Eating Disorders

Diane McGeachy

Psychologist
Child and Adolescent Psychotherapist
Accredited Gestalt Psychotherapist
Hobart, Tasmania

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Eating disorders affect both males and females. The onset of an eating disorder often begins in childhood or adolescence and if untreated, can remain with a person throughout their life. The severity of the eating disorder can fluctuate during different periods of stress or life transitions. It is common for someone with an eating disorder to keep their struggle secret from the people in their life and try to cope on their own.

Disordered eating can be identified by a person severely restricting their food intake or feeling out of control and overeating. A person may have rigid rules about food such as the types of food they can or cannot eat, calorie counting, weighing themselves frequently, measuring oneself and preoccupation about body weight and shape. Often a person’s self-worth is dependent on reaching or maintaining their ideal weight.

Types of Eating Disorders

Anorexia Nervosa

Anorexia nervosa is a serious mental illness with significant physical complications. It is a brain-based disorder that stems from a complex interaction of genetic, environmental and socio-cultural interactions. Anorexia is characterized by persistent restriction of energy intake resulting in significant low weight. A person may have an intense fear of becoming fat or gaining weight and experiences a disturbance of how their body shape or weight feels and looks.

Risk Factors of Anorexia Nervosa

  • Anaemia (iron deficiency)
  • Decreased immune system functioning
  • Intestinal problems (abdominal pain, constipation, diarrhoea)
  • Loss of menstrual periods
  • Increased risk of infertility in men and women
  • Kidney failure
  • Osteoporosis
  • Heart problems (sudden cardiac arrest)
  • Death

Bulimia Nervosa

Bulimia nervosa is more difficult to identify. The person usually maintains a normal weight due to binge eating (eating large quantities of food in a short period of time, usually two hours) and then engaging in a compensatory behaviour such as; purging in secret, excessive exercise, use of laxatives or diuretics. While people with anorexia may not believe they have a problem, those who struggle with bulimia often feel intense guilt and shame about their behaviour.

Risk Factors of Bulimia Nervosa

  • Chronic sore throat, indigestion, heartburn and reflux
  • Inflammation and rupture of the oesophagus and stomach from frequent vomiting
  • Stomach and intestinal ulcers
  • Chronic irregular bowel movements, constipation and/or diarrhoea due to deliberate misuse of laxatives
  • Osteoporosis
  • Loss of menstrual periods
  • Increased risk of infertility in men and women
  • Irregular or slow heart beat which can lead to an increased risk of heart failure
  • Worn tooth enamel, increasingly sensitive and decaying teeth as a result of exposure to stomach acid

Binge Eating Disorder

Binge eating disorder affects men and women equally. It is characterized by eating a large quantity of food in a SHORT time frame and not using methods such as purging, laxatives or exercise to compensate. People who binge eat typically experience deep feelings of shame and self-loathing, and feel as though they are out of control and cannot stop themselves from eating. There is much secretiveness around binge eating coupled with deep feelings of shame and self-disgust.

Risk Factors of Binge Eating Disorder

  • Osteoarthritis – a painful form of degenerative arthritis in which a person’s joints degrade in quality and can lead to loss of cartilage
  • Chronic kidney problems or kidney failure
  • High blood pressure and/or high cholesterol leading to increased risk of stroke, diabetes and heart disease

Other Specified Eating or Feeding Disorders (OSFED)

OSFED was previously known as eating disorders not otherwise specified (EDNOS) in the DSM-IV. Individuals who present with several symptoms of an eating disorder such as anorexia nervosa, bulimia nervosa or binge eating disorder but who do not meet all of the criteria of that particular disorder may be diagnosed with OSFED. According to the National Eating Disorders Collaboration approximately 30% of individuals who seek treatment in relation to an eating disorder are diagnosed with OSFED.

