Foreword b) About the author
c) Tips on how to use this guide d) Terminology
a) Our relationship with food
b) History of problem eating - an overview
c) Overcoming ignorance and offering hope
a) Understanding anorexia
b) More practical ideas for understanding anorexia
c) Diagnosis and symptoms of anorexia
a) Understanding bulimia b) Diagnosis and symptoms of bulimia
a) Treatments
b) Other forms of
I am a high school student currently in my junior year, passionate about raising awareness around eating disorders in my community. As a mealtime volunteer at St. Mary’s Hospital in London, I have firsthand experience with individuals struggling with these disorders. Additionally, I frequently collaborate on research projects with top universities across the UK to deepen my understanding and educate others about this critical issue.
I believe that eating disorders are often overlooked and misunderstood due to the stigma surrounding them Many people mistakenly believe that problem eating is voluntary, done for attention, or simply a matter of not wanting to eat. Through this guide, I aim to shed light on the realities of living with an eating disorder and challenge these misconceptions.
I am always open to discussing any questions you may have about eating disorders, so please feel free to reach out if you would like to learn more In the future, I plan to major in neuroscience to explore the complexities of the human brain and its physical and chemical effects further. My ultimate goal is to pursue a career in this field and find effective ways to mitigate the impact of eating disorders on our society.
I crafted this study guide to help you. I don’t know who you are, where you come from, or what background you have, but I know you are young and have struggled with something at some point in your life. Now, it is wrong for me to assume that - although I have yet to encounter someone completely content with their past - but if you claim to be in that position, this study guide remains relevant to you. My mission is to educate you on what the rest of the population may be going through, sharing how eating problems are often overlooked or generalised. Maybe helping you discover that the reason your best friend couldn’t come that day was not because their parents didn’t approve. There might be underlying factors at play, and I’m here to assist you in recognizing and addressing them.
The human brain is marvellously complicated; even calling it complicated could be a very restrictive way to put things, but the infinite number of ways that this vital organ functions is overwhelming, and it is something that occupies my mind every single day. Through the realm of these pages of compiled hard work, I hope to deliver my ongoing passion to you; I will help you facilitate your exploration and learning journey, preventing future generations from becoming ignorant of what young minds are battling these days: whether it is sorting inner dynamics, familial bonds, fostering friendships, or helping heal others’ relationships through informative insights.
Moreover, I tried to make this guide your haven: a space where you can feel understood while gaining valuable knowledge. There are many informative guides on the market exploring these topics, but I made this one special through its design, contents and hours of work put into it Feel free to read it however you like: take notes, annotate the margins, and make it yours! Flick through the pages, find the topic that you want to know more about, and read it from beginning to end, end to beginning, it is entirely up to you Much like the intricacies of the human brain, the possibilities are limitless! Create your routine and adapt your learning to your style or needs I want this to be as comfortable as possible for you
I do want to add that my ultimate goal was to reach as many people as possible, so I hope that the accessibility of the guide will help with that To ensure its reliability and depth, I did a very substantial amount of research: research based on secondary sources such as articles and case studies, but also primary research on interviews and anonymous forms so that you don’t have to Everything you require has been meticulously gathered and organised within this single creation
As a disclaimer, this guide is not for diagnosis and is in no way, shape or form an expert’s professional view Please, if you or someone you love is in danger, contact emergency services and seek professional help immediately I i;s essential to recognise when professional intervention is necessary for proper treatment and care At the end of this guide, you can find emergency contacts or spaces where you can learn even more about mental disorders.
Finally, I want to express my heartfelt gratitude to you. I don’t know who you are, where you come from, or what background you have, but I know that by just picking up this guide, you are actively doing something noble for yourself or someone you love. Enjoy!
Below are some tips that you may want to take into consideration when flicking through the study guide. Of course, you do not have to follow them, but I believe they would be useful in having a much more pleasant experience, helping you make the most of your learning:
Choose a suitable time of day and location for when you are reading this guide.
Do avoid reading before bed, or when you are alone, in case this could bring back or trigger unpleasant memories
Do annotate, highlight, and keep the information or concepts you think you may want to remember or look back on.
After each reading session, try to wind down and do something you find relaxing.
Let it be an activity not too over-stimulating and pick something that would allow you sit with your thoughts and reflect on what you have read.
The term “problem eating” may be unfamiliar to some people, and you may have picked this guide already knowing what it is, or you want to know what it is Either way, it is important that we clearly understand its meaning “Problem eating” is a term which encapsulates any negative thoughts towards food. As innocent as they might be or as severe, they all fall into this category Itistheinabilitytohavethatfoodfreedomyouhadasa young child when eating an entire tub of ice cream was your dream and was in no way something to be worried about. Problemeatingcouldhavemeaningtothingsunrelatedtoeating atall Suchaseatingatafixedhour,eatingwithaspecificutensil, having a “meal plan” that you ought to stick to, and the list continues It is that thing that stops you from living your life because your brain is trying to control your food intake or simplytheexperienceinsomeshapeorform
Something which is often overlooked and not many people know about is the difference between disordered eating and eating disorders Eating disorders are the result of disordered eating and are found at the extremity of the risk spectrum Disordered eating is common in the cases of athletes striving for a certain weight to qualify for a competition, brides losing a few pounds to fit in their wedding dresses or altering weight to decreasetherisksofanimportantsurgerycomingup.
