Eating Disorders – What are they?

According to the National Eating Disorders collaboration, eating disorders are estimated to affect approximately 9% of the Australian population and the rate is increasing. Additionally, approximately 15% Australian women experience an eating disorder during their lifetime. However, just because eating disorders are seemingly more common among females this does not mean males are immune. Eating disorders can affect men and women, young and old and people from all cultural backgrounds.

Eating disorders are a serious mental illness, they are not a life-style choice or a diet gone ‘too far’. Eating disorders can result in long term impairment to social life and can also be coupled with psychiatric and behavioural effects. Many people who have an eating disorder also present with depression, anxiety, personality disorders or substance abuse issues. The impact of eating disorders isn’t just felt by the individual, often they impact the entire family or the individual’s support network.

While there are some common eating disorders that are present today, there are also a couple of new terms becoming used more readily. Below is some information regarding some of the more common diagnosable (and not) eating disorders that are present in today’s society.

Anorexia Nervosa:
• Restricted energy intake, leading to lower than normal body weight and, often, the loss of a considerable amount of weight in a short period of time
• An intense fear of gaining weight, even when the individual is already underweight, starved or malnourished
• Disturbed by body image, including extreme emphasis on their appearance and the perception that they are overweight despite being considerably underweight

Risks associated with anorexia are severe and can be life-threatening:
• Anaemia (iron deficiency)
• Low immune function
• Intestinal problems
• Loss or disturbance of menstruation in girls and women
• Kidney failure
• Osteoporosis – weak and brittle bones
• Heart problems (abnormalities, sudden cardiac arrest)

Bulimia Nervosa:
Bulimia Nervosa can be defined as repeated episodes of binge eating followed by compensatory behaviours, used a way of trying to control weight after binge eating episodes:
• Vomiting
• Misusing laxatives or diuretics
• Fasting
• Excessive exercise

Risks associated with bulimia can include:
• Chronic sore throat, indigestion, heartburn and reflux
• Inflammation and rupture of the oesophagus and/or stomach from frequent vomiting
• Stomach and intestinal ulcers
• Chronic irregular bowel movements, constipation and/or diarrhoea due laxative misuse
• Osteoporosis
• Loss or disturbance of menstruation in girls and women
• Increase risk of infertility in men and women
• Irregular or slow heart beat – this can increase risk of heart failure

Binge Eating Disorder:
Binge eating disorder is defined by regular episodes of binge eating accompanied by feelings of loss of control, and in many cases, guilt, embarrassment and disgust. A person with binge eating disorder will not use compensatory behaviours, differentiating it from bulimia nervosa.

People with binge eating disorder may experience:
• Osteoarthritis – degenerative arthritis where joints degrade in quality and can lead to loss of cartilage
• Chronic kidney problems or kidney failure
• High blood pressure and/or high cholesterol – which can lead to increased risk of stroke, diabetes and heart disease

Other Specified Feeding and Eating Disorders (OSFED):
According to the DSM-5 (a diagnostic tool for eating disorders) a person with OSFED may present with many symptoms of other eating disorders but will not meet the full criteria for diagnosis of these disorders. People with OSFED commonly present with extremely disturbed eating habits, and/or a distorted body image and/or overvaluation of shape and weight and/or an intense fear of gaining weight. OFSED is the most commonly diagnosed of all eating disorders for both adults and adolescents and can affect both males and females

Although above are the diagnosable eating disorders you may have heard of a couple of other types of disordered eating/body image distortion terms being used. These can’t officially be diagnosed but we certainly do believe that they can exist among the population.

The term ‘orthorexia’ came about approximately 20 years ago and is defined as an obsession with ‘healthful’ eating. Although there are no formal diagnostic criteria some of the signs and symptoms include;
• Compulsive checking of ingredient lists and nutritional labels
• Increase in concern about the health of ingredients
• Cutting out whole food groups (e.g. sugar, carbohydrates, dairy, meat, animal products etc)
• An inability to eat anything but a narrow group of foods that are deemed as ‘heatlhy’
• Unusual interest in the health of what others are eating
• Spending hours per day thinking about what food might be served at upcoming events
• Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
• Obsessive following of food and ‘healthy lifestyle’ blogs on social media
• Body image concerns may be present

This is most certainly not an official term for an eating disorder, however is a term that can be used to describe mainly men who are suffering with body image issues as defined by Eating Disorders Australia. It is known as ‘reverse anorexia’ and can happen among men who believe they are too little or frail. Research has shown this is driving men to inject steroids as well as suffer psychologically. Muscle dysmorphia appears to be affecting males who have normal muscle mass but have a belief that their muscles are inadequate and can be exacerbated by their environment (i.e. gym) and social media.

Well done if you made it this far with the reading! This week’s blog was quite content heavy so thank you for your dedication! We feel it is a topic that needs to be discussed although uncomfortable for some people. It is important to note that it is not embarrassing to seek help if you feel you are struggling with any of the above. If you feel that you or anyone you know might be struggling with an eating disorder please have a chat to your doctor, psychologist or contact one of our dietitians – we’re here to help. You might also like to contact the Butterfly foundation online

Definitions derived from National Eating Disorders Collaboration, National Eating Disorders Association and Eating Disorders Australia.

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