We are dependent on food for survival. However, our relationship with food may go well beyond simple nutrition and the alleviation of hunger. It can be used to soothe, comfort or reward, provide consolation or uplift the spirits. In this respect food can act in ways similar to the mood-altering substances common to addiction. Neurotransmitters in the brain can be manipulated by patterns of eating (or not eating), including types, frequency and quantities of food to regulate emotional states.
For people with eating disorders, consuming or avoiding the consumption of food becomes less about real hunger and nutrition and more about the regulation of feelings; escaping some and achieving others. However, what at first appears a solution or a means of coping becomes in time, through compulsive repetition, a problem, producing many of the feelings it was originally meant to alleviate. In this regard there are further parallels with addiction.
Diagnostically, the commonest eating disorders are Anorexia, Bulimia and Binge Eating Disorder although an additional category has been created to account for the fact that not all eating disorders fit neatly the diagnostic profiles of the three conditions listed. This is termed Other Specified Feeding or Eating Disorder (OSFED). In some people these conditions or aspects of them may be found in combination.
People suffering from anorexia feel desperate to keep their weight as low as possible. They do so by not eating enough or exercising excessively and sometimes both. Because starvation becomes a reality, they can become life-threateningly ill. They often have a distorted body image, believing themselves to be fat even when they are dangerously underweight. While most common in young women, for whom it typically starts in the mid-teens, men and women of any age can develop anorexia.
People who develop bulimia go through periods where they consume large quantities of food in a very short space of time. They then induce vomiting, use laxatives or exercise excessively (called ‘purging’), sometimes combining these behaviours, to try to prevent gaining weight. Bulimia is most common in young women, typically beginning in teenage years.
Binge Eating Disorder is characterised by eating large amounts of food at one time until the person becomes uncomfortably full, at which point they are likely to feel upset, guilty or ashamed. Binges, which are often pre-planned may include “special” binge foods. Binge Eating Disorder can afflict men and women of any age, although it typically starts in the late teens or early 20s.
Eating disorders are treatable, but as with any serious condition with significant consequences, it is essential to seek help as soon as possible. Because there are often both mental and physical health complications, the involvement of medical expertise at an early stage is strongly advised. So-called talking therapies, mutual aid, as well as both in-patient and out-patient services may have a role to play in recovery from eating disorders.