These are all examples of disordered eating When the goal is achieved,somepeopleforgetabouttheirlifestylechangesandgo backtotheirbalanceddietwhilesomecontinuetopracticethese disordered habits, becoming the victims of psychological effects, wheretheyoughttoreceiveprofessionalcare
These effects link to 4 main feelings that the person wants to experience: comfort, celebration, reward, or punishment. Whatever the victim desires will provoke them into creating disordered decisions around food Their actions release endorphins,dopamineandotherchemicalsthatresultinfeelings ofwell-being,temporarilyalleviatingstressandpain
Eatingdisordersaresodangerousbecausetheyaffecthowweare physically, mentally, emotionally and behaviourally. Something importantisthateatingdisorderscouldaffecteveryone,however there are groups of people more at risk than others: females, adolescents, perfectionists, those who are competitive, worry about others’ opinions, have poor coping strategies, and those under intense pressure to succeed, have family members with eating disorders, promotion of dieting in your surroundings, having suffered trauma, confusion around sexual identity, and the list continues The science behind eating disorders is based onthe“feastingandfasting”concept Thisalterationbetweenthe two leads to changes in the dopamine receptors, so it is almost like developing an addiction, in this case, not around drugs or alcohol,butaroundfood
Theoddthingaboutfoodineatingdisordersisthatitisboththe problemandthesolution
Today, we are all faced with the challenge of making a choice. Humans have developed so much, that we have access to all types of food all year round That means that we are exposed to this overwhelmingly complex list of choices, making us doubt whether we have chosen the right one. That causes us to check the nutritional information section, starting to consider calorie labels and macronutrient scores Without even knowing it, we fall prey to the eating disorders. For example, yes soya is great! Butweshouldinnowayreplaceeverythingelseinourdietwith it True,itisrichinproteins,soitwouldbeaperfectadditionto ameal,butover-consumingitwilldepriveusofthekeyminerals and nutrients that other foods offer us. Imagine a world where there was no advertisement for the foods that you have in your fridge Woulditscontentsdifferinanyway?Mostprobably,yes
I want to tell you right now that these videos are highly unrealistic and most of the time far from reality, but it is sometimesdifficulttorealisethatonourown Istillstrugglewith this myself, and if you do as well, I advise you from taking a break from social media It could promote your well-being significantly There is hope, however, as there has been a significant increase in body-positive influencers and their comebackatdietculture,promotingpropernourishmentandcarefor ourbodiestofunctionaccordingly
Moreover, our choices are impacted by the way these products are promoted TV commercials, YouTube ads, and influencer sponsorshipsallaredesignedtoinfluenceourchoicesbymaking us believe that their food item is all that we have been missing We listen and we purchase Ironically enough, foods that have lately been labelled as “superfoods” are causing malnourishment, duetoourconsumptionofthemandthemonly.
I think we are all familiar with the introduction of “the meal deal” where a very nutrient-packed whole-meal sandwich has been paired with a bag of crisps and a sugary drink for a much cheaperprice That,ofcourse,isattractive,becauseyougetyour money ’ s worth, but this is not necessarily a healthier option Conversely, it is the opposite. This is evidence of how societal changes impact our food intake in so many ways Another example can be the increasing popularity of microwaves and air fryers or other quick and easy-to-use appliances All these cause ustobecomevictimstothe3-minutepre-preparedfrozenmeals that they sell for very cheap prices This leads to a decrease in wholesome, home-cooked meals, leading to unhealthy and imbalanceddiets,inducingproblemeating.
A topic that I wanted to approach was food culture and the media I will not sit here and say that the media is the main reason why eating disorders are peaking now, but it has had a huge impact on new generations and how they view food The size 0 models online, exposing their “what I eat in a day” videos, alongwiththeirso-called“advice”onhowtoloseweightfastand easily, are all very harmful to us Also mentioning their video intros of showing their flat stomach bodies create this idea of “if youea
All these factors are reasons why somebody may fall prey to an eating disorder, but to summarize, problem eating can also be caused by genetics and hormones, environment, life events or society and culture Keep in mind that this is just an overview, anditiscrucialtorememberthatthereisnoconcretereasonfor problem eating It can be labelled as a complex combination of mentalorphysicalfactors
Mostimportantly,rememberthateverysituationisdifferent.
Problem eating is not a new concept and has been around for a really long time In fact, scrolls and hieroglyphics from ancient times,containevidenceofnegativebehavioursandideastowards food,suchaspurgingorself-starvation
During those times, it was incredibly popular to religiously fast, leading to what we call today anorexia nervosa (which we will explore later on) It is important to add that both males and females were victims at the time In fact, a concept of anorexia mirabiliswassomethingthathasbeenrecentlydiscoveredtohave beenanissueintheearlyages Itentitlestheideaofamiraculous loss of appetite, acting as a symbol of purity and holiness This of course led to frequent premature deaths. Their efforts were to provethattothem,thespiritwasmoreimportantthanthebody Although there are different reasons for which eating disorders are developed nowadays, all circle around the yearn for selfcontrol Whetheritistolookacertainway,orproveapoint,itall leadstothesimilar,ifnotidentical,consequences
Bulimiahasalsobeenaroundforawhile.Itisbelievedthatitwas first introduced in Rome when they used the “vomitorium” approachinordertoeatasmuchfoodaspossibleandenjoyevery single dish It consisted of eating until you were full, to then induce vomiting and consume even more food. Many people sufferedfromthisdisease;infact,princessDianaclaimedtohave hadissuesherself,whichraisedawarenesstothepublic
Anorexia Nervosa, first labelled as “anorexia hysterica” by Queen Victoria’s physician, was actually a disease that included women only, hence the name change Binge Eating disorder is mostly having to do with greed and inability to control yourself when having a meal. It often includes incredibly voluminous intake of foodsinveryshortperiodsoftime followedbyguilt Thiswasnot classified as a distinct eatin thankfully has happened, sin treatment
Pica disorder is when some regular basis In some culture or other earthy substances, in This is not considered to be p toaddthatthereislittleevide
Avoidant restrictive food inta in young children and is often which most surpass Howeve food groups due to their tex occurrence and a habit in o become diagnosed It has been commonly in children whos processofdevelopment.
