You may have read the title of this article and decided that it's not relevant for you. Just take a moment to read a little further. Since qualifying as a Master Practitioner with the National Centre for Eating Disorders, I am working more and more in this complex area. And with the benefit of my training I know that there are more everyday symptoms than you might think.
Eating disorders are very, very common and are treatable. There are over-eating and under-eating disorders and the cross-over is complex.
What was a revelation to me is that disordered eating behaviours don't have to be extreme to constitute being a disorder. With the benefit of my training I now know that I suffered from Atypical Anorexia which manifested itself as Binge Eating Disorder. The labels don't really matter to be honest and we don't always use them in therapy. But sometimes diagnosis is useful to the patient to help them give meaning to behaviour that they experience as madness or badness, and to help them find a route to appropriate treatment. But this blog is much, much more about recognising that something isn't right, isn't normal and then having the courage to do something about it.
I binged and dieted for 40 years on and off throughout my life. I learned to live with it and I thought it was my 'normal'. I felt very isolated. Part of the reason for that was because for a long time I didn't understand what was going on or that I had an eating disorder. If I had, I would have been able to get more targeted help to treat it sooner.
Here are a few thoughts to begin with about what an eating disorder might look like.
Basically, you have problem if your eating behaviour, or your attitudes about food and weight are taking pleasure out of your life. People with eating disorders typically worry a lot about their weight and about the food they are eating. Eating disorders manifest themselves in a number of ways. Look at this list. You probably have an eating disorder of some kind if some of the following is happening:
Excessive concern and preoccupation about calories or fears of weight gain.
You use food in response to your emotions
Eating habits that you know in your heart are abnormal.
There is a lot of shame and guilt around eating.
You vomit to avoid gaining weight or use laxatives.
Your weight is fluctuating a lot.
There are a lot of foods you strictly avoid to control your weight, and you feel like a terrible person if you eat any of these foods.
You can eat large quantities of food beyond your hunger.
You have unmanageable cravings for certain types of food that you think you should not be eating.
You are pre-occupied with your body and your weight
Exercise is something you are driven to do; you would feel fat or like a bad person if you missed an exercise routine.
You feel uncontrolled around food.
You are depressed and irritable in response to your eating behaviour.
You pretend that you have eaten to get people off your back.
Let's have a look at the most common type of eating disorders. According to the National Centre for Eating Disorders they can be described as follows:
Binge Eating Disorder is the name of an eating disorder where a person is unable to prevent himself or herself from eating large amounts of food, often in a mindless state and in a short space of time; and the eating feels out of control. One difficulty knowing whether you have Binge Eating Disorder is that no-one knows exactly what kind of eating constitutes a “binge”. One man’s binge may be just another man’s hearty meal.
Compulsive Overeating is not quite the same as binge eating disorder; it describes a milder form of binge eating. But if you feel that you are a compulsive eater an it's troubling to you then what we call it doesn't really matter does it? Some people do not actually binge, they just go backwards and forwards to the fridge, looking for something that will satisfy their need to eat. Some people nibble a lot and can’t stop. Other people find that they cannot control themselves with specific foods like chocolate or cakes.
Here are some of the common behaviours in these eating disorders:
Eating faster than usual
Eating past the point of fullness
Eating when not physically hungry – and you call yourself an emotional eater
Eating alone or in secret
Feeling upset or guilty after overeating
Feeling that you are abnormal in your eating behaviour
Feeling “taken over” or “driven” as if you have been possessed
Trying to compensate for overeating by dieting, or restraining food. If you also purge to get rid of calories you are suffering from bulimia nervosa.
Bulimia Nervosa
Bulimia Nervosa means, ox-like hunger of nervous origin. It was first identified by Freud and was given that name in the 1980s to describe recurrent episodes of binge eating with attempts to get rid of calories and prevent weight gain. Bulimic symptoms include; vomiting, taking laxatives or diuretics and in 2016 excessive and obsessive exercise was added to a list of clarifying criteria.
Anorexia Nervosa
This is a state in which the person, most commonly but not exclusively female (and often but in young women or adolescents), refuses or is unable emotionally to eat sufficient food to maintain normal body weight. Low weight is highly desired even if they claim that they are unable to feel hunger or find eating simply uncomfortable. There are 3 criteria with anorexia which are important to know so that you can spot it. 1) one eats less energy than is needed to maintain a weight normal for height and age. 2) there is a an intense fear of weight gain or attempts to prevent weight gain. 3) a disturbance in body image which intensifies as weight is lost and the person “refuses” to acknowledge or act on the risks of underweight.
Weight is lost by eating less or avoiding food deemed fattening. What appears to begin as a means to look better to conform to society prescription of slimness, evolves into a fear of food inside. The symptoms become useful as a way, perhaps the only way available, to block difficult feelings, to feel special and different and to avoid what feels difficult in life. It's a complex disorder which needs highly specialist treatment and sometimes hospitalisation.
Emotional eaters eat a lot when they have bad emotions and even when they have good feelings. They feel that they have lost touch with hunger and can’t stop eating when they have had enough. They have a love-hate relationship with food.
Food Addicts are people who think that they are addicted to food they claim that it is worse than drug or alcohol addiction because “you don't need to drink alcohol but you do need to eat; food is everywhere and we have to eat it every day”. They feel that they are powerless to control their urges. At NCFED it is not believed that there is such a thing as food addiction even if your relationship with food feels like one.
So you can see that binge, compulsive, emotional eating and so-called food addiction is much the same thing. What is common among binge eaters, emotional eaters and compulsive eaters is that they all have food cravings, they all struggle to control their weight and they feel that they have a very conflicted relationship with food. But as I said above, we don't necessarily have to label it. The bottom line is, if eating “rules your life” or you see these signs in someone else, some kind of treatment is probably needed to live a normal, happy life with food.