Orthorexia

Orthorexia is a chronic preoccupation with “clean” eating or eating solely what the individual considers to be healthy food. Not having access to the preferred foods or eating foods that are not considered to be clean or pure can cause high levels of anxiety and distress for the individual. The focus of the preoccupation is not particularly in relation to the quantity of food consumed, but rather the health benefits or quality of food being consumed. Orthorexia is not currently recognised as a diagnosed eating disorder in the DSM-5.

Causes of Eating Disorders

There is no one cause to developing an eating disorder; however, there are several contributing risk factors that can be involved in the onset of an eating disorder. Some of these factors can include:

  • Genetic vulnerability
  • Personality traits (such as perfectionism and obsessive- compulsiveness)
  • Internalising cultural ideals and stereotypes
  • Trauma
  • Low self-esteem
  • Bullying
  • Body Dissatisfaction
  • Dieting from a young age

Athletes and Eating Disorders

Athletes who engage in individualised sports compared to team sports are at higher risk of developing an eating disorder. Those who have trained at a competitive level from a young age and who compete at state and national levels are found to be at greater risk of developing anorexia nervosa. When the focus becomes primarily on the athlete’s success rather than the effort and person as a whole it can facilitate disordered eating behaviours and body dysmorphia. Types of sports that may be a factor in a person becoming more vulnerable in developing an eating disorder are:

Athletes who engage in individualised sports compared to team sports are at higher risk of developing an eating disorder. Those who have trained at a competitive level from a young age and who compete at state and national levels are found to be at greater risk of developing anorexia nervosa. When coaches focus primarily on the athlete’s success rather than the effort and person as a whole it can facilitate disordered eating behaviours and Body Dysmorphia. Types of sports that may be a factor in a person becoming more vulnerable in developing an eating disorder are:

  • Weight lifting
  • Wrestling
  • Gymnastics
  • Dancing
  • Swimming
  • Running
  • Figure skating
  • Jockeying
  • Body building

Eating Disorders in Males

Eating disorders are often portrayed as an illness that only effect women, however according to the National Eating Disorders Collaboration one in three people who have an eating disorder in Australia are male. Additionally, 40% of individuals with binge eating disorder are men. It is believed that this number is underrepresented due to the potential for males to be less likely to seek help and health professionals less likely to identify eating disorder symptoms in men compared to women.

Recovery from an Eating Disorder

Recovery from an eating disorder is possible. Working with a professional or team of professionals who understand the complexities of eating disorders is essential. Additionally, finding someone with whom you feel comfortable and safe working with is crucial. Recovery includes focusing at times on the eating disorder directly and indirectly. It involves learning practical skills and tools to assist in developing a healthy and balanced relationship with food and one’s body. In addition, it may involve exploring interpersonal relationships and increasing one’s awareness of their needs and how they get their needs met. Other important aspects of recovery are skill building such as emotional regulation, problem solving, communication skills, set shifting, learning new coping mechanisms and increasing one’s distress intolerance.

Common approaches used when treating eating disorders include; Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), Family Based Psychotherapies such as Family Based Therapy (FBT) and the Maudsley Approach, Art and Creative Therapies, Somatic Approaches and Mindfulness. A holistic, multi-disciplinary approach is important to the successful treatment and management of eating disorders. Some of these professionals may include; Psychiatrist, GP, Paediatrician, Nurse, Psychologist, Dietician or Nutritionist, Social Worker and Occupational Therapist. Other additional forms of complimentary support may include; Yoga, Meditation, Remedial Massage, Mindfulness Practice, Acupuncture and more.

If you have an eating disorder or struggle with your relationship with food it can be helpful to explore these issues with a Psychologist or Counsellor. If you would like to book an appointment contact Diane McGeachy.

Diane McGeachy
Psychologist
Child and Adolescent Psychotherapist
Accredited Gestalt Psychotherapist

Phone: (03) 6285 8592
Email: enquiries@hobartcounselling.com.au

Hobart Counselling Centre
Level 1,
181 Elizabeth Street Hobart TAS 7000
www.hobartcounselling.com.au

RESOURCES
Butterfly Foundation
NEDC