For the purpose of anyone s around food but are not ti certified disorders, this cate examplecouldbesomeoneth aweightduetoextremerestri heightandgender Theymeet with anorexia, but since they cannotclassifyinthiscategory
Unspecified feeding or eating be diagnosed into one concre they are also referred to as ne orthorexianervosa,bigorexia,
Pregorexiaisoneothereatingissuewhichisevidenttobemetin pregnantladieswithanextremefearofgainingpregnancyweight Thiscanleadtosevereconsequencesforthemother,butthechild as well. Causes include genetical predisposition, as well as chemicalandhormonalimbalances
Eating disorders are incredibly impactful on sufferers They invade their lives and takeover their minds with greed and zero mercy Without question, the sufferer is the one that experiences mostsevereimpact;however,theirfamily’sstrugglesaredefinitely underrated
To help you grasp the idea of what it can feel like to have someone you love struggling with such an issue, it is like constantly walking on eggshells in your own home. Any sort of discussion regarding food, weight or getting back on track leads tosomesortofdisagreementortantrum
Something like an eating disorder puts on hold family outings, having people over, going on vacations or just living your everydaylifeandworkingtowardsyourowngoals Itisdefinitely a mental illness which is arguably most severe, as it takes over your entire life Therefore, in the UK, there are countless services andhelplinesthatareaccessibleandfreeofcharge
My family did not know anything about eating disorders before wehadtogothroughitourselves,andalthoughIamashamedto say it, we probably would have ended up having similar beliefs about this struggle Therefore, what I wish from the future is for people to become educated on the topic without having to go throughitthemselves
As mentioned earlier, there are so many facilities for people struggling with eating disorders and there is so much help available,howeveralthoughitisnotthebestthingtosay,itisthe brutalrealitythat“specialists”oftheseorganisationsarenotinfact properlytrainedforwhattheyaredoing Ofcourse,takethiswith apinchofsalt,anddoseekhelpifyourequireit,butIoftenheard storiesaboutpeoplethathadgonetotheirGPonlytohavebeen turned down because their BMI was not “unhealthy” or they shouldjust“gohomeandeat”
Tofixthis,specialistsmustbetrainedalotbetter,andIthinkthe topic of eating disorders should be even introduced in schools; either creating support groups to have lunch together, or educating every student on what this entitles There not being enoughawarenessrisen,sufferersgobytheprincipleof“notbeing sickenough”,whichshoulddefinitelynotbethecase Thedeeper yougetintoaneatingdisorder,theharderitistoescapeit Ifyou go to the doctor for smoking problems, they will not send you away because your lungs are “not damaged enough”, right? Then whydoesthishappenwitheatingdisorders?
Moreover, people struggling with a similar issue to you create regular meeting times and discuss about their feelings openly Thisisincrediblyhelpful,butsuchservicesarenotverycommon internationally IfyoudonotlikeintheUK,theUSA,oratleasta developed country, it is highly unlikely for you to find services that are available to you A solution could be doing them remotely,acrosscountries,sotherearealwaysoptionsandthereis noneedfordiscouragement
Unfortunately, the people around us are highly uneducated on the topic of eating disorders So many still believe that having an eatingdisorderisachoice,alifestyleyouarewillingtohave,alack of self-control or a desperate want for attention This, of course, could not be further from the truth and us, an educated and informedgeneration,shouldraiseawarenessevenfurther.
Tofixthis,specialistsmustbetrainedalotbetter,andIthinkthe topic of eating disorders should be even introduced in schools; either creating support groups to have lunch together, or educating every student on what this entitles. There not being enoughawarenessrisen,sufferersgobytheprincipleof“notbeing sickenough”,whichshoulddefinitelynotbethecase Thedeeper yougetintoaneatingdisorder,theharderitistoescapeit Ifyou go to the doctor for smoking problems, they will not send you away because your lungs are “not damaged enough”, right? Then whydoesthishappenwitheatingdisorders?
Eating disorders can definitely be treated, with proper care, love and,ofcourse,nourishment
Therefore, a suffering individual can go back to living a normal life after they have struggled However, although organ function, bodyweightandrelationshipwithfoodisfixed,thereisapartof our brain – insula, that remains affected When depriving the body of food, this part of the brain (responsible for perceiving taste, controlling anxiety, receiving hunger and satiety cues) shrinks and is damaged, having the inability to return to normal andthereforebeingpassedontofuturegenerations.
Iwanttowrapupthissectionbytellingyouthatthereishope!
