What is an eating disorder?

The term ‘eating disorder’ refers to a complex, potentially life-threatening condition, characterised by severe disturbances in eating behaviours. 
Eating disorders can be seen as a way of coping with emotional distress, or as a symptom of underlying issues.

  • Eating disorders are not primarily about food
  • People can and do recover
  • Eating disorders can affect anyone

Eating disorders are characterised by a variety of disordered eating behaviours such as:

  • Self-starvation – by fasting and/or food restriction
  • Purging – by self-induced vomiting, over-exercising, or laxative abuse
  • Bingeing – by consuming quantities of food beyond what the body needs to satisfy hunger

An eating disorder can be very destructive, both physically and emotionally, and people can get trapped into a destructive cycle without knowing how to cope with it.
 An eating disorder is not just about food and weight, but also about a person’s sense of who they are.

Treatment of an eating disorder will require attention to both the physical and the psychological/emotional aspects of the person. Treatment must always include respect for and sensitivity for the overall well-being of the person.
The distress of a person experiencing an eating disorder, whether or not it is acknowledged, may have a considerable impact on family and friends.

The main eating disorders

Although the term ‘eating disorder’ is applied to a wide range of disordered eating behaviours, there are three main classifications: Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder.

Anorexia Nervosa

  • A person will make determined efforts to attain and maintain a body weight lower than the normal body weight for their age, sex and height
  • They will be preoccupied with thoughts of food and the need to lose weight
  • They may exercise excessively and may engage in purging behaviours

Bulimia Nervosa

  • A person will make determined efforts to purge themselves of any food eaten, sometimes following a binge, and often following ‘normal’ food intake
  • They will engage in high-risk behaviours that can include fasting, excessive exercising, self-induced vomiting, and/or the misuse of laxatives, diuretics or other medications
  • They may maintain a body weight within the normal range of their age, sex and height. As a result, bulimia is often less obvious than anorexia and can go unnoticed for longer

Binge Eating Disorder

  • A person will engage in repeated episodes of bingeing without purging
  • They will likely gain considerable amounts of weight over time
  • They find themselves trapped in a cycle of dieting, bingeing, self-recrimination and self-loathing

Just because somebody doesn’t fit in absolutely with one particular category doesn’t mean they don’t have an eating disorder. A large number of people with eating disorders don’t fit strictly into one category but fluctuate between the three.

People experiencing an eating disorder may :

  • have dieted
  • have low self-esteem– though this may not be obvious, as people who develop eating disorders are often ‘high achievers’
  • show a marked over-concern with body shape, weight and size, and an obsession with food
  • see thinness as a magical solution to problems, while weight gain is feared
  • have difficulty identifying and expressing their real needs
  • view their body as larger than it actually is (distorted body image)
  • have problems around control
  • find it hard to talk about their feelings and to deal with conflict
  • be depressed and may become isolated
  • experience mood swings

What causes an eating disorder?

There is no single cause that can explain why a person develops an eating disorder.
It is usually a combination of factors (biological, psychological, familial and socio-cultural) that come together to create conditions in which an eating disorder is more likely to develop.

The disorder often develops gradually as a response to an upset in a person’s life. This could be a traumatic event, a loss or major change in a person’s life, bullying, an overload of stress, and/or critical comments about weight or shape. Sometimes, it’s not obvious what the trigger may have been.
A person with low self-worth or without a strong sense of identity may be more vulnerable.

People who develop eating disorders tend to be overly concerned with meeting the standards and expectations of others, and are super-sensitive to other peoples’ feelings.
This explains why eating disorders occur so often during adolescence when identity is an issue, the opinion of peers is so important, and parental expectations are resisted.

Eating disorders do not start out as a conscious choice and are not a wilful form of ‘attention seeking’.
Understanding the emotional background of the eating disorder is crucial to developing an appropriate response and treatment approach.

A coping tool

Understanding that an eating disorder is a person’s coping mechanism helps those around the person to realise how frightening and difficult it is for the person to let it go as they recover. It’s important that family and friends have realistic expectations of the pace of progress recovery takes.

For the person with an eating disorder, controlling food and the body is their way of relieving distress and achieving some degree of control over their life. Their world feels like an unsafe place, and, for many complex reasons, an eating disorder provides them with a sense of safety.
Once trapped within the eating disorder, people often feel they need to maintain it in order to survive. They don’t know who they are or how they could cope without it.

