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Eating Disorders

What are anorexia and bulimia?
Anorexia nervosa and bulimia nervosa are the most common of the eating disorders. People with anorexia have extreme weight loss as a result of very strict dieting. Some people may also make themselves sick, abuse laxatives or do excessive exercise to try and lose weight. In spite of this extreme weight loss, people with anorexia believe they are fat and are fearful of becoming what is in fact a normal weight or shape. About four out of ten people with fully established anorexia make a full recovery, and others improve. Only about three in ten continue to have major long-term illness. Untreated, about 15 per cent of all sufferers will die from the disorder within 20 years of its onset.

People with bulimia nervosa crave food and binge eat, though they are not emaciated. Afterwards they make themselves sick or misuse laxatives to get the food out of their bodies. Sufferers are very afraid of becoming fat.

Who has anorexia or bulimia?
Eating disorders affect seven girls in every 1,000 and approximately one boy in every 1,000. It usually begins to be a problem in teenage years, but can happen at any time.

Bulimia is more common than anorexia, although people with anorexia in particular do not always ask for treatment.

Occasionally men develop eating disorders, but anorexia nervosa is rare. Male development in puberty is very different from that of females. Related bodily concerns are different and less often lead to the extremes of dieting which commonly precede anorexia nervosa.

What causes eating disorders?
Eating disorders may develop partly in response to difficult life experiences such as abuse or social pressures arising in puberty and in growing up. They are also more common in cultures where it is considered desirable to be slim. Genetic factors seem to be important, especially in anorexia. Sometimes people with an eating disorder are depressed, and they may have obsessions.

What treatments are available?
Mental health professionals need a variety of skills to treat people with eating disorders. A doctor can help diagnose the illness and any associated physical problems resulting from it. In both anorexia nervosa and bulimia, self-help strategies can be very helpful. If this approach does not work, health professionals may suggest a course of psychotherapy.

If someone has lost a dangerous amount of weight, the first step will be to help the person start to regain that weight in order to survive. Some people with anorexia may need to be admitted to hospital and the nursing staff has an important role in supporting the patient in the early stages of treatment. Psychological and psychotherapy skills are also necessary at this acute stage, so that the mental health team can begin to understand why the illness developed and how to help the person to overcome it.

In anorexia, this talking treatment will involve the individual with the illness and sometimes other family members. The long-term aim will be to help that person change their attitude, behaviour and ways of thinking, and enable them to cope with the strains of life without the illness as a protection. Shorter-term expert talking treatments and also specific cognitive behavioural treatments are often effective with bulimia nervosa.

What can society do?
We can strive better to understand the distress that underlies and drives these disorders. We can provide access to such information and develop health promotion campaigns aimed at teenagers and young people. Information on how to cope with feelings and fears about growth or about being too fat is useful. We can offer more support in secondary schools and user-friendly services for troubled teenagers.

Recommended reading
Bulimia Nervosa:
Overcoming Binge Eating (1995).
Christopher Fairburn. Guildford Press.

Bulimia Nervosa:
Getting Better Bit(e) by Bit(e) (1993).
Ulrich Schmidt and Janet Treasure.
Psychology Press.

The Essential Handbook of Eating Disorders (2005) Janet Treasure. John Wiley & Sons Ltd

When dieting becomes dangerous: a guide to understanding and treating anorexia and bulimia (2003) Arthur Crisp, Deborah M Michel and Susan G Willard Yale University Press.
Self-help

Links and contact details

Name: beat – Eating Disorders Association
Web: http://www.b-eat.co.uk
Tel: 08456 347650 (Youthline)
TXT: 07786 20 18 20 (Youthline)
Tel: 08456 341414 (Over 18s Helpline)
Email: fyp@b-eat.co.uk (Youthline Email)
Email: help@b-eat.co.uk (Over 18s Helpline Email)
Info: beat is the leading UK charity for people with eating disorders and their families. beat is the working name of the Eating Disorders Association (EDA).

Name: Childline
Web: www.childline.org.uk
Email: On line message form – www.childline.org.uk
Tel: 0800 1111 (24 hour support)
Online chat: Visit the website – www.childline.org.uk
Info: You can contact ChildLine about anything – no problem is too big or too small. If you are feeling scared or out of control or just want to talk to someone you can contact ChildLine.

Name: Samaritans
Web: http://www.samaritans.org/
Email: jo@samaritans.org
Tel: 08457 90 90 90 (24 hour support)
Address (you can write a letter to the Samaritans – Chris, P.O. Box 9090, Stirling, FK8 2SA)
Info: Samaritans provides confidential non-judgemental emotional support, 24 hours a day for people who are experiencing feelings of distress or despair, including those which could lead to suicide.

Name: BBC – info pages on Eating Disorders
Web: http://www.bbc.co.uk/health/conditions/mental_health/disorders_eating.shtml

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