Many doctors have proven that the earlier you get help, the easier the recovery will be, and although eating disorder rates have significantly increased during the 21st century, the people coming forward and claiming to have struggled at some point, has increasedaswell Thatisproofthatyouarenotalone,andthereare so many people ready to help you. What I found helpful was following people online going through the same exact problem Many youtubers and Instagram users share their stories and h h d f l d d ke sure to give their yasafespaceforyou
some of my favourite
Anorexia nervosa is a mental illness that is composed of an extreme control of appetite Common sufferers are adolescents; normallyfemales,butcanalsobemales,bothofallages Itisoften found in people that are high-achievers and perfectionists, sensitive to criticism and life changes It is common for anorexia toappearintheirlivesduringunpredictabletimeswheretheyare incrediblyoverwhelmedandfeeloutofcontroltowardstheirlife decisions, hence why they start taking it towards their food intake Although these are the most common reasons, it is important to remember that every person experiencing this mentalillnessisdifferentandcanhavecompletelyuniquemotives forwhichtheyhavereachedthispointintheirlives
Some include looking more attractive, receiving admiration for their willpower towards restriction, feeling unworthy and shrinkingthemselvesdespitehavingastrongdesiretodisappear
It must be kept in mind that the initial admiration that they receive from those around, for perhaps looking more toned despite losing a few pounds, is just feeding their anorexic voice, leading them to continual downfall Therefore, if someone ’ s weight fluctuates, try not to mention it admiratively. Be precautious and make sure they know you are there to support them There is a quick escalation in the choices made by people that suffer from anorexia, the deeper they are into the disease This means that they are less likely to make rational decisions in regardtotheirhealth,whichisknownasvolitionattrition
People struggling with anorexia are under the influence of what we call “the anorexic voice” This is the “voice” in their heads that leads them to take irrational decisions about their health They often create weight goals, unhealthy habits, or calorie limits, becoming obsessed about food Once their goals are reached (eg acertainweight,acertainnumberofcaloriesinaday),newgoals are created, but the enemy is never satisfied It is a vicious cycle thatwecanonlypreventbytacklingtheproblemearly.
Secrecy and social isolation – People who suffer often drastically changetheirpersonalities Alltheystarttocareaboutishowthey lookorhowmuchtheyareeating,startingtobecomeselfishand ignorant This leads to habits such as lying to loved ones about their food intake, hiding it, or in worst cases even throwing it away This leads to a strict avoidance of social gatherings and interactions with friends They start to view these events where food is involved, as others’ efforts to make them gain weight, which, of course is irrational They end up staying alone, their onlycompanionleftbeingthatanorexicvoice.
damaging voice, you should project their own voice Remind them of their talents, their goals, their achievements Let them realise that without health and proper fuel, they will lose all of those things The disparity between the two voices is the reason why we refer to them as “sufferers of anorexia” rather than “anorexics”
p y y p y , whilst the anorexic voice is permanently there Inducing a challenge against the sufferer’s will, is going to lead to nowhere sincetheywillfindotherplacestorestrictfrom,inorderto“make up”forit
Beforeconfirmingthatsomeonestruggleswithanorexia,thereare manythingstoconsider.
Therefore, simply seeing a very underweight individual, does not meanthattheystrugglewiththismentalillness Forexample,they canhavehealthconditionswhere,despitehavingbalancedmeals, they do not have the ability to get the required nutrients, having notime/resourcestocook,etc
Thesepeoplemaybeseverelyunderweight,butitisinnowaydue toastrongdesireofweightloss
In order to diagnose someone as a sufferer from anorexia, they shouldmeetallofthefollowingcriteria:
Intensefearofweightgain
Significantlylowerbodyweightthantheirheight,sex,andage ·Denialofthedangerstheyarepronetoexperiencingdespitetheir lowbodyweightandmalnutrition
Anorexia can be of two types: restricting type, and binge eating/purging type Restrictive anorexia is the most common type, and it involves extreme calorie restriction through odd habitsthattheindividualhasdevelo d Thi i l d i l a certain number of calories in a groups or colours from their diets problematic Iffacedwithconsumi sufferers will experience intense anorexiaislessfrequentandstillin atsomepointwhenstarvationfeels triggers strong emotions of guilt, overexerciseinordertocutthecalo
Warning signs and symptoms –symptomsfoundinsufferingindivi in late stages of the illness, so kee them:
Psychological signs: depression, acknowledge dangers associated w thoughts due to their errored escalation of obsessive behavio concentrating, low self-esteem irritability and sensitivity, perf relationshipsandsocialinteractions
Physical signs: weight loss, reductio anaemia, electrolyte and mineral d stomach pains, swelling of hands, f lips, brittle fingernails, poor circula reduced metabolism, bad breath vomiting, loss of teeth due to ja bloating,amenorrhoea(interrupted blood pressure and slow heart rat hair over body and face, loss of lib reducedimmunesystem,frailappea
Behavioural signs: repeated weigh eating in public, avoidance of c taking,laxativesorweightcontrol food, obsessive reading and w constant excuses to why they are tinypiecesbeforeswallowing,self-h baggy clothes, lying about weigh aftermealstogotothetoilet,prete over-exercising
Consumingsomanycaloriesinsuchalittleperiodoftime,leads to extreme discomfort, guilt and shame, which triggers their purging or excessive exercising habits, so that they dispose of the extracalories
Purging methods range from self-induce weight loss pills or diuretics. Self-induced v times a day in sufferers, or even a few time recognised by identifying bruised hands ca down the throat, yellow and sensitive tee vomit, as well as abnormal nerve and mus severedecreaseinelectrolytes
Laxativesareusedtoincreasethefrequency buttakingthemoverandoveragain,means to be increased in order to get the same ef getting used to the substances. Many laxatives contain the chemical phenolphthalein which damages blood cell production and damages bone marrow Sufferers also start to experience severe bloating and constipation due to the damage of the bowel muscles.
