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Eating disorders - anorexia nervosa and bulimia nervosa What are eating disorders? Everyone needs food to survive. But for some people, food can become an overwhelming and destructive force that can completely dominate their thoughts, feelings and actions. People can be said to have eating disorders when their life revolves around food and they take extreme measures to control what they eat. Anorexia nervosa and bulimia nervosa are two common eating disorders, and affect women in particular.
What is the difference between anorexia and bulimia? Anorexia is an illness that occurs mainly in teenage girls, although increasingly boys suffer from it too. People with anorexia are obsessed with being thin and are terrified of gaining weight. As a result, they starve themselves (especially avoiding high-calorie foods), and exercise obsessively until they become extremely thin and well below the normal weight for their age and height. Bulimia usually affects women in their early to mid-twenties. People with bulimia are also terrified of gaining weight, but they can usually keep within a normal weight. This is because they eat very large amounts of fattening food (called 'bingeing'), but then get rid of that food by vomiting or by taking laxatives. Why do people get these eating disorders? We do not know exactly what causes anorexia or bulimia. Many explanations have been suggested, although the precise reasons may be different for each person. A fear of not being able to cope or feeling overwhelmed are common among people with anorexia or bulimia. For instance, adolescence is full of major changes – both physical and emotional – and some teenagers may be confused or uncertain. Denying themselves food may be one way to establish some control in their lives. Others may resort to food to block out disturbing feelings. People with bulimia are often unsure of themselves, lack confidence in their abilities or suffer from depression. Binge eating may be one way to cope with these unhappy, unsettled feelings. Today's 'thin is beautiful' image may be a contributing factor. The waif-like ideal promoted through the media can put pressure on women of all ages to diet, sometimes to excess. Other triggers of eating disorders may include upsetting events, such as divorce, or difficult or abusive family relationships. What health problems are caused by anorexia and bulimia? Anorexia can cause many serious health problems. Usually women stop having their menstrual periods. Dry skin and thinning hair on the head are common, although fine hair may grow on other parts of the body. Other complications include difficulty sleeping and concentrating, constipation, depression, frequently feeling cold, getting ill often, brittle bones that break easily (osteoporosis) and weakened muscles. If severe anorexia isn't treated, the person may die. Bulimia may be less noticeable as sufferers usually keep a constant weight. However, continually vomiting and/or taking laxatives causes other health problems, which include a puffy face and swollen fingers, muscle weakness, stomach pains, long-term constipation and tooth decay as, over time, the stomach acid brought up by vomiting dissolves the tooth enamel. How are these eating disorders treated? Recognising an eating disorder quickly is vital to recovery. A person with an eating disorder can be helped much more easily if the problem is identified and treated early. The first port of call is usually the family doctor, who may refer the person to a counsellor, psychiatrist or psychologist who is trained in treating people with eating disorders. For most people with anorexia, the weight loss is not too severe and they do not need to be treated in hospital. However, for treatment to be successful, they must want to change, and accept professional help and support from family and friends. The first treatment step is to bring the person back to, or near, an acceptable weight. This means making sure the person has regular meals with the family and eats enough calories to gain weight. With bulimia, the priority is to re-establish a consistent pattern of eating, with three meals a day at regular times. Keeping a diary of eating habits and learning about healthy eating and sensible weight control are often helpful. Medication, such as antidepressants or tranquillisers, may be prescribed
in the short term to help people through a distressing time. Be sure to
ask your doctor about possible side effects. Self-help groups may help too. It is often comforting to talk to other people who have been through the same thing, and who offer understanding and acceptance without blame or guilt. How can family and friends help? It can be upsetting to witness loved ones putting their health and lives in jeopardy. As a member of the family or as a friend, it is natural to want to help. But unwanted pressure or criticism from others usually makes matters worse. If possible, accept their behaviour instead of confronting them with it. Unless it's a life-threatening situation, try to let the person make his or her own choices and let the person know that love and support is consistently there. Once the person has recognised the problem, offer to help with practical matters such as finding medical assistance, self-help groups and other resources that may be needed to do battle with the eating disorder. Is it possible to get over an eating disorder? Yes – it can be a long and difficult process. Sufferers may need to have psychotherapy for months or years, and relapses can occur in times of stress. Approximately 50% of people with anorexia who are treated in hospital continue to have symptoms for many years. An eating disorder is difficult to overcome, but with commitment, patience and support it can be done.  Download Acrobat PDF version
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