Eating disorders are not primarily about food

For ‘Eating Disorders Awareness Week’ Mags Gargan speaks to Bodywhys about combating the myths behind these conditions

“Eating disorders are not unique to young people,” advises Jacinta Hastings, CEO of Bodywhys, the Eating Disorders Association.

Bodywhys is a national voluntary organisation founded in 1995 to support people affected by eating disorders and this week it has been organising a number of events as part of ‘Eating Disorders Awareness Week’. The aim of the week is to break down stigmas and combat myths around eating disorders and to encourage people to seek help.

Although the term ‘eating disorder’ is applied to a wide range of disordered eating behaviours, there are three main classifications: Anorexia Nervosa (self-starvation), Bulimia Nervosa (purging) and Binge Eating Disorder. Often these terms conjure up the stereotype of young girls obsessed about their appearance, but eating disorders can affect men and women at any age and they are not primarily about food.

There are many reasons why people develop eating disorders and often the combination of events, feelings and pressures is what leaves a person feeling unable to cope. The person blocks out this feeling by controlling their food.

However, the sense of security the person gains from the eating disorder is fleeting, and they need to continue to control their food in order to regain and hold on to this sense of security. This is how the eating disorder develops and establishes itself in a person’s life – they get trapped in a vicious cycle of having to progressively increase their control over their food (and body) in order to feel like they can cope and survive.

The Department of Health & Children estimates that up to 200,000 people in Ireland may be affected by eating disorders and an estimated 400 new cases emerge each year, representing 80 deaths annually. Anorexia nervosa has one of the highest mortality ratios and also brings risk in terms of suicide.

Destructive

“An eating disorder can be very destructive, both physically and emotionally, and people can get trapped into the destructive cycle of the eating disorder without knowing how to cope with it,” Jacinta says. “An eating disorder is not just about food and weight, but also about a person’s sense of who they are. Treatment of an eating disorder will require attention to both the physical and the psychological/emotional aspects of the person. Treatment must always include respect for and sensitivity for the overall well-being of the person.”

After more than 20 years in operation Jacinta says Bodywhys now has a clearer picture of the Irish context in relation to eating disorders. “We know more about what services are available, how people can access help, what young people say about body  image, what advice schools might need in relation to this issue, what support parents and family members need and why the role of online services is important. We work in partnership with other organisations to ensure the most up to date and accurate information is available.”

Jacinta thinks there is also a gradual acknowledgement within society of eating disorders as a serious and complex mental health issue. “This is something we’ve always known, but it’s been challenging to get this message to sink into wider society.”

Disorders

There is often a mixture of physical and psychological symptoms with eating disorders and while it is not always obvious to someone looking in from the outside, family and friends might notice that something is going on.

“There may be some weight loss or fluctuations, a noticeably changed attitude towards food that might be out of character (i.e. not a diet), compensatory behaviours such as over-exercising or purging. As well as that, and something often seen as a ‘red flag’, is a change in personality. Other experiences include low mood, anxiety and low confidence. The nature of eating disorders, the stigma, feelings of guilt and shame mean that it’s often a very hidden issue.”

Eating disorders may sometimes present somewhat differently in men. For example, rather than restricting their diet, men affected by anorexia may focus more on over-exercising and behaviours focussed on building muscle mass.

Misconceptions

The misconception that eating disorders are a ‘female issue’ can sometimes make it harder for a man to acknowledge to himself or others that there is a problem of this nature. This in turn can mean that a man is less likely to seek support and help for an eating disorder or related issue. However, in terms of treatment and the recovery process, anyone experiencing an eating disorder needs help and support to make the journey to recovery.

Jacinta says that for anyone thinking of approaching a person about an eating disorder, the most important thing is to show your willingness to be there for them and to listen without judgement.

“Try to show the person that you are not trying to ‘fix’ them or make them stop what they are doing right now. Show them you understand that whatever they are doing helps them feel safe, and that they may be frightened to acknowledge that there is a problem. It is a good idea to read up on the issue before you talk to them, to understand how an eating disorder works and affects someone,” she says.

“The distress of a person experiencing an eating disorder, whether or not it is acknowledged, may have a considerable impact on family and friends. It is not unusual for someone to deny that they have a problem… for their defences to go up when asked about it. This is because specific eating disorder thoughts are very controlling and it is a challenging for someone to assert their rational thoughts against the eating disorder ones.”

Specialist

In terms of getting help, often the first port of call is to talk to a GP who may assess the issue or refer to a specialist. “It’s important to say that people can and do recover from their experience of an eating disorder. That is, their life is no longer controlled by intrusive thoughts around food and weight and they develop coping mechanisms that are not self-destructive. Recovery is not a straightforward process, but it is possible,” Jacinta says.

Bodywhys can play an important role at any stage for people affected by eating disorders. It offers a lo-call national helpline; local support groups, an email support service and weekly online support meetings. The various support services are designed to offer non-judgemental, confidential support and understanding to people affected by eating disorders at any stage of their journey. All services are provided by trained and supervised volunteers and the feedback suggests that one of the main benefits people find valuable is being listened to.

*Bodywhys offers face-to-face support groups in Dublin and Carlow and two online groups – BodywhysConnect for adults and YouthConnect for teenagers. It also offers a confidential lo-call helpline on 1890 200 444 and an email support service on alex@bodywhys.ie For more information see www.bodywhys.ie

Personal stories

Helen: “Food was about calories, to be feared and then abused, to punish myself for not being okay and to numb the feelings of shame and guilt that accompanied this not-okay-ness. Exercise was about becoming less, burning fat and shrinking. Everything I did was driven by fear.”

Claire: “The irony of bulimia is that it starts out as a situation which is completely in the control of the person. However, it quickly snowballs and becomes a situation which is totally uncontrollable. My first binge terrified me because I had no control over it, the hunger was from deep within and was insatiable.”

Alf: “My relationship with food is moving towards normal. Having admitted where I was, having gone through treatment, I feel so much more comfortable in myself. I’m happier because of it and the people around me are happier. I’m in a really good place and learned a lot about myself.”