Psychological signs: include preoccupation with body size and weight, m control w experienci change, tr lowself-es
Finally, diuretics are like laxatives, but instead, they increase the frequency of urination. These are actually quite ineffective in weightloss,theconsequencebeingthelossofwaterthatthebody reallyneeds,whichcausesseriouskidneyproblemsanddizziness
Sufferersenteraviciouscycle:theyrestrict,theybinge,theypurge and so on. Supplying the food that they binge on is also an importantfactor,anditcanthereforebecomeverypricey Similar to drug addicts, sufferers can start stealing food or money from loved ones, but instead of drugs, the substance of abuse is food, whichisinnowayillegal.
Adiagnosisisgivenonlyifallofthefollowingcriteriaaremet:
-Repeated episodes of compulsive eating during very short periods of time, and feeling out of control when doing so This is knownasbingeing
-Acts of attempt to get rid of the extra calories consumed. (e.g. takinglaxatives,purging,diuretics,etc)
-Thetwoactsmustoccuratleastonceaweekforaminimumof threemonthstobeconsidered.
-The individual’s self-evaluation being based on their weight and appearance
-The disturbance does not occur exclusively during episodes of anorexia.
Physical s bleeding a tooth deca visiondist memory, but within pain, acid dehydratio
·Behaviour hesitance
hiding huge quantities of food, use of laxatives and diuretics, planning binges, disappearing straight after meals, spending considerable time in the loo, blocking lavatories and sinks, excessive use of air fresheners, disappearance of food, running outofmoneyduetoexcessivespendingforbinges,alwaysbeing surrounded by food k i f i f b clothes,eatinginsecre aboutbeinghungry,al
i.Understandingbingeeatingdisorder.
Binge eating disorder (BED) is a form of addiction to food, in which it is difficult to restrain oneself from eating. The main cause is normally low self-esteem, food becoming a substitute for certainemotionsthatarelacking Foodbecomestheonlyreliable source of temporarily relieving unhappiness and numbing the pain People suffering from this disorder will eat regardless of whether they are hungry or full This disorder is very similar to bulimia, but for this, there is no intention of compensatory behaviour(laxatives,diuretics,etc.).
Therefore, the weight of a person suffering from BED is often ranging from slightly overweight to severely obese A trait of sufferers is that they hoard food or hide it Unfortunately, the sufferers’ life starts to revolve around the idea of food. From the momenttheywakeuptothemomenttheyfallasleep,alltheycan doisplantheirbinges,orfixatetowardsitemsinthekitchen The craving for pushing down their emotions, can only be fulfilled once they consume the food, hence the consequences of this mentalissuearesevere
ThenumberofBEDcasesisveryalarming,intheUK,therebeing 12 million reported sufferers There is a very similar number of males and females that live with this illness, but women are slightly over This may be because of the societal expectations, whichmayleadtothembeingmorelikelyinreportingtheircases, skewingtheresults
BED is random and can affect anyone, of any age, although it is more common in adults than in young people It starts from feeling unworthy, so it is common in people that grew up overweight and bullied, food being the thing that they turn themselvestosothatitdecreasestheimpactoftheirfeelings Just likeanorexia,itcouldbearesultofgenetics
Nurture and development of BED is commonly found in individuals whose households promoted food as a way to show love, affection, and approval, hence the trait of feeling that you have to “deserve” food Moreover, in households where food is commonly used as a way to relieve boredom or sadness, or even whereitisusedasapunishment.This,again,makespeoplefeelas though they need to deserve food This is also common when peoplepromotedieting,weightlossandrestriction
BED has many harmful consequences. Since most of the population suffering from it is mostly obese, this illness comes withthecomplicationsfacedbysideeffectsassociatedwithit For example, type 2 diabetes, heart disease, cancer, sleep apnoea, high blood pressure, gallbladder disease, high cholesterol, adrenal exhaustion fatigue or osteoarthritis These risks are associated with physical wellbeing, but psychological ones are also major Theseincludeconfusion,lowself-esteem,guiltduetolackofselfcontrol,andincreasedsusceptibilitytodevelopingdepression
Sufferersstarttofeelasthoughtheycannotsocialiseanymoredue to their embarrassment and shame This causes them to selfisolate,whichisamajortriggerforcomforteating Thisgenerates theviciouscyclethatitisreallydifficulttogetoutof.
It must be known that BED is not an illness that all overweight people experience. People that are overweight may “binge”, in terms of having huge amounts of calories in one sitting, but they can be perfectly comfortable with that, therefore not experiencing guilt or shame However, not having the diagnosis and in result the psychological signs, this does not make them immunetoallthephysicalhealthrisksthattheyareproneto
It is important to know what small steps sufferers can take in ordertostarttheirjourneytowardsrecoveryandbuildahealthier relationshipwithfood Somestrategiesinclude:
Meal planning and sticking to a list when grocery shopping but ensuring to not limit yourself from certain food groups, labelling othersas“bad”or“forbidden”
Havehealthysnackingoptionsreadyandpreparedforyourself.
·Donotshopwhenfeelinghungry
Talk with a friend and ask them to join you when shopping It willhelpyoumakerightchoicesandavoidover-purchasingitems thatyouarelikelytoover-consume
·Goonfrequentshoppingtripstominimisefoodthatisbought
·Try not to divide your attention when eating Turn the TV off andanyotherdistractionthatmayaffecttheamountoffoodyou eat.
