Sharing my personal experience, knowledge and enthusiasm about how we can do more for people with this serious mental illness.
I know how it feels to be extremely slim. Until my thirties I was under-weight, and in my twenties people mistakenly thought I had an eating disorder and told me I was ‘skin and bones’. I was not happy with how I looked, but in my case, it was not because I had a restrictive eating disorder and/or habit of over exercising. My metabolism was naturally working hard and being a worrier, I was constantly on overdrive and burned my energy fast. I was always on the move: physically and mentally. However, it did not interfere with my everyday life, and now with the right support, self-awareness and experience, I’m at a place where I am happier with how I look.
A person with an eating disorder (ED), however, presents with a different story. It interferes with their everyday life and is a serious mental illness with the highest mortality rate. Eating disorders involve extreme disturbances in eating behaviours such as obsessively counting calories, rigid diets, secret binges and purging. For example, buying the same food cans from a particular shop weighing exactly 240g, or believing that it’s enough to live only from food supplements or liquids alone. Likewise, secretly buying a variety of sweets online and after binge eating these, feeling guilty: purging and living without food for days.
Eating disorders also involve distorted, self -critical attitudes about weight, food and body image. Negative thoughts and feelings fuel damaging behaviours, such as binging, vomiting, laxative abuse, avoidance, suicidal thoughts and self-harm. Restricting food is used to feel in “in control”, to deal with uncomfortable and painful emotions: shame, low-self-esteem, anxiety, lack of control, anger, trauma. Overeating temporarily soothes loneliness, sadness or anger.
There are three types of eating disorders:
Anorexia Nervosa (In Latin means “Loss of appetite”).
Often this is about power and control – a ‘Shedding a of a heavy load – mentally’. Eating makes sufferers feel guilty, and is therefore extremely restricted. It is an illusion of ultimate control and seen as self- punishment. Likewise, it is a sense of letting go of suffering.
I have understood from sufferers that bulimia is often about shame. Lack of control, fear of being found out, and failure. People with bulimia might eat of large quantities of food and after trying to compensate for that overeating by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging).
Binge eating disorder
The main symptom of binge eating disorder/compulsive overeating is eating very large amounts of food in a short time and often in an out-of-control way. We all sometimes overeat, but binge eating is a serious eating disorder. Sufferers find it difficult to stop eating during a binge. There might be feelings of guilt and disgust at their lack of control during and after binge eating, and unlike those with bulimia, people with binge eating disorder do not regularly use purging methods after a binge. Binge eating episodes are associated with eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not physically hungry, eating in secret through embarrassment and feelings of disgust, shame or guilt during or after the binge.
For those who are dealing with or supporting someone with an eating disorder, I would like to share what I have observed and learned working in an eating disorder ward.
From family, friends and other support teams:
- Be a listening ear, and be available if you are able to. Your presence, and offering comfort through hugs (in some cases lots of hugs and less talking) can be helpful.
- Please remember that it is an illness. We may hear some strong words from the person with an eating disorder (which come from anxiety, fear, loss of control) but remaining calm, present and patient, despite all anger, frustration, and tears, is crucial. I am not saying it’s easy, but it is necessary.
- Discussing attempts to lose weight or overeating, displaying unhealthy eating behaviours at the table and general opinions around food is fundamentally unhelpful for people with an eating disorder.
- Offer structured support during mealtimes. Ask what they might find helpful during eating. Remember that there are many fears and anxieties around food. Reassurance and boundaries are helpful. It is important to be consistent as many sufferers might find a way to reduce their food intake by hiding it, spitting it out and just generally fighting for having a lighter option instead.
- Support, support, support! Distraction after meal times such as playing games, talking and watching movie can all help to alleviate pressure and anxiety around food.
- Communicate: eating disorders can be incredibly lonely and isolating.
Finally, it’s not easy, but I strongly believe that with the right army of support (which is absolutely crucial), reassurance, patience, boundaries and encouragement, recovery from eating disorders is possible. We must show empathy to those suffering. Communicating “I am your friend” and mirroring positive emotions will help to reduce the negative cycle. Sending love to all, and remember if you or a loved one is struggling with an eating disorder, please reach out to your GP for support.
Other helpful resources:
Written by Laura, Westmeria counsellor