Eating disorders are mental disorders characterised by abnormal eating patterns that impact physical and or mental health. There is quite a bit of misunderstanding so let’s take a look at the most common conditions here…
Anorexia nervosa – this is perhaps the “classical” eating disorder where the patient eats extremely little food and becomes dangerously thin. Anorexia can be fatal. Anorexia affects women 10 times more than men. Anorexia usually starts in teenagers or young adults, and affects some 4% of women at some stage in life. The exact causes are unclear but societal and peer pressure, together with an often-excessive focus on extreme slimness (such as is portrayed by models and many celebrities) are thought to be major factors.
Bulimia – another fairly well-known eating disorder characterised by episodes of excessive eating that are followed by vomiting/purging. Bulimia also affects women most commonly and some 2% of women will experience it in their lives, often as teenagers or young adults. Causes are not fully understood but are thought to be similar to Anorexia.
Binge eating – this is a “newer” eating disorder where people eat excessively for short periods of time (but without the subsequent vomiting that characterises Bulimia). It is not clear just how common this is but estimates suggest that some 2% of people are affected each year. Binge eating is twice as common in women as in men. Causality is also not clear but societal and peer and life pressure are important factors.
Each of these eating disorders is associated with other mental health problems such as anxiety, depression, and substance abuse. This association may be causal in either direction – eating disorders may cause mental health complications and mental illness may lead to eating disorders – so that patient care can be complicated and challenging.
The treatment of eating disorders usually involves a mix of counselling/psychotherapy and medication, together with a firm approach to normalising eating & lifestyle patterns. Family therapy may be helpful (family relationships and dynamics can be part of the condition, causally or in simple association). In severe cases hospitalisation is necessary, and specialised multidisciplinary teams (e.g. psychiatrist, psychologist, occupational therapist, nurses) are optimal. Some 50-70% of patients make a full recovery while the balance continue with some symptoms (often controlled but not 100% cured).
Ironically and cruelly, society has often taken a rather judgmental approach to these conditions, seeing them as “trivial” or “silly” and expressing views such as “oh, just eat, come on” etc. This is extremely unhelpful and, as with other mental illnesses, we need to approach eating disorders as medical conditions full stop. There is no place for judging those who are suffering so much.
In many ways eating disorders may be seen as a reflection of an unhealthy society, and there is much to ponder there. Certainly, these are serious mental illnesses that can even be fatal. While these conditions are not fully understood, and treatment outcomes are imperfect, much can be achieved with good early specialist treatment.