All About Eating Disorders Awareness Week (Trigger Warning)
Eating Disorders Awareness
Eating disorders are serious, complex and potentially life-threatening mental illnesses. They are characterised by disturbances in behaviours, thoughts and attitudes to food, eating, and body weight or shape. Eating disorders have detrimental impacts upon a person’s life and result in serious medical, psychiatric and psychosocial consequences. Eating disorders do not discriminate and can occur in people of any age, weight, size, shape, gender identity, sexuality, cultural background or socioeconomic group.
Defined as a mental health disorder where food is used as an element to gain a sense of control to cope with various feelings and challenges, an eating disorder can come in many forms and is thus not a linear experience for all sufferers. Unhealthy eating habits may include restricting your food intake or excessively eating, as well as concerns on weight and body image (1). In the UK, February 28th to March 6th is Eating Disorders Awareness Week (2). This week highlights and brings awareness to all eating disorders and helps to share evidence-based information (3). This year's Eating Disorder Awareness week is focusing on increasing the amount of education surrounding eating disorders for medical students, as at present they only receive 2 hours of education, with 1 in 5 medical schools providing no education at all. During Eating Disorders Awareness Week, people join together to help the Beat Eating Disorders charity to campaign for those who have struggled or are struggling, raise awareness and money for eating disorder services, and share personal experiences (4).
Types & Prevalence of Eating Disorders
Eating Disorders in Depth
Anorexia Nervosa - Anorexia (or anorexia nervosa) is a serious mental health disorder where individuals are at low body weight as a result of restricting the amounts of food and drink they consume. Affecting people of any gender, age, ethnicity or background, sufferers may form “rules” with regards to what they feel they can and cannot eat, as well as the place and time that they will eat at. Some people who suffer from anorexia may experience a pattern of bingeing (consuming lots of food in one sitting) and purging (5).
Avoidant/Restrictive Food Intake Disorder (ARFID) - ARFID is a disorder in which an individual avoids particular foods or types of food, has limited overall food intake, or suffers with both of these factors. There are many reasons someone might avoid or restrict intake, such as having a sensitivity to the texture and taste of certain foods, or having a bad experience with a particular food, such as vomiting or choking (6).
Binge Eating Disorder (BED) - Binge eating disorder is a serious mental health disorder where individuals eat very large amounts of food while feeling like they are not in control of what they’re doing. Affecting people of any gender, age, ethnicity or background, evidence has found that BED is more common than other eating disorders. However, people with BED do not usually follow a binge eating episode with a method of getting rid of the food as seen in bulimia, although some may fast between binges (7).
Bulimia Nervosa - Bulimia (or bulimia nervosa) is a serious mental health disorder, affecting people of any age, gender, background or ethnicity. Similarly, to BED, individuals who struggle with bulimia eat large amounts of food (binge), but they follow this with a method of ridding their bodies of the food. These methods include vomiting, fasting, over exercising, or taking diuretics or laxatives (8).
Orthorexia - Orthorexia is an unhealthy fixation on consuming “pure” food. Pure or impure food may vary between individuals. Like other eating disorders – “clean” eating in this case – is used to cope with challenging feelings or situations, or to feel a sense of control. With that said, orthorexia is currently not recognised in clinical settings as an eating disorder on it’s own (9).
Other Specified Feeding or Eating Disorder - Anorexia, BED, and bulimia are officially diagnosed using a specific criteria of physical, behavioural, and psychological symptoms. In cases where a person’s symptoms do not fall under the same symptoms as these disorders, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED). OSFED affects the highest percentage of people out of all eating disorders, and can affect people of any gender, age, ethnicity or background (10).
Pica - Pica is a disorder in which individuals eat non-food substances with no nutritional value, such as paper, paint, ice, or chalk. To diagnose it, someone has to experience pica for a minimum of one month, not be a part of a followed practice and developmentally inappropriate. Pica is often kept hidden until medical consequences occur, such as infections or metal toxicity, and it is more likely to first occur in children (11).