Recovery

It is precisely because the eating disorder serves a purpose that it becomes very difficult to stop its progress.
For the person affected, the eating disorder can seem like an effective coping mechanism and it can take hold very quickly. The longer it is established, the more it takes on a life of its own and takes over the life of the person affected, so early intervention is really important.

Often, by the time they begin to understand what is happening, they are unable and too scared to try and stop. It is as if the eating disorder is now controlling them. Also, for many, overwhelming feelings of helplessness, guilt, shame and self-loathing become an insurmountable block to seeking help.

Recovery begins with
:

  • a will to change
  • an acknowledgement that the eating disorder is a problem
  • working to build up a strong sense of self and a new, healthy way of coping that does not need the eating disorder to feel safe

Recovery requires working on underlying issues, building self-esteem, and learning to manage and express feelings, as well as addressing the physical and nutritional aspects of the disorder.
Recovery takes great courage and commitment.

Much sensitivity, compassion, respect, understanding and patience will be needed by those around them (family, friends, G.P., and other members of the treatment team) if a person is to be successfully encouraged and supported on their journey towards recovery.

People can and do get better.

Further information can be found in the books listed on the Bodywhys booklist and from other websites for eating disorders and related issues. See the bodywhys list of websites or contact the Bodywhys Helpline: Lo call 1890 200 444.

Acknowledgements

This factsheet has been produced in collaboration with Bodywhys (www.bodywhys.ie).

Helpful sites

Comments Show all comments

  1. Fenella says:

    Hi Sharon,

    We’re very sorry to hear about what your daughter, you and your family are going through. It can be very stressful trying to get support and help for a loved one when it seems like there are very few support options available to us.

    There are a few options open to you rather than admitting your daughter to hospital, although in some situations, this may be the level of support needed.

    You may have already contacted some of the following health services or support organisations, but we’ll mention the steps involved in getting help just in case you haven’t already tried some of these options.

    The first step in getting help is usually to see your GP. If your daughter is under 18 years of age, you will probably have to go with her, otherwise she can attend on her own. The GP can advise and support and should be able to refer to local services and supports that can help. These supports may include counsellors, psychiatrists and support groups.

    A referral from the GP is usually needed to see a psychiatrist, but it is possible to self-refer to see a counsellor. The GP will be able to recommend and/or refer to a counsellor, but if you and your daughter want to have a look yourselves, you can visit www.counsellingdirectory.ie and search for eating disorder or anxiety counsellors within your local area.

    Bodywhys are the Eating Disorders Association of Ireland and they have lots of information about eating disorders and supporting someone with an eating disorder. They run support groups in some counties in Ireland and they also have online support groups, which might be useful if there isn’t a support group close to you. Bodywhys have a helpline number and they might be able to offer additional information, visit their website to find out more, www.bodywhys.ie.

    We hope this is helpful Sharon. We agree that there can be a lack of formal supports for young people, especially when it comes to their mental health, but we hope we’ve let you know of some support and help options available. Your daughter is very lucky to have a mum like you watching out for her and we truly hope she gets the support she needs and deserves.

    Take care,
    Fenella

  2. sharon says:

    I know how u feel its about time some of us her in ireland started to shout, my daughter has an eating disorder/anxiety disorder. We live in the nidlands and there is no support.
    its very stressfull on all the family and our extended family have ran because they feel ;leave it to the experts, which there is none only to admit her into a mental hospital which is not the answer only to make things worse. I hope nothing happens my child because of all this lack of support in our country,

  3. reachout says:

    Hi Pauline,

    We are sorry to hear about everything you and your daughter are going through. It's concerning to hear that you have found it difficult to access services in your local area. Bodywhys is a service that supports people with eating disorders and their family's. They have a low cost help line that may be able to help you find services in your local area and they provide on-line support groups and email support.

    It's great to have a week of events to raise awareness about eating disorders and very disappointing that you have not heard any coverage about it. ReachOut.com are featuring Harriot Parsons from Bodywhys as our expert this month. She is taking questions on eating disorders. We have also written a blog tackling some eating disorder myths and have been promoting Eating Disorders Week through our social media channels.

    Eating disorders are a very important issue that affect over 200 000 people in Ireland. It is definitely not only adolescents that suffer from eating disorders. Eating disorders can affect anyone at any age.

    Thanks for getting in touch with us to highlight this important issue.

    All the best
    Roisin

  4. pauline clune says:

    my daughter has been suffering from an eating disorder with 17yrs, we have tried everything, we have no support as we live in clare we are very angry as this is' eating disorder awareness week' and we have'nt herd a mention of it on any radio station also its not just adolesent's that suffer Could you please highlight it more Thank you

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