or your loved ones can help you see that you aren’t alone. You can learn new ways of coping and find support from others.
HospitalizationIf you start to develop serious health problems, you may need to be treated in the hospital.
MedicationSome antidepressants may help treat bulimia and binge-eating disorder. Other medications may be prescribed to help treat eating disorders or other mental illnesses that go along with an eating disorder.
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Restricting Food Or Dieting
- Making excuses to avoid meals or situations involving food
- Eating only tiny portions or specific low-calorie foods, and often banning entire categories of food such as carbs and dietary fat
- Obsessively counting calories, reading food labels, and weighing portions
- Developing restrictive food rituals such as eating foods in certain orders, rearranging food on a plate, excessive cutting or chewing.
- Taking diet pills, prescription stimulants like Adderall or Ritalin, or even illegal drugs such as amphetamines
Find Healthy Coping Mechanisms And Self Care
After you identify the circumstances, emotions, or situations that trigger your eating disorder, developing coping mechanisms is another great tip to avoid eating disorder relapse.
Self care is also especially important for someone trying to avoid an eating disorder relapse. For example, eating enough food regularly, getting enough sleep, and attending your schedule meetings with your therapist can make a huge difference in avoiding a relapse, especially during a high-stress event like Covid-19
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What Do We Know About Eating Disorders In Teens
The teenage years are a time of rapid physical, mental and social change and can present both opportunities and challenges. Some teens are able to manage this time of transition very well while others may struggle to adapt.
Teens who develop eating disorders are showing signs of a personal struggle.
All teens have worries and concerns. However, teens with an eating disorder may be experiencing worries and fears that intensify and progressively take over their lives.
They may be worried about not having friends, how to manage the demands of school and part-time work, their appearance, a family separation, dating, bullying, future plans, etc. These worries may cause them to feel that they are “not good enough” which may make them anxious, angry or sad. They may become stressed and feel they are losing their self-confidence and sense of control over their lives.
How Are Eating Disorders Treated
Eating disorders are best treated by a team that includes a doctor, dietitian, and therapist. Treatment includes nutrition counseling, medical care, and talk therapy . The doctor might prescribe medicine to treat binge eating, anxiety, depression, or other mental health concerns.
The details of the treatment depend on the type of eating disorder and how severe it is. Some people are hospitalized because of extreme weight loss and medical complications.
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Warning Signs Of An Eating Disorder
Many people worry about their weight, what they eat, and how they look. This is especially true for teenagers and young adults, who face extra pressure to fit in and look attractive at a time when their bodies are changing. As a result, it can be challenging to tell the difference between an eating disorder and normal self-consciousness, weight concerns, or dieting. Further complicating matters, people with an eating disorder will often go to great lengths to hide the problem. However, there are warning signs you can watch for. And as eating disorders progress, the red flags become easier to spot.
Do Differences In Metabolism Body Weight Community Expectations Or Culturally Specific Diets Exist Across Various Cultures
No significant metabolic differences exist between cultural or ethnic groups that explain differing obesity rates. But other factors do have an impact.
Data suggests that when someone moves to the United States, their risk for obesity skyrockets within the first year. I have a friend who came here from Peru when he was about 15 years old. He remembers being amazed by all of the food here. He was stunned by how fast food costs so little. And he couldnt believe how delicious and calorie-dense it was. He became obese and developed high blood pressure within three years. The risk of developing a serious eating disorder for adults who immigrate to the United States remains low. But as kids are raised in American culture, their risk will quickly approach that of the general population.
African Americans are also affected by huge economic and social disparities. These sadly persist and greatly contribute to obesity among that population. Unemployment, incarceration and education rates for African Americans are greatly disadvantaged compared to age adjusted white individuals. It is difficult to imagine prioritizing diet and exercise if your family does not have the luxury of safety or steady jobs.
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But You’re All Better Now Right
“Someone in recovery can feel a lot of pressure to get back to ‘normal’ again,” says Mosesso. “You can’t just wipe all those feelings away like a chalkboard. Like with drug addictions, relapses happen the key is not exacerbating the patient’s guilt for falling back into old habits.” Understanding that this will be a lifelong struggle can be one of the best ways to support your loved ones.
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Encouraging A Person To Get Help
Aside from offering support, the most important thing you can do for a person with an eating disorder is to encourage treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult it is to overcome, so urge your loved one to see a doctor right away.
A doctor can assess your loved ones symptoms, provide an accurate diagnosis, and screen for any medical problems that might be involved. The doctor can also determine whether there are any co-existing conditions that require treatment, such as depression, substance abuse, or an anxiety disorder.
If your friend or family member is hesitant to see a doctor, ask them to get a physical just to put your worries to rest. It may help if you offer to make the appointment or go along on the first visit.
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What Are The Symptoms Of Eating Disorders
It is not always easy to tell if someone has an eating disorder, since they may try to hide it because of shame or guilt. However, some of the behaviours associated with eating disorders include:
- Dieting: this could mean calorie counting, fasting, skipping meals, avoiding certain food groups or having obsessive rituals related to eating.
- Binge eating: including hoarding of food or the disappearance of large amounts of food from the kitchen.
- Purging: vomiting or using laxatives to rid the body of food. People who purge often make trips to the bathroom during or after eating.
- Excessive exercise: a person may refuse to disrupt their exercise routine for any reason, insist on doing a certain number of repetitive exercises or become distressed if unable to exercise.
