Eating disorders

Eating disorders are serious mental illnesses. They can affect people of all age groups, genders, backgrounds, cultures, and in different body sizes. The number of people with eating disorders is increasing. Eating disorders are estimated to affect almost one million Australians. Some groups in the community are at greater risk, including females, children, and gender and sexually diverse people.

We understand more about eating disorders now than ever before. Yet, many people can live with an eating disorder for a long time without being diagnosed or accessing treatment. Seeking support from a professional as early as possible can help people to recover more quickly and reduce the impact of the eating disorder on the person’s health and wellbeing.

Symptoms of eating disorders

While the experience of an eating disorder can look different for each person, there are some warning signs that are more common to people with eating disorders. These may include:

• change in weight or weight fluctuation
• body dissatisfaction
• preoccupation with body size, shape or weight
• sensitivity to cold
• faintness, dizziness and fatigue
• mood changes and irritability
• social withdrawal
• anxiety or depression
• inability to concentrate
• increased interest in preparing food for others
• obsessive rituals around food and eating, such as only drinking out of a certain cup
• eating alone or in secret
• wearing baggy clothes or changes in clothing style
• excessive or fluctuating exercise patterns, exercising through injury or illness
• avoiding social situations involving food
• making excuses not to eat
• disappearance of large amounts of food from the refrigerator or pantry
• trips to the bathroom after eating
• constant and excessive dieting.

Types of eating disorders

The main types of eating disorders include:

• Anorexia nervosa – characterised by restricted eating, weight loss, and fear of gaining weight.
• Bulimia nervosa – periods of binge eating (often in secret), followed by attempts to compensate with excessive exercise, vomiting, or periods of strict dieting. Binge eating is often accompanied by feelings of shame and a sense of a loss of control.
• Binge eating disorder – characterised by recurrent periods of binge eating. Binge eating can include:
  • eating much more than usual
  • eating until uncomfortably full
  • eating large amounts when not feeling hungry.
• Feelings of guilt, disgust and depression can follow binge eating episodes. Binge eating does not involve compensatory behaviours, such as for bulimia nervosa.
• Other specified feeding or eating disorder (OSFED) – feeding or eating behaviours that cause the individual distress and impairment, but do not meet the criteria for the first three eating disorders.
• Avoidant restrictive food intake disorder (ARFID) - feeding or eating behaviours that can include restriction or avoidance that leads to a person not meeting nutritional/energy needs, including:
  • fear associated with certain foods or the process of eating
  • sensory sensitivity to certain foods (such as the texture of foods)
  • lack of interest in eating or food.

Causes of eating disorders

Eating disorders are complex – there is no single cause of eating disorders. Social, psychological and biological factors all play a part, in varying degrees, for different people.

Social factors

Contributing social factors may include:

• sociocultural messages that focus on the 'ideal' body size and shape
• normalisation of dieting and weight loss to achieve this ‘ideal’ body size and shape
• pressure to achieve and succeed
• peer pressure to be or behave in a certain way
• a cultural tendency to judge people by their appearance
• occupations or activities that emphasise a particular body shape and size – for example, ballet, modelling, elite sports.

Major life changes or events may also contribute to the onset of an eating disorder, including:

• relationship difficulties
• transition to new school or employment
• pregnancy and childbirth
• the death of a loved one.

Biological factors

Contributing biological factors may include:

• adolescence and its associated physical changes
• genetic or familial factors (for example, family history of an eating disorder).

Psychological factors

Contributing psychological factors may include:

• low self-esteem
• negative body image
• perfectionism
• depression
• anxiety or difficulty coping with stress
• impulsivity
• obsessive thinking
• difficulties expressing emotions.

If you think you have an eating disorder

If you think you may have an eating disorder, it is important to seek help and to reach out as early as possible.

Getting professional help and support from others is important. Recovery looks different for everybody, but recovery is possible.

Family and friends of someone with an eating disorder

Parents, siblings, partners, friends, extended family, work colleagues and others who are providing care or support a person with an eating disorder can also be impacted by the eating disorder. Eating disorders work to isolate people from their loved ones and the journey of recovery can be difficult for everyone.

There may be feelings of confusion, grief, anger, guilt and fear. While these feelings are completely normal, carers and support persons need to remember to take time out for themselves to restore energy. Seeking support and looking after yourself will also make you better able to support your loved one.

The most important thing is to show love, care and faith in the person, and seek professional support at the earliest possible time.

Some suggestions for family and friends include:

• Find out as much as you can about the eating disorder to help you understand and support your loved one.
• Be honest and open about your concerns.
• Calm, clear, concise communication is the best approach with everyone.
• Use 'I' statements rather than 'you' statements. For example, say 'I am concerned for you because I have noticed you don’t seem happy at the moment' rather than, 'You aren't happy at the moment'.
• Focus on the person's behaviour, rather than their weight/size, food consumption or physical appearance.
• Take care of yourself and seek support for yourself when you are feeling overwhelmed.

Treatment and recovery for people with eating disorders

Many different forms of treatment are available for eating disorders. It is important to remember that different approaches work for different people. Finding the right approach and early intervention maximises the likelihood of recovery. Professional help and support from others is important. A good place to start is making an appointment with your GP (doctor).

Because eating disorders affect people physically and mentally, a range of health professionals might be involved in treatment, including a GP, dietitian and psychologist or other mental health professional.

Where to get help

• Your GP (doctor)
• Your local community health centre or another health practitioner
• Dietitian
• Psychologist
• Eating Disorders Victoria Hub Tel. 1300 550 236
• Butterfly Foundation Tel. 1800 334 673
• Dietitians Association of Australia Tel. 1800 812 942