·Use smaller plates It gives the illusion that you are having more food,whichwillendupsatisfyingyourself.
·Take the time and effort to frequently prepare your own meals from scratch You are less likely to quickly eat the food You will wanttosavouritandenjoywhatyouhaveprepared
Put down your cutlery after each bite for about 10 seconds This ensures that you will have a normal eating pace and will mean thatyouarelesslikelytobinge
Tryandfocushardonhowyourfoodsmellsandlooks Thiswill help you enjoy every part of your meal, meaning that you are morelikelytoslowlyeatit
·Psychological signs: preoccupation with food, anxiety, depression, low self-esteem, feeling unattractive, guilt and self-disgust, feeling out of control when eating, suicidal ideation, seldom feeling satisfied,sugarcravings
·Eatsmallbite-sizedpiecesoffoodratherthanloadingyourcutlery
Ensure that you chew for at least 8 seconds to maintain that slow pace.
·Drinkplentyofwatertohelpdigestionaswellasfeelfuller
Never go on unsustainable diets, depriving yourself of major food groups, as that will increase the cravings, have treats, and allow yourselftoeatnormally,buttryandportionit
Relapsing is normal, so don’t be let down if that happens to you. Weareallhumans,andyoucangetbackontrack
Practice mindfulness and focus whether you are hungry or have emotional cues This will help to listen to your body and get into thehabitofhavingfoodwhenyourbodyneedsit
i.i.Diagnosisandsymptomsofbingeeating
Adiagnosisisonlygivenifallcriteriabelowaremet:
-Eating very voluminous amounts of food in very short periods of time, and feeling out of control when doing so, unable to stop or limitthemselves
-Eating until uncomfortably full/eating large amounts of foods despite not being hungry/eating very rapidly than normal/eating aloneduetoshame/self-disgust/depression
-Considerabledistressaboutbingeing
-Bingeingatleastonceaweekforthreemonths
-Nocompensatorybehavioursafterbinges
Physical signs: sleep apnoea, headaches, acne, fungal infections, high blood pressure, kidney problems, weight gain, sweating, tremors, back pain, asthma, stroke, irregular menstrual cycle, pregnancy complications, osteoarthritis, heart disease, gall bladder disease, type 2 diabetes, high cholesterol, mobility issues, hypertension
Behavioural signs: eating very fast, eating until uncomfortable, eating when not hungry, eating secretly, frequent binges, purchasing vast food quantities, eating alone, hiding food, eating of frozen/uncooked/disposed of foods, stress eating, eating at night
In Pica disorders, individuals suffer from consumption of items that are not meant to be consumed Over time, there have risen differentcategoriesforeachcaseofitemsconsumed:
-Amylophagia–consumptionofstarch
-Geophagia-consumptionofsoilsubstances
-Papophagia-consumptionofice
-Coprophagia-consumptionoffaeces
-Xylophagia-consumptionofwood
-Urophagia-consumptionofurine
-Trichophagia-consumptionofhair
-Hylophagia-consumptionofglass
-Lithophagia-consumptionofpebbles
-Mucophagia-consumptionofmucus
These categories are only the most common ones that have been reported,buttherearemanyotherthingsthatsufferersconsume Some examples are cigarette butts, glue, buttons, sponges, magnets,etc.
Pica disorder is often met in individuals that face intellectual disabilities, but are also very common in pregnant women, in theireffortstosatisfycravings.
Pregnancycravingsareoftenharmless,astheyconsistincommon fooditems,suchaschocolate,saltyfood,oddcombinations,etc.
These,oncesatisfied,areinnowayaffectingtheirwayoflifeand is therefore not an obstacle to their everyday lives. However, sometimes, the craving is not a healthy to consume item Sometimes the item represents something inedible which, once consumedwillcausehealthproblems.
Lotsofpregnantwomenarehesitanttotalktotheirdoctorabout their cravings because it is often so strong that they cannot imagine not satisfying it, or they are simply ashamed of the abnormality of it It is very important that Pica disorder is a mental illness, and it should be treated. If you or someone you know feels as though they may have the illness, they should contacttheirdoctorimmediately
It is very unknown on the causes of Pica disorder since so little sufferers report it, but suspicions include nutrient deficiencies, parental neglect, or abuse. It is unusual since the nutrient deficienciesdonotleadtoacravingthathasthatcertainmineral, thereforethereisnotalotofcertaintyinthisclaim;anotherclose linkofPicahasbeenOCD(obsessivecompulsivedisorder)
Dangers of pica disorder are really severe and can lead to worm infestations, parasitic infections from soil and faeces, poisoning andgastrointestinalproblems.Picadisordercanveryoftenleadto d hi
Now that we have looked at common disorders, it is essential to understandthatpropertreatmentisnecessary,regardlessofwhat you may be struggling with Therefore, the next section of the study guide will focus on recovery and returning to living a normal,healthylifestyle
Firstly: BMI In eating disorders, BMI is a very important factor Whether it is specialists’ ways to bring an individual to a normal weight, or disordered thoughts telling you that you are not enough,itisaverymisleadingmeasure Infact,themeasurement was developed in order to compare population averages, and not for self-diagnosis It does not consider muscle and fat mass as separatethings,meaningthataverymuscularandfitpersonmay appear as overweight when that clearly is not the case In eating disorders, it could be very triggering to use BMI calculators and measurements, so, although I am not a specialist, I do not recommendusingthose
I do want to mention that although I understand that it is incredibly difficult for the loved ones of a suffering individual to see them struggling, recovery is only possible he/she accepts the help and acknowledges that they have a problem Their cooperation is crucial and without that, no forcing of any kind, evenifwell-intended,willgetthemtoreachrecovery.
