Eating disorders
Anorexia
Anorexia sufferers starve themselves, and have a terror of gaining weight. Sufferers frequently have a distorted perception of their shape and weight (dysmorphia) and will continue to think they are overweight even after they become extremely thin, and are very ill or near death.
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The behavioural symptoms of an anorexic include mood swings, restlessness and hyperactivity. Often the anorexic develops eating habits such as refusing to eat in front of other people, frequently claiming they have already eaten when offered food, becoming excessively fastidious about what they will and will not eat, and becoming very secretive and defensive around food. Anorexics may start to wear baggy clothes to avoid the extent their weight loss becoming apparent to others, and will become more and more isolated and withdrawn from friends and family.
Food and eating comes to dominate the life of a person with anorexia. Anorexics think obsessively and continually about food as their bodies are in starvation. Weight loss is often accelerated by excessive dieting, exercise and other extreme methods such at the abuse of laxatives.
There are many serious medical risks associated with anorexia. They include shrunken bones, mineral loss, low body temperature, irregular heartbeat, permanent failure of normal growth and development of osteoporosis. Other effects of anorexia are constipation and abdominal pain, dizzy spells and feeling faint, a bloated stomach, puffy face, poor blood circulation and feeling cold. Laxative abuse is extremely harmful to the body: it can wear out the bowel muscle and causes it to decrease in function.
A person with anorexia will usually use their eating disorder as a way of coping with painful feelings of anger, shame, guilt, fear and self loathing, and to experience a sense of control which is absent in their life except in the case of food. This sense of control is however an illusion, and the eating disorder soon takes complete control of the sufferer. Anorexia is used as a way for a person to feel better about themselves, but it is a "quick fix" and a false answer to underlying self loathing; the reality is one of greater, not less, emotional pain and isolation, not to mention the physical effects of anorexia, which, left untreated, can be fatal.
With the right treatment, however, a full recovery is possible, and anorexia sufferers can rebuild a healthy relationship with food and with themselves.
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Bulimia
Bulimia is a serious eating disorder, which involves the misuse of food to try to resolve emotional difficulties. The major symptoms are binge eating followed by self-induced vomiting or "purging". It is also quite common for a bulimic to abuse laxatives and diuretics. Purging may occur several times a day, often after each meal.
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One of the major signs of someone suffering from bulimia is regularly disappearing to the lavatory immediately after meals. A bulimic may also be very secretive about food and unwilling to discuss it, or frequently want to eat alone and isolate. Other symptoms and indicators are the erosion of dental enamel due to acid in the vomit, swelling of the glands near the cheeks, a depressed mood and frequent complaints of sore throats and abdominal pain.
Bulimia is, however, a condition which exists in a frame of guilt and shame, and sufferers are frequently very skilled at masking symptoms. Bulimia can thus often go on for many years without becoming apparent to others. This is because the sufferer's weight usually remains relatively constant, and outwardly there may be no sign that anything is wrong.
Although outward symptoms are often subtle and/or concealed, bulimia has severe physical consequences: frequent binging and purging will cause electrolyte imbalance and dehydration, and vomiting can lead to low levels of essential salts in the body. This can cause weakness in the muscles, kidney problems and heart problems. Acid from the stomach also erodes the tooth enamel.
People who suffer from bulimia usually have a very low self esteem and may place a lot of importance on their weight and appearance. A bulimic is preoccupied with food intake, and generally feels she/he is very overweight, although in fact is usually near a normal weight. Bulimia frequently occurs together with other psychiatric disorders such as depression and substance dependence.
Bulimia is often a way for some people to effect a form of control over their emotional lives. At other times the vomiting of bulimia becomes a sufferer's only way to communicate pain and a need for help. When a person is incapable of facing feelings, defining problems, and resolving them effectively, that person is more likely to become susceptible to the onset of bulimia.
When someone has been vomiting regularly and for a long time, the body becomes use to rejecting food. It takes time and careful therapeutic management to change the bulimic's entangled relationship with food and its control to a healthy one. It is possible to recover from bulimia and break free from the vicious cycles of bulimic behaviour.
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Overeating
Compulsive overeating is a disease of addiction manifested in an obsessive, compulsive relationship with food. The sufferer uses food as a means of trying to suppress or control uncomfortable feelings. He or she may often (but not always) overeat starchy and/or sugary foods that create a 'sugar high' to try to escape difficult emotions. This binge eating is usually followed by intense feelings of guilt and remorse, but unlike victims of bulimia, compulsive overeaters do not always attempt to purge their food by vomiting or using laxatives.
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Medical symptoms of compulsive overeating can include (but are not restricted to) significant weight gain (although this does not always occur) and a plethora of associated illnesses such as obesity, diabetes, malnutrition, high cholesterol, hypertension, sleep apnoea, breathing difficulties, heart disease, depression, joint problems, kidney problems and risk of heart attack.
Sufferers of compulsive overeating, which can also be described as binge eating or food addiction, are likely to embark on crash diets or periods of starvation and compulsive exercise in a desperate attempt to 'balance out' their overeating or to lose the weight gained through overeating. People with this disease often suppose that their problems are caused primarily by their size, and subscribe to the belief that they would be happy if they were thinner. However, due to the compulsion of the disease and the restrictive nature of these fad diets, sufferers are rarely able to sustain these diets and often resume their binge eating behaviour, resulting in a vicious cycle of overeating and under-exercising alternating with under-eating and over-exercising. The longer this continues, the more serious the damage caused to the body and the more difficult the cycle is to break.
Compulsive overeaters are likely to feel increasingly negative about themselves as their obsessive behaviour progresses and the side effects become more and more difficult to disguise. Like all sufferers of eating disorders, binge-eaters can be extremely secretive about their food addiction. They will often refrain entirely from eating in public so that no-one is aware of their illness and wait until they are alone so that they can binge in private in an attempt to curb some of the shame and humiliation caused by their illness. This makes it very difficult for friends and family to notice or understand their disease and as the façade of a normal life is continued, the sufferer feels less and less able to seek help. Other victims of compulsive overeating, however, binge-eat in public, in a humiliating ritual of self-deprecation. They will often act the fool to entertain the people around them, believing that if they pretend that their behaviour is amusing and acceptable to others, it will assuage some of the guilt and shame they feel underneath their seemingly robust, happy-go-lucky exterior.
Despite ubiquitous beliefs and advice from doctors, the media and the Government that people suffering from weight problems need only to stick to a diet and do more exercise, for those whose weight issues are caused by compulsive overeating, an additional and more specialised form of help is required to cure the emotional and behavioural problems that underlie the symptoms of compulsive overeating.
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Sometimes the challenges of tackling personal difficulties with food extend beyond nutritional management and support. Where clients have serious difficulties with their eating patterns, and are suffering from harmful disorders such as bulimia, anorexia or compulsive overeating, it can be important to seek further help with the emotional and psychological aspects of these conditions.
Tina works as the nutrition advisor to Charter Harley Street, a specialist clinic based in Harley Street in Central London offering counselling and treatment services to clients suffering from eating disorders and addiction problems such as substance misuse and alcoholism, as well as individual and couples/family therapy. Tina can provide you with an introduction to Charter where you will be able to book an assessment to discuss your situation in complete confidence and be advised on your best options for any further treatment.
Please call 020 7323 4970, or visit:
Charter Harley Street