What are eating disorders?
Eating disorders are a range of conditions that can affect someone physically, psychologically and socially. They are serious mental illnesses and include anorexia, bulimia and binge eating disorder. Nearly a million men and women in the UK are affected by eating disorders.
Although serious, eating disorders are treatable conditions and full recovery is possible. The sooner someone gets the treatment they need, the more likely they are to make a full recovery where their lives no longer dominated by a fear of food.
Who gets eating disorders?
Anyone can develop an eating disorder, regardless of their age, sex or cultural background. Young women are most likely to develop an eating disorder, particularly those aged 12 to 20, but older women and men of all ages can also have an eating disorder. Children as young as seven can develop anorexia and there is a greater proportion of boys in this younger age group.
Eating disorders claim more lives than any other mental illness – one in five of the most seriously affected will die prematurely from the physical consequences or suicide.
Eating disorders are complex and there is no one single reason why someone develops an eating disorder. A whole range of different factors combine such as genetic, psychological, environmental, social and biological influences. A number of risk factors need to combine to increase the likelihood that any one person develops the condition.
What causes eating disorders?
A number of factors can contribute to causing eating disorders, and these can vary from person to person. There is world class research going on – much of it in the UK and involving collaborations with centres of excellence across the globe. The latest research is showing us that they are much more biologically based than was previously thought.
Eating disorders are complex and not everyone will experience the same symptoms. People will respond differently to treatment and can take different amounts of time to recover. Some people can be affected by more than one type of eating disorder or find their symptoms changing type as they recover.
Diagnosis of an eating disorder
Doctors and healthcare professionals use internationally agreed criteria to make a diagnosis of an eating disorder. Diagnosis is usually essential to be able to access treatment. Diagnosis is made by ‘taking a history’ which means talking to the person, rather than just by physical tests or medical checks.
The two main classification systems are the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). Both cover eating disorders and are very similar in the criteria they use. The DSM is used more frequently in the USA and the latest version was published in 2013 is DSM-5.
The main eating disorders listed in the DSM-5 are anorexia, bulimia and binge eating disorder (BED). The next version of the ICD is due to be published in 2017 and is likely to include binge eating disorder as a separate eating disorder as DSM-5 has done.
Do You Have An Eating Disorder?
Eating disorders can affect anyone. Boys, girls, men and women from all backgrounds, ages and ethnic groups can be affected by eating disorders.
Eating disorders are mental illnesses and can be a way of coping with feelings or situations that are making you unhappy, angry, depressed, anxious or worried.
Eating disorders are complex; there’s no single cause and not all symptoms will apply to all people. You may feel that you have a mixture of anorexia, bulimia and binge eating disorder or even alternate between them. Some people also find they are affected by other mental health issues, an urge to harm themselves or abuse alcohol or drugs.
Even if you don’t have these symptoms if you are worried and upset by something, anything, it is important you find someone to talk to. Don’t bottle it up.
Sometimes people worry about talking to someone because they feel their eating disorder isn’t serious enough, they don’t want to worry people or waste their time, or because they feel guilty, embarrassed or ashamed. Whether your eating difficulties began recently, you’ve been struggling for a while or you’re finding yourself relapsing, you deserve support and with this support you can overcome your eating disorder. Eating disorders are illnesses and you deserve to have your concerns acknowledged respectfully, to be taken seriously and to be supported in the same way as if you were affected by any other illness.
Help and Treatment
It is usually very difficult for people with eating disorders to get better on their own. It is important that you find professional help and support as soon as possible.
Treatment for eating disorders
Recommended treatment for an eating disorder differs depending on your diagnosis as follows:
Treatment for Anorexia
You should expect that most of your treatment will be as an outpatient and any psychological treatment should last for at least six months. If you are thought to be at serious risk your GP might recommend inpatient or day patient treatment.
Psychological treatments such as cognitive behaviour therapy (CBT) are some treatments that you might be referred to once diagnosed with anorexia. They aim to help psychological recovery and you should expect that aspects of your physical health should be monitored at the same time. You might also have access to a specialist to give you advice about diet and food but this shouldn’t be the only treatment you’re offered. You may be prescribed medication for anorexia as a part of your treatment plan. Make sure your doctors tell you about any side effects the medication might cause and make a note of them on your medical records.
Inpatient treatment is offered to patients of anorexia if your physical health is very poor or your team think that you might be at risk of harming yourself in some way. If you’re in outpatient treatment and have either not improved or your illness is getting worse, inpatient care may also be recommended. Inpatient treatment is likely to be located further away from your home than outpatient treatment but it should be within reasonable travelling distance.
Treatment for bulimia
Cognitive behavioural therapy (CBT) is often offered to those who do not find self-help treatment works for them. Treatment should comprise of up to 20 sessions and last for around four or five months. The other psychological treatment recommended in the NICE guidelines is interpersonal therapy (IPT) which should follow CBT if unsuccessful or you would prefer to follow this line of treatment.
Medication can be offered alongside a programme of self-help or talking therapies to supplement these treatments if necessary. They can help you to reduce the number of times you are bingeing and purging.
In the majority of cases all treatment for bulimia will be as an outpatient but if your physical health is of concern or you are at risk of hurting yourself, inpatient treatment might be suggested.
Treatment for binge eating disorder
Psychological treatment such as CBT can be very helpful. Medication is also sometimes recommended as an accompaniment to therapy. Similar drugs used to treat depression might be suggested by your doctor. Sometimes this alone can help to reduce the behaviour patterns associated with binge eating disorder.