TURN TO THE person next you, mention the term eating disorders, and they might picture a 15-year-old girl with anorexia.

They might assume she will get over it without much fuss, or believe she needs to cop on and stop obsessing over portion sizes. Many of us have made assumptions about mental illnesses.

The voices of people affected by eating disorders can and do include a 26-year-old who is successful in her career, but feels unable to speak up because it might reveal that she is not coping and is using food in a self-destructive way.

It may be the 38-year-old mother who has struggled with binge eating disorder for over a decade and feels emotionally and psychologically trapped in a vicious cycle.

It may be an aunt in her 60s worried about her 20-year-old nephew’s excessive exercising, low mood and how much his personality has changed recently. She might phone Bodywhys to ask whether it’s “too late” to say something.

‘It breaks a person down’

People affected by eating disorders are normal, intelligent and genuine. They have hopes and dreams. They have a sense of humour and warmth. They go to school, college and work. They have good and bad moments with families and friends.

It is the illness which is the problem, not the person. It crushes their spirit. They might describe it as a “monster”, “torture” or a “bully”.

The eating disorder, as a separate entity, does not care how much it breaks a person down. It is not interested in fairness or reason. The eating disorder voice controls a person’s daily life.

Imagine for a moment an extra voice in your head, questioning your every move, wanting to punch you on the inside of your skull for doing something “wrong” or “awful” – eating. Magnify it and think about what it would be like to carry this around.

Effects

An eating disorder is a serious and complex mental health issue where a person experiences a significant disturbance in their relationship with food, weight and body. They impact on a person’s physical and mental health and their quality of life. These disorders can result in poor circulation, loss of periods, exhaustion, and tooth decay, digestive problems, along with feelings of guilt and shame. It can be life-threatening.

According to a study in the Lancet, around 1 in 20 people will experience an eating disorder in their lifetime.

Eating disorders are characterised by behaviours such as self-starvation, bingeing, ‘purging’ through vomiting, over-exercising or laxative abuse.

However, eating disorders are not primarily about food – it’s about a person’s sense of who they are.

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 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

An eating disorder is sometimes used as a self-destructive coping mechanism. It sounds counter-intuitive, but this ‘works’ for some people.

Eating disorders operate by a distorted logic, often bringing a sense of safety, control and relief. This, left unchecked, is where a person can get into significant difficulty, where such behaviours become someone’s default way of coping with the world around them. In some cases the consequences are fatal.

Lack of awareness

According to a recent study in the Lancet Psychiatry, over the past decade, 15,165 articles were published worldwide on eating disorders compared to approximately 200,000 on depression. Considering the lack of research, and the stigma, it is not surprising that the stereotypes associated with eating disorders remain deeply problematic.

Families come under significant pressure when an eating disorder becomes a part of their son or daughter’s life. Parents often describe a sense of uncertainty and helplessness as they see how an eating disorder becomes increasingly entrenched in their child, including adult children.

Parents may feel unable to talk to close friends as a means of easing their distress.

A significant misconception for those looking in from the outside is that parents should be able to “just get that child to eat”. The reality of eating disorders is that they are not primarily about food or weight, but are a symptom of underlying issues. The effects of eating disorders are felt beyond the kitchen or mealtimes.

Getting help

Eating disorders are not caused by the mainstream or social media. They are often rooted in a stressor or upsetting event which has personal significance. This is why they can be difficult to treat and involve ups and downs on the road to recovery. Denial and resistance are at the heart of the illness.

In 2015, 51% of callers to the Bodywhys helpline were not in any form of treatment, while 41% of email contacts had experienced an eating disorder for over ten years.

Recovery from an eating disorder is possible. The first step towards recovery is acknowledging that there is an issue. But, recovery is not solely about normalising weight and eating behaviours. Ultimately it is about finding a different way of coping that enhances life.

When someone tells you that they have an eating disorder you can do something simple – ask “what it’s like for you?” and listen.

Barry Murphy is the communications officer for Bodywhys.

Read: Increasing numbers of older people are suffering from eating disorders

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