Eating disorders

What is an Eating Disorder?

Anorexia nervosa and bulimia nervosa are the two most serious eating disorders although binge eating can also be included.

Each illness involves a preoccupation with control over body weight, eating and food.

People with anorexia are determined to control the amounts of food they eat.

People with bulimia tend to feel out of control where food is concerned.

Anorexia affects two out of every 100 teenaged girls, although their illness can be experienced earlier and later in life.  Most people who have anorexia are female, but males also develop the disorder. Bulimia may affect up to three in every hundred teenage girls.

While these rates show that few people meet the criteria for these eating disorders, it is far more common for people to have unrealistic attitudes about body size and shape.  These attitudes may contribute to inappropriate eating habits or dieting practices.

The causes of eating disorders are complex, but experts agree that ‘marketing and advertising’ contribute to the problem with their unrealistic ‘portrayals of physical perfection’ (The Australian Medical Association Position Statement on Body Image and Health, 2002).

Available from: http://www.ama.com.au/web.nsf/doc/SHED-5G4UVU.

Both illnesses can be overcome and it is important for the person to seek advice about either condition as early as possible.

 

Eating Disorders and Sexual Assault

Eating disorders can become a mechanism with which to cope with rape, incest and other trauma.  Eating disorders are common for adult survivors of childhood sexual abuse and for survivors of sexual assaults as adults.  Basically, the eating disorder, whether it is bulimia or anorexia, acts as a diversion from the horrific memories encompassing the psychological, emotional, spiritual and physical realms.  Not all victims of sexual assault develop eating disorders and not all people with eating disorders have been sexually assaulted.

However, some studies indicate that almost 30%of women suffering from bulimia were raped at some point in their lives.  Girls who are sexually abused appear to be at a double risk for eating disorders.

“Many disorder behaviors are a direct consequence of trauma. Some of the disorders caused by sexual violence include (PTSD) Post Traumatic Stress Disorder, and eating disorders (ED). It is estimated that almost 30% to 40% of eating disorder patients are survivors of sexual trauma. For a person already vulnerable to eating disorders or suffering from bad self-image, a traumatic incident like rape or incest can trigger an eating disorder.

There are countless reasons why women and men (though women are still a majority) who have survived rape, sexual abuse, incest, or molestation use eating disorders as a coping mechanism. For some developing eating disorders is a way to avoid sexuality. In other cases, an eating disorder may be a way to hide anger or frustration and seek the approval of other people. Unhealthy eating is often the symptom of a bigger problem. Since survivors often feel that they cannot show their anger and resentment directly, they may resort to unhealthy ways like starving or overeating to express on the outside what is hurting them on the inside. In addition, victims might start viewing their body as a source of shame, and an eating disorder may be used as a form of self-punishment.” (http://www.aftersilence.org/eating-disorders.php)

In stressful events like rape or molestation, the victim often feels utterly powerless, and may seek new ways to improve his or her sense of control. Our culture and society place great emphasis on body image. Being thin is equated with maximum control. As a result, victims may start avoiding food or limiting intake to dangerous levels. By doing so, some survivors of sexual violence no longer feel powerless in their lives. Sadly, commercials, magazines, and advertisement that show unrealistic bodies can keep motivating a person to indulge in unhealthy eating behavior.

Symptoms of anorexia:

Anorexia is characterised by:

  • A loss of at least 15% of body weight resulting from refusal to eat enough food, despite extreme hunger;
  • A disturbance of perception of body image in that the person may regard themselves as “fat” when they are of healthy body weight or are underweight;
  • An intense fear of becoming fat and of losing control;
  • A tendency to exercise obsessively
  • A preoccupation with the preparation of food;
  • Making list of “good” and “bad” foods.

 

Symptoms of bulimia:

Bulimia is characterised by:

  • Eating binges which involve the consumption of large amounts of calorie rich foods, during which, and afterwards, the person feels a loss of personal control and self-disgust
  • Attempts to compensate for binges and to avoid weight gain by self-induced vomiting, and/or by the abuse of laxatives and fluid tablets
  • A combination of restricted eating and compulsive exercise so that control of weight dominates the person’s life.

 

Food can often become an area where a survivor can exert control by:

  • Deciding when and if they can eat
  • How much and what they eat
  • Denying themselves when they are hungry
  • ‘Punishing’ themselves for feelings or memories they have about the abuse, by not eating or by eating and then purging
  • Working through the hunger
  • Surviving on very little amounts of food

Accomplishing these things can feel like victories in gaining control over their lives and bodies after the sexual assault or abuse took that control and choice away.  Some survivors may deny themselves food in order to become thin and lose any resemblance of a female figure.  Other survivors may want to gain weight to cover or hide areas of their body, or in attempt to make themselves appear less attractive.  This may or may not be on the conscious level of the victim.  Vomiting can become a means to express the revulsion and repressed emotions caused from the assault as well.

(Reference: www.health.columbia.edu/docs/topics/sexual_violence/ed_sexual.html)

 

Effects of anorexia and bulimia:

 

Physical effects

The physical effects can be serious, but are generally reversible if the illnesses are tackled early.  If left untreated, severe anorexia and bulimia can be life threatening.  Responding to early warning signs and obtaining early treatment is essential

Both illnesses, when severe, can cause:

  • Harm to the kidneys
  • Urinary tract infections and damage to the colon
  • Dehydration, constipation and diarrhoea
  • Seizures, muscle spasm or cramps (resulting from chemical imbalances)
  • Chronic indigestion
  • Loss of menstruation or irregular periods
  • Strain on most body organs

Many of the effects of anorexia are related to malnutrition and can include:

  • Absence of menstrual periods
  • Severe sensitivity to the cold
  • Growth of down-like hair all over the body
  • Inability to think rationally and to concentrate

 

Severe bulimia is likely to cause:

  • Difficulties with activities which involve food
  • Loneliness, due to self-imposed isolation and a reluctance to develop personal relationships
  • Deceptive behaviours relating to food
  • Fear of the disapproval of others if the illness becomes known, tinged with the hope that family and friends might intervene and provide assistance
  • Mood swings, changes in personality, emotional outburst or depression

 

How can I help if I know someone who has an eating disorder?

Finding out that someone you care about has an eating disorder can be hard.  The person does not have these behaviours to make you feel bad or guilty but they can be difficult to understand.   Find out as much information as you can to support this person.

Changes in eating behaviour may be caused by several illnesses other than anorexia or bulimia, so a thorough physical examination by a medical practitioner is the first step.

Once the illness has been diagnosed, a range of health practitioners can be involved in treatment as the illnesses affect people physically and mentally.

Be supportive without reinforcing the behaviour by letting the person know that you are there for them if she/he wants to talk.  Make the initial approach, but don’t push that person to disclose the information.  If you are concerned about the person but unsure how to bring it up, you may speak with a counsellor or help line for more information or strategies.

 

Where to go for help?

  • Your general practitioner
  • Your school or university counsellor
  • Your community health centre

And finally, don’t forget to take care of yourself.  Recognise that this is a difficult situation and you need time to adjust and make sure you are caring for your needs as well as the person you are caring for.

For further information and support, please contact Laurel House (North) on 6334 2740, Laurel House North-West on 6431 9711, or email counsellors@laurelhouse.org.au