- Social withdrawal: the person may avoid social events and situations that involve eating, or they prefer to eat alone.
- Body image: the person may focus on body shape and weight.
- Change in clothing style: the person may start wearing baggy clothes, for example.
There are also physical signs that a person may have an eating disorder, such as:
- Weight changes: fluctuations in weight or rapid weight loss.
- Disturbed menstrual cycle: loss of or disrupted periods.
- Being cold: sensitivity to cold weather.
- Inability to concentrate .
Some of the emotional signs of an eating disorder include:
Risk Factors For Anorexia Nervosa
Several factors have contributed to our relative lack of understanding of risk factors for anorexia nervosa. First, there is the pervasive sense that anorexia nervosa is a disorder chosen by women in pursuit of an unrealistic sociocultural body size ideal. Such beliefs can hamper attempts at identifying true risk factors. From a basic epidemiological perspective, identification of risk factors for anorexia nervosa has been difficult. The prevalence of the disorder in the population is relatively low, no more than 1% or 2% among females , and the prediction of a rare event is challenging, as evidenced by longitudinal studies in which no incident cases of anorexia nervosa emerged .
Unfortunately, few if any studies have satisfied the standards outlined above for identification of true risk factors. Although the available study designs have yielded suggestions about possible risk factors, confounds in their design have made it impossible to determine whether the traits examined are truly risk factors or phenomena associated with anorexia nervosa in some other way. Ultimately, novel designs will likely be required to identify factors that increase risk for anorexia nervosa.
Table 15.1 Risk Factors for Anorexia Nervosa
AN, anorexia nervosa CSA, childhood sexual abuse SES, socioeconomic status.
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Questions To Ask Your Doctor
Asking questions and providing information to your doctor or health care provider can improve your care. Talking with your doctor builds trust and leads to better results, quality, safety, and satisfaction. Visit the Agency for Healthcare Research and Quality website for tips at www.ahrq.gov/patients-consumers.
More information about finding a health care provider or treatment for mental disorders is available on our Finding Help for Mental Illness webpage, available at .
Causes Of Eating Disorders
Experts say that there are many reasons for eating disorders. Though the exact cause of eating disorders is still not known. It is believed that a combination of biological, environmental, and psychological factors contribute to the symptoms of eating disorders.
Biological factors include:
- Careers that promote being thin such as modeling
- Sports that emphasize maintaining a lean body such as wrestling, diving, gymnastics
- Traumatic events
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Effects Of Dieting On Psychological Status
Dieting and weight loss have also been identified as precipitants to adverse emotional reactions, including depression, anxiety, and irritability . Myers, Raynor, and Epstein evaluated childrens psychological status, as determined by mothers reports on the Child Behavior Checklist , while they participated in a family-based behavioral program. From baseline to 1-year follow-up, participants percentage overweight decreased an average of 20%, and during this time, global child psychopathology decreased significantly, while global competence increased. The proportion of children who met clinical criteria for at least one behavior problem decreased from 29% at baseline to 13% at follow-up. Improvements in some aspects of psychological status, including somatic complaints and social competence, were positively associated with weight loss.
Levine and colleagues found significant reductions in symptoms of depression and anxiety at the end of treatment that were maintained at 8-month follow-up. Epstein and colleagues observed that total behavior problems and internalizing behavior problems decreased significantly at 18-month follow-up. Twelve percent of participants reported seeking treatment for depression during the decade of the Epstein, Valoski, Wing, & McCurley follow-up, a rate that does not appear high for children who have sought professional weight reduction services . These findings, as a whole, do not indicate that dieting has a negative effect on mood .
I Ate So Much Last Night I’m Going To Skip Breakfast
There’s a difference between having disordered eating behaviors and having an eating disorder. Normalized eating changes every day, as Mosesso describes: “someone who doesn’t have a history of an eating disorder can binge on Thanksgiving dinner one day and skip breakfast.” These aren’t healthy behaviors but it doesn’t lead that person down the slippery slope of daily restriction. Take the time to explore your own relationship with food, but understand that while you may be able to eat a sleeve of Oreos and skip your next meal without ruminating too long about it, just talking about that could trigger a relapse in someone in recovery.
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How Common Are Eating Disorders
The eating disorders anorexia nervosa and bulimia nervosa, respectively, affect 0.5 percent and 2-3 percent of women over their lifetime. The most common age of onset is between 12-25. Although much more common in females, 10 percent of cases detected are in males. Binge eating disorder and OSFED are more common and rates of ARFID are not yet known as this diagnosis was defined relatively recently.
Treatment For Eating Disorders
You can recover from an eating disorder, but it may take time and recovery will be different for everyone.
If you’re referred to an eating disorder specialist or team of specialists, they’ll be responsible for your care.
They should talk to you about the support you might need, such as for other conditions you have, and include this in your treatment plan.
Your treatment will depend on the type of eating disorder you have, but usually includes a talking therapy.
You may also need regular health checks if your eating disorder is having an impact on your physical health.
Your treatment may also involve working through a guided self-help programme if you have bulimia or binge eating disorder.
Most people will be offered individual therapy, but those with binge eating disorder may be offered group therapy.
Read more about the different treatments for:
Treatment for other specified feeding or eating disorder will depend on the type of eating disorder your symptoms are most like.
For example, if your symptoms are most like anorexia, your treatment will be similar to the treatment for anorexia.
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