Eating Disorders Information
What is Anorexia Nervosa?
Anorexia involves restricting the amount of food eaten because of a strong desire to lose weight. People suffering from anorexia experience an intense dissatisfaction with their body’s appearance, shape and size. They will skip meals and reduce the range and amounts of food they eat, becoming preoccupied with food, nutrition and calories, whilst denying hunger pangs. Some people with anorexia also over exercise, make themselves sick and/or take laxatives due to an overwhelming need to get rid of what has been eaten. In girls and young women, if their periods had started before developing anorexia, they may stop.
Anorexia can affect people in many other ways including:
Physical changes – problems with sleeping, feeling weak, cold and dizzy, constipation, diarrhoea, bladder problems, damage to tones and internal organs, hair loss, dry skin, increase in fine body hair.
Changes in Behaviour –people may become withdrawn from friends and family, feel lonely and no longer take part in activities they used to enjoy. Anxiety and preoccupation about eating can cause people to lie about eating, hide food, eat in secret, choose only low calorie foods and develop rigid daily routines. There may be lots of arguments around mealtimes, some family relationships may become strained and break down and the person may be irritable and moody. It may become difficult to concentrate on schoolwork
Psychological changes (Thoughts and Feelings)– seeing themselves as fat despite having lost an unhealthy amount of weight; being extremely fearful and ambivalent of returning to a healthy weight; low self esteem; being self-critical and feeling sad and worried
Who suffers from Anorexia Nervosa?
Anorexia is more common in females and usually develops between 15 – 25 years of age, however it can occur in younger ages and in boys. People from all backgrounds can suffer from anorexia.
Why does Anorexia develop?
There is no single answer to this question but anorexia is only partly about wanting to lose weight. For each person the difficulties and challenges they face will be different. For many it develops at a time of change, and can be associated with feelings of anger, anxiety, guilt or sadness, which can lead them to feel out of control. Through individual and family therapeutic work, it is hoped they will develop a better understanding of what has contributed to the problems they are experiencing.
Can children and young people overcome Anorexia?
Yes – many people will recover from anorexia but this can take a long time.
Bulimia Nervosa and Binge Eating Disorder Information
What is Bulimia Nervosa?
Bulimia Nervosa involves binging and purging. Binging is characterised by overeating large quantities of food that is considered more than others would eat in a fairly short period of time (e.g. 2 hours). With this comes a sense of a loss of control, shame and guilt about what has been eaten followed by an attempt to compensate for the binge through purging. Purging can include a number of ways to try and get rid of what has been eaten e.g. self-induced vomiting, laxatives, diuretics and over exercising and fasting. In order to be categorised as Bulimia Nervosa the Binge-Purge cycle has to be present at least once a week for a minimum of three months and be coupled with an over evaluation of shape and weight when defining the self. Often weight appears normal as the binge-purge cycle may prevent excessive weight loss. However Bulimia Nervosa can affect people in many other ways
Glands in the cheeks (parotid glands) become swollen due to excessive purging, dizzy, feeling tired and weak, irregular periods, fainting, hair loss, dry skin, abnormal blood chemistry, erosion of tooth enamel, bowel problems and possible serious damage to organs.
Changes in Behaviour
Withdrawal from friends and family as preoccupation with shape and weight increases, hoarding food, hiding of compensatory behaviours e.g. hiding vomit and laxatives, excessive exercise, regular visits to the toilet to self-induce vomiting, regular increases in checking body shape or weight e.g. mirror checking, or avoidance of looking in the mirror or getting on scales due to fear or shame, family relationships may become strained owing to the preoccupation with shape and weight as the individual becomes moody and disengaged.
Psychological changes (Thoughts and Feelings)
Thoughts about being out of control around food and hatred for body, feeling shame and guilt for binging, high levels of distress owing to the preoccupation with shape and weight, distorted view of body shape or weight and changes in personality and mood such as sadness and increased anxiety.
Who suffers from Bulimia Nervosa?
Bulimia often has an onset of late adolescence into early adulthood although this can occur at an earlier or later age. Females and males of all background can suffer from Bulimia Nervosa.
What is Binge Eating Disorder?
Binge eating disorder similarly to Bulimia is characterised by overeating large quantities of food that is considered more than others would eat in a fairly short period of time (e.g. 2 hours). With this comes a sense of a loss of control, shame and guilt about what has been eaten and often high distress. There is absence of purging in binge eating disorder but again the binge has to occur at least once weekly for a period of three months to be considered as Binge Eating Disorder.
There are other eating difficulties that may cause as much distress but do not quite fit into the categories above. This may be when excessive weight loss has occurred but the weight is still within the normal range so does not meet the criteria for Anorexia Nervosa. Or when compensatory behaviours such as vomiting does not occur as regularly as once a week to be considered Bulimia Nervosa or perhaps excessive weight loss is present and but there is no preoccupation with shape and weight. These difficulties have been considered as eating difficulties in their own right that may require therapeutic support. Binge eating disorder and other eating difficulties such as those outlined above can affect people in many ways similar to those outlined for Bulimia and Anorexia
Why do eating difficulties develop?
There is no single answer to this question but often eating difficulties are only partly about wanting to lose weight. For everyone the difficulties and challenges they face will be different. For many it develops at a time of change, and can be associated with feelings of anger, anxiety, guilt or sadness, which can lead them to feel out of control. Through individual and family therapeutic work, it is hoped they will develop a better understanding of what has contributed to the problems they are experiencing and how to manage the difficulties so they have less of an impact on life.
Can people overcome Bulimia and other eating difficulties?
Yes many people recover but it can take time.
What help can our Practice offer?
Whilst support from family and friends can really help, help from professionals is also usually needed.
- We have a number of experienced psychotherapists, psychologists and CBT therapists who are experienced in working with young people, their families and adults with eating disorders.
- We also have a small outreach team who can offer home visits, advice and support on eating plans and re-feeding.
- We can help and advise parents and partners on how best to help their family member recover. Family work has a strong evidence base for restrictive eating disorders in children and young people.
- We offer individual psychological therapies. This may involve approaches such as Motivational Work, CBT or Psychotherapy.
- CBT has been evidenced to be successful in treating Bulimia Nervosa and Binge Eating Disorder and food phobias.
- We liaise closely with GP’s and advise on physical monitoring. We don’t work with people in the community with a BMI of less than 16 – and would advise referral to local NHS services at this point.
Bryant-Waugh, R. & Lask, B. (2004). Eating Disorders: A parent’s guide (2nd Ed.) Abingdon: Routledge
Orbach, S. (2002). Susie Orbach on eating, London: Penguin.
Treasure, J. (1997). Anorexia Nervosa – a Survival Guide for Families, Friends and Sufferers, Hove: Psychology Press
Cooper, P. (2009) Overcoming bulimia nervosa and binge eating. London: Robinson.
Fairburn, C.G (2013) Overcoming binge eating (2nd Ed.)New York: The Guilford Press.
Schmidt, U. & Treasure, J. (1993). Getting better bit (e) by bit (e): a survival kit for sufferers of Bulimia nervosa and binge eating disorders. Hove: Psychology Press