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Beauty / Ali Horsfall

The Body Experts: How To Spot An Eating Disorder

Shockingly, in a recent survey it was revealed that more than one in three adults (34%) in the UK could not name any signs or symptoms of eating disorders – meaning we may not know as much as we think we do about the complexities of these disorders. A low awareness of the early signs has been linked to delayed treatment and an increased risk of the illness becoming severe and enduring so having knowledge is crucial to helping yourself or others.

Today we hear more about the signs of eating disorders from Caroline Price, Director of Services at eating disorder charity, Beat.

What are the different types of eating disorder?

“An eating disorder may be diagnosed as bulimia, anorexia, or binge eating disorder but many people may also be diagnosed with ‘other specified feeding or eating disorder (OSFED)’. This means that their symptoms don’t exactly match what doctors check for to diagnose bulimia, anorexia, or binge eating disorder, but that doesn’t mean that OSFED is not still very serious. It’s also possible for any eating disorder symptoms and therefore diagnosis, to change over time.

What are the symptoms of an eating disorder?

“Some of the symptoms of specific eating disorders include the below, but it’s important to remember that someone doesn’t have to have all of them to be suffering. It’s not always obvious that someone has an eating disorder – remember, they are mental illnesses.”

Bulimia

Behavioral signs

  • A person may either frequently check their body shape or weight OR avoid looking at their body or checking their weight.
  • They may compare their body with that of others
  • Eating large amounts of food (binging)
  • Purging after binging by vomiting, over-exercising, using laxatives or diuretics, fasting
  • Organizing life around shopping, eating and purging behavior
  • Secrecy, especially about eating
  • Hoarding food
  • Mood swings
  • Irritability
  • Social withdrawal
  • Misuse of laxatives and diuretics
  • Misuse of alcohol
  • Self-harm
  • Compromise of education and employment plans
  • Disappearing during or soon after eating (in order to purge)
  • Excessive exercising

Psychological signs

  • Spending a lot or most of the time thinking about food
  • Feeling anxious and tense, especially around meal times or when eating in front of others
  • Difficulty concentrating
  • Low confidence and self-esteem
  • Worries about weight and shape
  • Fear of gaining weight
  • Distorted perception of body shape or weight
  • Feeling of loss of control over eating
  • Feelings of guilt and shame after binging and purging
  • Other mental illnesses, such as depression or anxiety

Physical signs

  • Vomiting
  • Difficulty sleeping
  • Tiredness
  • Bloating
  • Constipation
  • Stomach pain
  • Swelling of the hands and feet
  • Poor skin condition
  • Damage to teeth
  • Irregular or stopped periods
  • Enlarged salivary glands
  • Calluses on the backs of the hand if fingers are used to cause vomiting
  • Imbalance in electrolytes – essential substances found in the blood
  • Stomach problems
  • Regular changes in weight, which may go up or down, though often remains “normal”
  • Lack of sexual interest

Anorexia

Behavioral signs

  • Not being truthful about food intake / meal regularity
  • Not being truthful about weight loss
  • Strict dieting and avoiding food believed to be fattening
  • Counting the calories in food excessively
  • Eating only low-calorie food
  • Missing meals (fasting)
  • Avoiding eating with other people
  • Hiding food
  • Cutting food into tiny pieces to make a small food intake less obvious or to make food easier to swallow
  • Eating very slowly
  • Taking appetite suppressants, such as slimming or diet pills
  • Obsessive and/or rigid behavior, particularly around food
  • Irritability
  • Excessive exercising – this might involve exercising when not physically well enough to do so, or feeling guilty or anxious about not exercising
  • Vomiting or misusing laxatives (purging)
  • Social withdrawal and isolation
  • Compromise of education and employment plans

Psychological signs

  • Fear of fatness or pursuit of thinness
  • Excessive focus on body weight
  • Distorted perception of body shape or weight
  • Underestimating or denying the seriousness of the problem, or believing there isn’t a problem at all, even after diagnosis
  • Spending a lot or most of the time thinking about food
  • Anxiety, particularly about eating in front of other people
  • Low confidence and self-esteem
  • Difficulty concentrating
  • Perfectionism and setting very high standards
  • Other mental illnesses, such as depression, anxiety, or obsessive-compulsive disorder (OCD)