They will always find a way to cut corners and act contrary to whateveryoneelsesuggests Moreover,onceagreedtotakeonthe journey of recovery, families must keep in mind that every experience is rather unique Different people require different treatmentsandnoteverythingworksforeveryone Reasonwhy,at the beginning, a lot of therapies can be experimented with in ordertofindtherightone
I understand it is comforting to read others’ stories, and try to followtheirfootsteps,but,fromexperience,itwillneverworkout ifyoutrytosticktothatyourself Finally,thisroadwillnotbeeasy Even though the person recovering will start to make good progress,thereisahighchanceofrelapse.
Do not let that discourage you. It is normal and in fact, those are themomentsthatyourlovedoneneedsmostsupport
Ensure to let them know you are there for them. Also, be aware thatitisalongprocess,andhoweverlongitwilltake,itwillallbe worthit Trustme
Treatment starts with inpatient eating disorder hospitalisation for most people. It is crucial when the person suffering is in dangerofserioushealthissues Oncetheyaredischarged,itisvery commonforthemtobetreatedasanoutpatient,monitorisedby an eating disorder service That is what will provide them with the support that they need in order to ensure that they are maintaininggoodprogress Once,weightstartstorestore,andthe individual is no longer at high risk of complications, they will be advised to join therapy groups, individual therapy, self-help sessions and sometimes even family therapy That can help everyone around listen to everyone ’ s point of view and become more understanding of what their actions may have on others’ feelings. In the UK eating disorder services and therapy facilities are very over-subscribed, hence it may be a good idea to turn to private healthcare if the financial possibilities allow that However, if not, if the situation is severe, do not wait and seek A&Ehelp
Thisformoftherapyishighlyeffectiveforinindividualssuffering with eating disorders It helps the sufferer focus on the present moment and the future, which is very important, as eating disorders mostly arise from past trauma Many anorexia sufferers havemanagedtomakegoodprogresswiththistherapy,andthere alsostartstobesuccessinbulimiasufferers.
An option to begin the recovery journey is CAT (cognitive analytic therapy) This requires the sufferer to work along with the practitioner in order to recognise the good and the bad in their lives It often needs to be practiced for around 20 hourly sessions in order to see results These therapies can be very creative, as they can involve drawing, journaling or even movement Normally,therewillbethreekeystages:
1The formulation phase: this is a phase when the individual’s background is established. This is in terms of family, experiences, success, and failures It is so that the practitioner gets an idea of youandwhereproblemsmayhaverootedfrom
2Thereformulationletterphase:Thisisaveryactivephasewhen both the patient and practitioner work along and start approaching the problems with solutions. This is mainly consistingofidentifyingpatternsinbehavioursandlearningwhat triggersthem,ultimatelylearningtoavoidthem
3The ending phase: This is part of the process when both the practitioner and the patient start to accommodate with the transition phase that comes with the end of therapy. This is so that it will not appear as a shock to either party and they can become comfortable with continuing their lives without that support.
AnotherformoftreatmentisBBTwhichiscognitivebehaviouraltherapy.Thistherapyisbasedonhelpingusrecognisethefactthathow we feel is mainly based on what we think, which ultimately affects how we behave It is proven to be highly effective in anorexia and bulimiasufferers,asitfocusesonrelaxationandhowtotackleemotionsonaday-to-daybasis Thetherapistwillhelprecognisehabitsthat trigger irrational thoughts that the patient may have This is done with the help of a journal where the patient gets to log their eating patterns and ultimately be helped to identify reasons for points of relapse For example, very stressful times or meeting someone ’ s expectationsmaytrigge eringoftensetcertainlimits on what they are able o o change them gradually so that recovery can event g in intake and behaviours, willstarttorevealreaso
Next, we will be looking at counselling and psychotherapy This form of therapy is also referred to talking therapy Talking therapyismadesothatasafeenvironmentwillbecreatedforthe sufferer where they can confide in their professionally trained practitioner, exposing their past, and how they feel. This is very intimate, and it is very important for the patient to not feel judgedinanyway
Highly trained specialists will focus on the patient’s Family participation and nutritional support are also highly encouraged physical and mental health, helping them implement healthy habits into their routines, helping them move away from their disordered selves. Some institutions may even conduct biochemicaltestssothattheyensureoptimisationofrecovery
Throughcommunicatingandfeeling,itisbelievedforthesufferer to find the solutions themselves. They will start to feel open to theircounsellorandwillverywellgetalongwiththem,asitisnot intheirinterestforthesufferertogetwell
Thismeansthattherewillnotbepressureandthefocuswillshift a little bit. The time taken for the patient to reach a point of recovery is unknown, It is very much dependent for the patient’s personalityandhowawaretheycanbe,orhowopentheycanbe
Specialist treatment centres are also an option In the case for eatingdisordersspecifically,thesecentresareeitherforinpatients oroutpatients,meaningthatthesuffererwilleitherberequiredto always stay supervised (inpatient) or just during the day
Next, we can consider interpersonal psychotherapy. This involves shorter term therapy that consists of stages which are very similar to CAT The entire process can last up to 20 weeks, with each stage at 3-4 weeks long Initial, intermediate, and final phases are thesameasCAT,withfewbutminordifferences.Themethodhas been adopted from depression treatment therapy but has been adaptedforeatingdisorders ItverycommonlyhealsBEDbutcan work for anorexia and bulimia patients. It focuses on four main goals There are role transitions, interpersonal deficits, grief, and interpersonal disputes The sufferer eventually learns to escape destructive behaviours that have “helped” maintain the eating disorderpatterns.
