Eating disorders are complex medical and psychological conditions; they are so much more than just dieting and exercising. There a multiple different eating disorders however the two most common in South Africa are Binge Eating Disorder and Anorexia Nervosa. It is also important to remember that eating disorders affect individuals of all genders, any socioeconomic class, any age, and any body size. We need to not prejudge just by someone’s appearance and break the myths and stigmas around disordered eating.
I’m going to tell you a bit about the different disorders, some signs and symptoms to look out for in yourself or your friends, some possible underlying causes you may relate to, and some management techniques to help improve your relationship with food.
Different eating disorders (according to the DSM 5)
Pica Disorder : eating non-food substances
Rumination Disorder : regurgitating food
Avoidant / Restrictive Food Intake Disorder : avoiding certain foods based on sensory characteristics (e.g.: weird textures) and restricting intake due to consequences (e.g.: weight gain)
Anorexia Nervosa : fear of weight gain, restricted intake and distorted mental image of body shape or size
Bulimia Nervosa : binge eating and then forcing vomiting or using laxatives
Binge Eating Disorder : rapid binge eating (no self-induced vomiting)
Other Specified Feeding or Eating Disorder and Unspecified Feeding or Eating Disorder : characteristics of disordered eating but does not meet the full criteria for another disorder
Each eating disorder has various characteristics and specific criteria that need to be met in order to be diagnosed so these descriptions are just very basic explanations.
Signs and symptoms
It will always be difficult to narrow down very specific signs and symptoms because every client we see will present differently and have very different underlying causes, beliefs, psychological insight, etc. These signs and symptoms are just the common ones that we see but not all of them.
Emotional Signs:
Preoccupied thoughts and fears around your body image
Frequent mood fluctuations
Withdrawal and isolation from others
Body insecurity
Lowered self-esteem
Feelings of guilt after eating
Changes in personality
Desire for control
Behavioural Signs:
Refusal to eat certain foods
Excessive counting calories
Uncomfortable eating around others
Skipping meals or limiting portions
Food rituals (excessive chewing, not allowing food to touch, etc)
Constantly trying new diets
Frequent checking in the mirror for flaws
Inappropriate use of laxatives or diet pills
Secretive or excessive exercise
Frequently weighing self
Hiding food
Wearing baggy clothes to hide your body
Physical signs:
Noticeable changes in weight
Gastrointestinal complaints
Menstrual irregularities or no period at all
Difficulties concentrating
Dizziness / fainting
Abnormal blood labs
Feeling cold all the time
Unable to sleep or sleeping too much
Unexplained wounds on your body that will not heal
Dental sensitivity
Dry skin and hair
Brittle nails
Fine hair on your body (called ‘lanugo’)
Yellow or grey skin
Unusual swelling of body parts
Have you maybe noticed some of these signs or symptoms in yourself or with someone you know? It is okay if you are struggling to admit your problem or struggling to even know where to begin to get help, this is normal! Take some time to reflect and confide in someone you love before starting your journey of healing.
Underlying causes
Some common underlying causes to eating disorders that you may not know about are biological factors such as irregular hormone functions, genetics, nutritional deficiencies, and your natural stress response. You may also start to realise through your reflection that there are environmental or psychological causes. Some environmental causes could be a dysfunctional family, certain body-focused careers, past or present trauma, peer or societal pressure, life transitions, sports performance, and cultural perspectives. Also, some psychological underlying causes include other mental health disorders, negative self-esteem, perfectionism, impulsivity, intimate relationship problems, bullying, some personalities, stigma, anxiety, difficulty self-regulating your emotions, and being highly sensitive.
So now, HOW TO MANAGE AND GET HELP
Begin to reflect on your eating patterns as I have suggested above, this helps you begin to acknowledge and accept that you have a problem you need to get help for
Seek an eating disorder support group, or an inpatient treatment centre, or an outpatient treatment centre, or a psychologist / medical doctor who can point you in the right direction – there needs to be professional intervention
Get ongoing counselling and support from your friends and family
Try rephrasing – this is rephrasing the way you speak about yourself to rewire your brain (e.g.: “I can’t eat a bagel” becomes “my eating disorder is telling me to not eat a bagel”)
Try challenge your thinking by telling yourself the facts which counter this belief and the evidence that proves your eating disorder thoughts wrong
Find your coping mechanisms – call a friend, write a journal, listen to music, take a walk, paint, have someone keep you accountable to eating, etc
Build up your self-esteem and self-confidence (have a look at a previous article I wrote on this!)
Eating disorders are dangerous and cannot be solved by ‘just eating’. Remember you are not your eating disorder, you are so much more then this one part of you, and you are worthy of the help and self-love you need to get better.
Please reach out to us if you need help, direction, or support in any way!