Physical signs

  • Weight loss
  • Irregular periods, or periods stopping altogether
  • Lack of sexual interest
  • Difficulty sleeping
  • Tiredness
  • Feeling dizzy
  • Stomach pains
  • Constipation
  • Bloating
  • Feeling cold or have a low body temperature
  • Growth of soft, fine hair all over the body (called lanugo)
  • Hair loss
  • Physical weakness
  • Loss of muscle strength
  • Effects on hormone levels
  • Swelling in the feet, hands or face (known as oedema)
  • Low blood pressure

Binge eating disorder

Behavioral signs

  • Buying lots of food
  • Organizing life around binging episodes
  • Hoarding food
  • Eating very rapidly
  • Eating when not hungry
  • Eating until uncomfortably full
  • Avoiding eating around others
  • Social withdrawal and isolation
  • Irritability
  • Mood swings
  • Compromise of education and employment plans

Psychological signs

  • Spending a lot or most of their time thinking about food
  • A sense of being out of control around food, or a loss of control over eating
  • Feeling anxious and tense, especially over eating in front of others
  • Low confidence and self-esteem
  • Feelings of shame and guilt after binging
  • Other mental illnesses, such as depression or anxiety

Physical signs

  • Tiredness
  • Difficulty sleeping
  • Weight gain
  • Bloating
  • Constipation
  • Stomach pain
  • Other stomach problems
  • Poor skin condition

OSFED

Specific examples of OSFED include:

“Atypical anorexia – where someone has all the symptoms a doctor looks for to diagnose anorexia, except their weight remains within a “normal” range.

“Bulimia nervosa (of low frequency and/or limited duration) – where someone has all of the symptoms of bulimia, except the binge/purge cycles don’t happen as often or over as long a period of time as doctors would expect.

“Binge eating disorder (of low frequency and/or limited duration) – where someone has all of the symptoms of binge eating disorder, except the binges don’t happen as often or over as long a period of time as doctors would expect.

“Purging disorder – where someone purges, for example by being sick or using laxatives, to affect their weight or shape, but this isn’t as part of binge/purge cycles.

“Night eating syndrome – where someone repeatedly eats at night, either after waking up from sleep, or by eating a lot of food after their evening meal.”

Signs of OFSED might include:

  • Preoccupation with and/or secretive behavior around food
  • Self-consciousness when eating in front of others
  • Low confidence and self-esteem
  • Poor body image
  • Irritability and mood swings
  • Tiredness
  • Social withdrawal
  • Feelings of shame, guilt, and anxiety
  • Difficulty concentrating

What are the myths surrounding eating disorders?

“Eating disorders are complex mental illnesses and anyone, no matter what their age, gender, or background, can be affected. Sometimes, the way that eating disorders are portrayed in the media doesn’t reflect the full spectrum of eating disorders and people who can develop them – studies suggest that around a quarter of people with eating disorders are male, 80-85% of people with eating disorders are not underweight, and they can also be common in people over the age of 40. Just because the symptoms, feelings and circumstances are dissimilar to what is usually portrayed, that doesn’t mean an eating disorder isn’t happening.”

Why might someone be suffering with an eating disorder?

“Eating disorders can be a way of coping with feelings or situations that are making the person unhappy, angry, depressed, stressed, or anxious. They are not the fault of the person suffering, and no one chooses to have an eating disorder. Sometimes people worry about talking to someone because they feel their eating disorder isn’t serious enough, they don’t want to worry people or waste their time, or because they feel guilty, embarrassed or ashamed. But no matter whether eating difficulties began recently, you’ve been struggling for a while, or someone was treated for an eating disorder in the past that might be coming back, everyone deserves to have their concerns acknowledged respectfully, to be taken seriously and to be supported in the same way as when affected by any other illness.”

Is it possible to recover from an eating disorder?

“‘Recovery’ is different for each and every person affected by an eating disorder. For some people it might mean that they never have another eating disorder thought again. For others it means that, although these thoughts are still there, they happen less frequently, and they’re able to control them through the coping mechanisms and techniques they’ve learned, meaning they no longer have the same impact on their daily life. It’s important to remember that recovering from an eating disorder is hardly ever a straightforward process.

“If you’re worried about yourself or someone you know, even if only some of the signs are present, you should still seek help immediately. Getting help as quickly as possible gives the greatest chance of a full recovery from an eating disorder and the first step is usually to talk with someone you can trust and make an appointment with the GP.”

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