Rumination Disorder - Rumination disorder is an illness that includes a repetitive and habitual behaviour of bringing up food that is not fully digested. Often occurring without pain or effort, it is not linked with nausea or disgust. With this disorder, someone may re-chew and re-swallow food, or just spit it out (12).
Eating Disorders in the UK
Did you know that around 1.25 million people in the UK have an eating disorder, with 25% of people affected being men? Recent investigations by the NHS have found that up to 6.4% of adults showed symptoms of an eating disorder. Many people develop eating disorders in their teenage years, but it is not unheard of for individuals to develop an eating disorder later on in life. Anorexia has been seen in individuals as young as 6, and as wise as 70 (13).
Stereotypes & Risk Factors
Research by the UK’s eating disorder charity Beat, has found that stereotypes on who gets eating disorders are stopping BAME, LGBT+ and people from less well-off backgrounds from seeking and receiving the help they need. This could consequently make it more of a challenge for individuals from said groups to recover. A poll found that approximately 39% (4 in 10) of people thought eating disorders were more common in white people than other ethnicities. However, clinical findings have shown that they are as common or more prevalent amongst BAME people than white people. Additionally, LGBT+ people are at a heightened risk of eating disorder with 37% of lesbian, gay or bisexual respondents in Beat’s research saying they would not be keen on asking for help, compared to 24% of heterosexual people. Finally, Beat found that 30% of people thought less well-off people were less likely to have eating disorders than affluent people, when in reality eating disorders happen at close rates across all levels of income and education (14).
Biological, psychological, and social risk factors for developing most eating disorders (anorexia, bulimia, BED, or OSFED) may include:
Biological risk factors:
-Having a relative with an eating disorder.
-Having a relative with a mental illness such as depression or addiction.
-Having a past with dieting.
-Expending more calories than what you take in, which leads to negative energy balance.
-Having Type 1 Diabetes.
Psychological risk factors:
-Being a perfectionist.
-Having body image issues.
-Having a history of an anxiety disorder.
-Being behaviourally stubborn.
Social risk factors:
-Facing weight stigma.
-Being bullied or made fun of.
-Internalising an “ideal body” appearance set by society.
-Facing acculturation.
-Feeling isolated and lonely.
-Having past trauma (15).
Seeking Help
If you think you have an eating disorder, see your GP as soon as possible. They might refer you to a specialist in eating disorders to help guide you. If you want to help a loved one with an eating disorder, let them know you’re concerned for them and encourage them to see a GP (16).
Asking for help doesn’t come easy for some people, but it is a courageous and important step in the recovery journey. Eating disorder treatment services are provided by the NHS for all age groups. Most patients will have access to a form of outpatient treatment, like cognitive behavioural therapy or guided self-help. Significantly ill individuals might be admitted to an eating disorder inpatient ward, where they will have regulated meal times, therapy and skills classes (17).
It should be noted that eating disorders are not all about food itself, but about the feelings people are faced with. How someone treats their relationship with food may make them feel more capable of coping or being in control. Eating disorders are incredibly complex and require specialist help. The sooner people seek intervention the better the prognosis. Bottom line is, an eating disorder is NEVER the fault of the person who is suffering from it, and anyone who is currently dealing with one needs kind and compassionate support to help them on their way to recovery (18).
Resources:
Beat Eating disorders - Leaflets, Books, and Guides.
Mind - Services and Organisations.
NHS - Eating disorders support.
Written by: Lujayn Alatawneh (ANutr)
References:
https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/eating-disorders/overview/
https://www.beateatingdisorders.org.uk/support-our-work/eating-disorders-awareness-week/
https://www.beateatingdisorders.org.uk/media-centre/eating-disorder-statistics/
https://www.beateatingdisorders.org.uk/news/beat-news/eating-disorder-stereotypes-prevent-help/
https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/eating-disorders/overview/
https://lordslibrary.parliament.uk/eating-disorders-awareness-week-2021/
https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/