General Information

Definitions of Eating Disorders

Eating disorders affect about 1-3% of women and girls. This means that 3 out of every 100 women are struggling with this problem. Although eating disorders are much more common in women, men also develop these disorders. The course of an eating disorder is highly variable. Some people have disordered eating at one point in their lives and then achieve a full recovery. Other people have recurring episodes of disordered eating, especially during times of stress. Finally there are some people who struggle with disordered eating every day for many, many years. People are at different stages in their readiness to deal with their eating disorder and more or less resistant to discover the role of the eating disorder in their lives.

WHAT IS ANOREXIA?

Only a trained professional can diagnose Anorexia, but the following information will provide an overview of the symptoms a professional would look for:

To be diagnosed with Anorexia, a person must experience the following symptoms:

• Fear of weight gain
• Body image dissatisfaction
• Extremely low body weight
• Three consecutive missed menstrual cycles

Anorexia checklist:

• Do you have an intense fear of weight gain?
• Do you feel and overwhelming need and drive to be thin?
• Do you need to be thin to feel good about yourself?
• Do you perceive yourself as fat even though others do not think you are?
• Have you missed three consecutive menstrual cycles? This criterion does not apply to males, females who have not had their first period, post menopausal women, and those taking birth control pills.

There are two types of anorexia: restricting versus binge-purge type

PHYSICAL EFFECTS OF STARVATION:

• Hair falls out in large clumps
• Wounds are slower to heal
• Muscles cramp and ache
• Protruding bones make sitting painful
• Pulse rate decreases
• Cold temperatures become intolerable
• Sex drive diminishes
• Irregular or absent periods/menstrual cycles
• Lanugo – a baby fine hair growth, especially on the face
• Weakness/fatigue
• Dizziness
• Irregular heartbeats
• Dry skin
• Frequent constipation
• Edema (swelling/water retention)
• Cold hands and/or feet

PSYCHOLOGICAL EFFECTS OF STARVATION:

• Diminished social interaction
• Irritability
• Depression
• Anxiety
• Depression
• Low mood
• Poor sleeping pattern
• Poor concentration
• Feelings of worthlessness
• Feelings of hopelessness
• Suicidal feelings
• Social anxiety
• Increased worries
• Panic attacks
• Mood swings
• Difficulties with judgment and decision making
• Preoccupation with weight, shape and food
• Decreased self esteem
• Self-harm behaviours
  

Purging can lead to:

• Frequent dental cavities
• Sore, burning mouth or throat
• Chest pain
• Frequent heartburn
• Enlarged, swollen and/or infected salivary glands

WHAT IS BULIMIA?

Bulimia involves the following symptoms:

• Regular episodes of binge eating
• Eating binges that are followed by compensating behaviours to prevent weight gain (vomiting, laxative abuse, over exercise and fasting)
• Self evaluation (how you feel about yourself as a person) is largely determined by shape and weight

The use of appetite suppressants and other slimming products are also compensatory behaviours which are directed at weight loss. Many of these products contain ephedrine, an amphetamine-like substance that can have harmful; side effects on your nervous system and heart, including increased blood pressure, rapid heart rate, nerve and muscle damage, stroke, memory loss, seizures, heart attacks, anxiety, psychosis and death. People who take these products feel revved up, jittery, anxious and may have trouble organising some of their thoughts.

Compensating behaviour checklist:

• vomiting
• laxatives
• diuretics
• enemas
• diet/cleansing teas
• excessive exercise
• restricting calories and avoiding certain food types
• fasting
• appetite suppressants
• chewing food and spitting it out

A person is diagnosed with bulimia if the binge eating and compensatory behaviours occur on average at least twice a week for at least three months.

CONSEQUENCES OF BULIMIA

Physical complications of purging

• Electrolyte imbalances
• Potassium deficiency
• Dehydration
• Water retention
• Menstrual irregularities
• Fatigue and headaches
• Osteoporosis
• Parasthesias (tingling feelings in your hands and around your mouth)
• Heart irregularities that can result in death
• Gastrointestinal complications
• Vomiting blood
• Esophageal tears
• Swollen salivary glands
• Reflux
• Kidney complications
• Dental problems
• Constipation and bowel obstruction

Psychological complications

• Depression
• Low mood
• Poor sleeping pattern
• Poor concentration
• Feelings of worthlessness
• Feelings of hopelessness
• Suicidal feelings
• Social anxiety
• Social isolation
• Increased worries
• Panic attacks
• Mood swings
• Irritability
• Difficulties with judgment and decision making
• Preoccupation with weight, shape and food
• Decreased self esteem
• Self-harm behaviours
• Drug use and abuse
• Alcohol use and abuse
• Shoplifting
• Excessive shopping
• Risky sexual behaviours
  

While someone may not meet the full diagnostic criteria, they may still have a serious eating disorder. Also important to note are sub-clinical eating disorders, which are those eating patterns which cause distress and concern in a person’s life but which may not meet all the diagnostic criteria. These fall into the category of:

EATING DISORDER NOT OTHERWISE SPECIFIED

This category includes people with many different combinations of symptoms:

• All the criteria for anorexia are met, except that the individual menstruates regularly
• All the criteria for anorexia are met, except that the individual's weight is in the normal range
• All the criteria for bulimia are met, except that binge eating occurs less frequently than twice a week
• An individual who repeatedly chews and spits out, but does not swallow large amounts of food

BINGE EATING DISORDER

Recurrent episodes of binge eating

Binge eating is characterised by:

• Eating in a discrete period of time, an amount of food larger than what most people would eat in a similar period of time
• A sense of lack of control over the eating and the ability to stop eating
• Eating much more rapidly than normal
• Eating until feeling uncomfortable full
• Eating large amounts of food when not feeling physically hungry
• Eating alone because of one's embarrassment of how much one eats
• Feeling disgusted with oneself, depressed and guilty after overeating
• Marked distress regarding binge eating
• Binge eating occurring at least an average of two days a week for six months
• The binge eating is not associated with regular use of inappropriate compensatory behaviours (e.g. purging, fasting, excessive exercise and does not occur exclusively during the course of anorexia or bulimia.

FUNCTIONS OF EATING DISORDERS

An eating disorder may play many roles in one's life and may work to serve one or more of the following functions:

• helps you to cope with negative thoughts and feelings (depression and anxiety)
• relieves or manages stress
• protects your self esteem
• controls your weight
• suppresses traumatic memories
• helps you feel in control
• helps you hold your family together
• gives comfort
• helps you receive attention from family members or friends
• gives you a unique identity
• gives you time for yourself
• relieves boredom
• helps you to deal with anger by channeling emotion inward
• allows you to procrastinate on overwhelming tasks
• it feels familiar (companion, habit)
• helps you strive for perfectionism
• focuses and distracts you from more difficult issues
• acts as an excuse for failed expectations
• gives you discipline/punishment (I don’t deserve to eat”)
• gives you momentary freedom (play, escape, high, temporary amnesia)
• numbs your emotions
• buffers your relationships (removes emotions)
• purging allows you a perception of normalcy-allows for “normal eating”
• acts as an excuse for escape from daily stresses
• helps you fit the ideal of society
• gives you a sense of accomplishment