Eating disorders are very complex conditions that can affect someone emotionally, physically and socially. Eating disorders are serious mental illnesses; anorexia, binge-eating disorder and bulimia. In the UK, more than 700,000 people are affected by an eating disorder.  There is, unfortunately, no credible data available on the prevalence of eating disorders in India.  However, professionals are of the view that the incidents of the problem is alarmingly on the increase. 

Twenty years ago, the cases of eating disorders — the most common of which is anorexia nervosa — were negligent in India. However, psychiatrists claim that in the past few years, the figure has increased from anything between five and 10 times, and it won’t be surprising if it has gone many folds over. What is more alarming is that increasingly girls of a younger age are falling prey to anorexia and bulimia.

While young women (aged 12 to 20) are more likely, anyone can develop an eating disorder, regardless of age or gender. There is no one reason why a person will develop an eating disorder; there could be a range of factors that have had influence, including genetic, social, environmental, psychological and biological.

It has been suggested that eating disorders claim more lives than any other mental health problem. Eating disorders are serious, yet they are treatable and people can make a full recovery. The journey is long and isn’t easy, but it is possible to get help and fight the fear.

Food plays an important part in our lives. While our personal relationship with food will change (eating healthier, having cravings, losing our appetite or eating too much) this is normal and will affect each of us from time to time. But eating disorders are very different. They can be detrimental to both physical and emotional health, and even be life-threatening. It’s scary, but if you’re worried about yours or a friend’s health, it may be time to speak up.

Types of eating disorders

Anorexia nervosa causes a person to feel overweight, even though they may be considerably underweight. The desire to lose weight can lead to the person skipping meals, starving themselves and/or exercising excessively.

 

Bulimia can cause a person to feel as though they have lost control in their relationship with food. People with bulimia can fall into a cycle of eating excessively (binge-eating) and purging - through vomiting, over-exercising or using laxatives.

 

Binge-eating disorder sees people experiencing a loss of control and overeating regularly. Sometimes described as compulsive eating, a person may rely on food for emotional support or use food as a way to mask difficult feelings. Affecting both men and women, binge-eating disorder is more common in adults.

Eating disorder not otherwise specified (EDNOS)

In the past some people with disordered eating may have been diagnosed with EDNOS (eating disorder not otherwise specified). This was used in the DSM (Diagnostic and Statistical Manual of Mental Disorders until 2013. Nearly 50% of all those diagnosed with an eating disorder were diagnosed with EDNOS and studies suggested that many of these did in fact have binge-eating disorder.

The DSM classification system changed in 2013 to ensure more people with eating disorders received a diagnosis that accurately described their symptoms and behaviours.  EDNOS is no longer used as a diagnostic term and since the change, diagnosis will be anorexia, bulimia or binge-eating disorder.

Spotting the signs

Eating disorders can be a way of coping with feelings of anger, sadness, depression, anxiety or worry. They are complex illnesses and there is no single cause that will apply to everyone. Anyone can be affected and situations will differ from each individual. However, if you are worried about your own health, or a loved one, there are several warning signs you can look out for, including:

• skipping meals
• commenting on their weight, even if they are of a healthy weight/are underweight
• weighing themselves repeatedly
• avoiding eating situations, feeling uncomfortable eating in public or making excuses
• only eating low-calorie foods
• change in behaviour or personality
• withdrawing from social situations or hobbies they previously enjoyed
• using or mentioning ‘pro-anorexia’ websites

 

If you suspect a friend or family member has an eating disorder, it can be difficult to know what to do, but offer support. Be gentle in your approach and let them know you’re there to listen if they want to talk. Your friend may not know they have a problem, or if they do know, they may not be ready to seek help. Fear is a powerful thing and it can be difficult to see a way out of the dark place they're in. Try not to make assumptions and let them know you will be there to help when they are ready.

Getting help

People with eating disorders may worry about talking to someone. If they suspect a problem, they may feel ashamed or embarrassed, which can make seeking help difficult. Fear plays a big part in eating disorders and even if the person wants help, they may be afraid of taking the next step. Recovery will mean changing eating behaviours which can be a terrifying prospect for someone with an eating disorder. While this can feel daunting, the aim of recovery is to fight that fear and regain a healthy attitude to eating and body image.

Whether the problem is more recent, or you’ve been dealing with it for a while, you deserve support and recovery is possible. If you are worried about anything, find someone to talk to, whether it is a friend, family member or even a professional. Remember you’re not alone.

Counselling for eating disorders

The first port of call when seeking help is generally through your GP. Speaking up can feel scary and it takes so much strength to start the journey. If you’re worried about going to the GP alone, ask a friend or family member to go with you if you can. If you’re not ready to visit a medical professional or your loved ones, counselling is always an option. This gives you space to talk about what you’re going through in a private, non-judgemental setting.

Treatment is available and recovery is possible. It will usually involve monitoring physical health, as well as taking steps to understand the potential psychological causes and effects. While treatment will depend on the individual and the eating disorder, common options include:

• self-help
• cognitive behavioural therapy (CBT)
• family therapy
• Medication
• interpersonal therapy (IPT)

 

What should I be looking for in a counsellor or psychotherapist?

There are currently no laws or regulations in place that outline what training and qualifications a counsellor must have in order to treat eating disorders. However, there is a set of clinical guidelines that provide advice about the recommended core interventions in the treatment and management of eating disorders.