Ruadhán Jones
There’s a fine line between disordered eating and an eating disorder writes Ruadhán Jones
Many of us might have felt the urge to padlock fridge and cupboard doors over lockdown. Boredom, stress and the ready availability of food were a tricky trio to overcome. But while that kind of eating might be frustrating, it wouldn’t qualify as an eating disorder.
Using food for comfort only becomes a serious problem if becomes a habit, an automatic or ‘go to’ behaviour that turns into a compulsion underpinned by a sense of a loss of control. When a person feels compelled to disordered eating, this is the realm of an eating disorder.
Roughly 4% of the world’s population is likely to suffer from an eating disorder in their life. There are three main types, the most well-known are anorexia and bulimia, but a third disorder has been identified in recent years – Binge Eating Disorder (BED).
What is BED?
BED involves regularly eating large portions of food all at once until you feel uncomfortably full, with episodes marked by feelings of a lack of control. Someone with BED may eat too quickly and even when he or she is not hungry.
Episodes are often followed by feelings of guilt or upset, leading them to conceal the episodes. They typically occur once a week over an extended period. The disorder affects around 3.5% of women and 2% of men.
The reason this disorder has only been recently identified is due to its similarity with bulimia. This involves similar periods of binge eating, but whereas bulimia involves compensatory episodes of purging, BED doesn’t – though periods of dieting may be involved. As a result, obesity and weight gain are frequently associated with BED.
What are the signs?
The main symptom of BED is eating large amounts of food in a short time, often in an out of control way. This isn’t always the case, however, as binges may be planned in advance. Binges almost always occur in secret and an appearance of ‘normal’ eating is often maintained in front of others.
While it might seem counterintuitive, one of the major ‘tells’ for an eating disorder is a fixation on dieting and fitness. One of the precipitating factors of BED is a period of dieting. This has a physical and a psychological effect.
When your body is in starvation, it will give you strong cravings for food because it’s not receiving enough nutrition. It keeps food on your mind. Psychologically, this can lead to a fixation and raises the risk of a loss of control. A minor slip from the diet can lead to completely abandoning the diet and going too far the other direction.
Most binges can be divided into four stages: tension build up, tension release, post-binge and new beginning. The tension could come from a known or unknown source, but regardless it will cause an unsettled feeling that will increasingly call for release.
Binging provides an apparent release of the tension, blotting out negative thoughts and feelings. This is short lived, however, being followed by a post-binge ‘hangover’. Symptoms may include headaches, nausea, diarrhoea, lethargy and fatigue. The final stage is followed by a period of determination to improve and perhaps a strict diet.
What are the causes?
The causes of eating disorders are quite varied and largely depend on the individual’s personal habits, their social and cultural background and their family situation.
Typically, however, those who suffer from eating disorders tend to show certain psychological characteristics. Low self-esteem, depression and feelings of ineffectiveness or powerlessness often precede the onset of eating problems.
Another psychological trait is a predisposition to think about the world in ‘all or nothing’ terms. They tend to set high standards for themselves in areas like academic or professional achievement and a related tendency to be self-critical.
Social, cultural and familial backgrounds can also play a part. An overemphasis on physical appearance and particular body types can influence how the person views themselves. Parents who have issues with weight and body image can, often unconsciously, transmit these concerns to their children.
The result of these combined causes is that responses to stressors become unhealthy. For those suffering from BED, binge eating becomes a coping mechanism.
How to treat it?
Broadly speaking, there are two approaches to treating BED. One is seeking professional support, the other is self-help. Depending on the seriousness of the eating disorder, a combination of both may be required to overcome it.
When treating BED and other eating disorders, it’s important to remember that to achieve long-lasting change may be difficult. It will require you to understand and address the underlying factors in order to combat BED.
But that doesn’t mean you can’t address it in the short-term – by focussing on the factors that are maintaining the binge eating, it is possible to change your eating habits. In fact, gaining control over your eating habits in the short term can help you identify the underlying issues and it will be easier to deal with them.
Helping yourself
Self-help is a good place to start when addressing an eating disorder. By educating yourself about the disorder, it can help bring to the fore the unconscious thoughts and feelings which are fuelling your disorder.
When trying to help yourself, it’s advisable either to use a self-help manual or else to work in conjunction with a professional consultant. The first piece of advice specialists recommend following is to stop dieting. While our first thought when we’re putting on weight might be to go on a new, faddish or more serious diet, for those with BED is an unhealthy pattern of fasting and binging.
What is recommended instead is to gradually replace this pattern with a more regular meal plan. This is a better means for controlling weight gain and loss, allowing for natural variations without overreacting. Once you begin to eat regularly and healthily, you will be able to achieve a healthy weight that is comfortable for you.
Along with a regular meal plan, a good idea is to start a food diary. When trying to address eating disorders, your head can quickly become filled with thoughts of food. Using a food diary helps you to give these thoughts, which are quite natural, a proper focus and release.
Equally, by keeping a food diary, you can develop an overview of how you are eating. By this, I mean how much you are eating; how often; when; and if you felt in control while you were eating. While the temptation will be not to write in when you’ve had a binge, it’s important to do so in order to become aware of your eating patterns. Identifying your individual eating pattern is essential to recovery.
If you’re looking for a self-help manual, Bodywhys.ie have a useful self-help booklet on their website which can be accessed here.
Professional treatment
If your eating disorder is quite severe or if you find that the underlying issues it results from are difficult to address, it can help to seek professional advice. If you do decide to go down that route, there are a number of options open to you.
A trusted General Practitioner (GP) can be an important source of support in these circumstances. He or she can advise you on the severity of your condition and can refer you onto the relevant support. If necessary, he or she can provide ongoing monitoring or advise on a course of treatment to take.
If you are struggling to come to terms with managing your BED in the short-term, working with a dietician may help. Though it won’t address the underlying issues, it will give you the scope to do so by helping you gain control over the immediate effects of BED.
If it is the case that psychological or therapeutic counselling is necessary, you may wish to visit a psychotherapist. This kind of treatments is often referred to as ‘talking therapy’ and gives you the space to work through your feelings and emotions. Bringing your concerns out into the open can help clarify them and allow you to develop new strategies for coping.
For further information, go to Bodywhys.ieor visit the HSE’s website here.