Medication and medical interventions are also effective ways to startone’sjourneyandareoftencominghandinhandwithother formsoftherapies.Theseareoftenusedwhensufferersalsoshow signs of depression It is very common for patients to experience depression,hencethemedication
Accompanying eating disorders is also OCD, as we saw earlier, which can be tackled by taking anxiety treatment Moreover, treatingtheside-effectsofinsomniacanbewithsleepmedication In the case of obese binge eating sufferers, surgical procedures may be necessary, as their weight is of great risks This involves stomach shrinkage, making it impossible for them to consume large amounts of food. For anorexia sufferers, surgical procedures are not required, but refeeding is, therefore supervision is also requiredintheircase
Animportantkeyfactisthatrefeedingamalnourishedbodytoo quickly can cause the sufferer to experience refeeding syndrome This can develop pulmonary, neuromuscular, haematology, electrolyte,andcardiaccomplications.Thereisalsoariskofdeath ifdevelopingcardiacarrythmia
Death can also be a risk in result of confusion convulsions of the patientorlapsingintoacoma
An important factor that many people are curious about is the sectioning process This is when the sufferer refuses help from professionals,refusestoeat(inanorexia)andisatveryhighriskof death.Inthatcase,theylosetheirlibertyandendupinthehands ofprofessionals Moreover,thesectioningprocessthatleadsfrom Seclusions from the community is in the case of the ones around the sufferer are at risk (eg a parent suffering from anorexia and owns full custody of their child. The disease is likely to interfere withthechild’swell-being,reasonwhysectioningisrequired)
Thesectioningprocessiselaborateandhasseveralsteps.Firstly,a mental health assessment will take place by a medical team, a family member, or the emergency services Then, a minimum of these people decides that detention is the only possible option These people are either doctors and/or approved mental health professionals Theassessmentwilltakeintoconsiderationmedical risk, psychological risk, psychosocial risk and insight/capacity or motivation. The decision is then taken, but the family of the sufferer may appeal the decision taken, in which case, they will give a three day written notice to the health managers After being sectioned, the individual will be entitled to free aftercare oncedischarged
As mentioned earlier, it is quite dangerous to undergo refeeding of This sectioning only happens when the professionals believe thattheindividualisinapositionwheretheyareunabletomake a rational decision and are self-imposed starvation In extreme cases, the refeeding process will not be natural and will require a naso-gastric tube, which feeds the nutrients directly to the stomach Ifthereisonethingthatisoughttoberemembereditis that refeeding of an anorexia sufferer should never be done withoutprofessionalsupervision
Firstly,averyhelpfulresourceofhelpisnutritionalsupport This required very commonly in individuals suffering with anorexia Since, they have severely restricted for such a long time, they develop very unrealistic ideas about how much food is healthy to beconsumed,orwhatabalanceddietshouldlooklike Therefore, a nutritionist can help with that. They will help the recovering individualtomealplanandtakegooddecisionssurroundingfood intake Beside changing diet, a suffering individual will also receive help on how to differentiate between listening to hunger cuesoremotionallyeat
Joining self-help groups is also a very proactive step in one ’ s recovery journey Meeting up with a few people that are going through what you are going through can be very reassuring and canimposetheideathatyouarenotaloneinyourrecovery.
You can share experiences, ideas and thoughts or feelings with everyone around you, without the fear of being judged, as it is a confidentialandjudgment-freespace.
Many self-help groups have libraries and very useful resources on helpingthememberswithdocumentationandlearningmoreand moreaboutthedisorders
Documentation is therefore encouraged and all of these small things that self-help groups stand by, are frequently very motivatingforsufferingindividuals
Acupuncture is not a solution for eating disorders, but it is definitely an approach that once taken, can improve mental and physical health The positioning of fine needles around the body inareasoftargetorgans,isbelievedtorestabilisethebody’senergy flow and therefore bring a sense of relaxation and calmness, helping with mental difficulties ACT or “acceptance and commitment therapy” is another alternative and involves the practicing of mindfulness in order to come to terms with one ’ s bodyimageandbehavioursaroundfood Ithelpsthemrecognise patterns that trigger their compulsive disorders from a psychological point of view It is slightly less common, but still provestobeeffectiveinalongwithpropertreatments.
Hypnotherapy is a way of inducing a form of locked attention, helping the sufferer focus on their problem in a very heightened stateofconcentration Methodsofrelaxationenablethepatientsto use their right side of the brain more effectively which will help them in making more rational decisions. Meditation is also very widely used in suffering individuals It involves relaxation, as a result, starting to come to terms with one ’ s body It promotes selfhealing by activating self-awareness, enabling the sufferer to arrest destructiveeatingdisorderhabits Inthiscategory,yogafallsaswell People suffering with anorexia often abuse working out, and continue pushing themselves despite having bruises, cuts or feeling extremely fatigued and tired due to malnourishment. Therefore, the low impact sport, yoga, helps the body remain mobile and flexible, without an overwhelming effort being made It also helps relax and connect with your body, becoming more appreciative of it
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References
https://jeatdisordbiomedcentralcom/?
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