Eating disorders are on the rise. It might not seem like it, but between 1.25 and 3.4 million people in the UK alone are affected by an eating disorder. Most eating disorders develop during the teen years, but they can start as early as 6 or as late as 70 or even 80. And surprisingly, eating disorders have the highest mortality rates among psychiatric disorders – above depression, anxiety and even schizophrenia.
Part of this is because our understanding of what eating disorders are and how they work has changed. They might have existed since 700 BC, but for a long time we only really knew about the 2 big ones – anorexia and bulimia. Both of these were defined in 1689, while other forms of eating disorders didn’t even start to be recognised until the 1980s. So, it’s no surprise that we don’t know as much about them.
Let’s fix that today.
Common Types of Eating Disorders
Remember, that all of these are recognised as serious mental illnesses. While many sufferers can hide their struggles and behaviour, they need support and treatment in order to recover. There are many types of eating disorders, but here is a summary of the most common.
Anorexia: Probably the most well-known of the eating disorders, Anorexia (or anorexia nervosa) is a mental illness that causes people to limit how much they eat or drink. They create ‘rules’ around what they can or can’t eat, when they can eat and in what situations. It’s a serious condition that can affect absolutely anyone. While it’s often characterised by a very low body weight, it isn’t always. People of any size can suffer from anorexia, as it’s a mental health condition with physical effects.
Bulimia: On the opposite side of the coin, bulimia is the term used to describe the cycle of eating large quantities of food (this is called bingeing) and then trying to get rid of it all through purging activity. Purging can take the form of vomiting, taking laxatives or diuretics, fasting or even exercising excessively. During a binge, people with bulimia don’t feel in control of what, how much or how quickly they’re eating, they are just driven to eat. They then feel overcome with shame and fear, which is what pushes them to purge. It’s a vicious cycle that can be difficult to break free of without help.
Binge Eating Disorder: Binge eating disorder happens when people eat very large quantities of food without being in control of what they’re doing. They will usually eat a huge amount over a short period of time, known as bingeing. But unlike people with bulimia, they don’t then get rid of the food through purging, though sometimes they will fast between bingeing. This disorder is far more than just ‘overindulging’. The binges are often very distressing, with many sufferers feeling disassociated from what they’re doing, eating far more than they would want to and even eating things they wouldn’t normally eat.
Diabulimia: Most often diagnosed in women with type 1 diabetes, who have realised they can achieve thinness without all of the messy bits like starving themselves, exercising excessively, or spending huge amounts of money on the latest diet craze. All they have to do is manipulate their insulin intake. By underdosing insulin, they cause sugar to be excreted in urine. It’s incredibly unhealthy, and if the person also has anorexia, it’s lethal.
Orthorexia: Orthorexia is one people are less familiar with, despite the term being coined in 1997. While it’s not a formally recognised condition, it is a form of eating disorder that can cause just as much damage as the rest. Someone suffering from orthorexia will have an unhealthy obsession with eating ‘pure’ food. The definition of ‘pure’ can vary from person to person, but it often means that someone will be stringent in cutting out certain foods, obsessing over their diet and feeling unable to put aside their personal rules about what they can do – even if they want to.
ARFID: Stands for Avoidant/Restrictive Food Intake Disorder. It’s typically characterised by someone avoiding certain foods or types of food, having a restricted intake, or both. Anyone of any age can have ARFID, but it’s easily noticeable in children. Kids who are often labelled as ‘extremely fussy’ eaters who will only eat a small number of foods are often suffering from ARFID. They might be very sensitive to taste, texture, smell or appearance. They might have fears or worries about the consequences of eating, or even just have a low interest in eating.
OSFED: It’s a bit of a catch-all term for Other Specified Feeding or Eating Disorder. This is what’s diagnosed when someone’s symptoms fit the criteria for an eating disorder, but not a specific one. It’s an umbrella term that encompasses a variety of eating related issues, including atypical anorexia, bulimia nervosa or low frequency, purging disorder or night eating syndrome.
PICA: The compulsion to eat non-food substances that have no nutritional value. Paper, soap, metal, paint, chalk, ice, anything that isn’t food and the body can make no use of. Pica affects people of all genders and ages (but is rarely diagnosed in children under 2), and is often left undetected until something else flags it up. Usually metal toxicity, cracked teeth or other infections. People with pica don’t usually avoid regular food, but instead just feel the desire to eat non-food items on top of a normal diet. Scientists have some theories about what causes pica, but they don’t have any clear ideas on what causes it yet. What they do know is that it’s more likely to happen if you:
- Are pregnant
- Have an iron deficiency
- Are autistic
- Have an intellectual developmental disorder
- Suffer with depression
- Are schizophrenic
- Have obsessive-compulsive disorder, trichotillomania or excoriation disorder
Rumination Disorder: One of the less common disorders, this illness involves the repetitive, habitual bringing up of food that might be partly digested. It’s an effortless process for them, and happens without nausea or disgust. The person may re-chew and re-swallow the food or just spit it out, but they often don’t feel in control of their disorder.
It’s About More Than Food
There’s one thing all of these disorders have in common – it’s not really about food. They might be called ‘eating’ disorders, but all of them are really about control. They’re a coping mechanism. People often turn to eating disorder behaviours when they feel out of control or afraid, struggling to keep things together. So they control the one thing they feel they can control – food.
Remember these are all mental disorders. So while the outside symptoms are about food, the real cause is the emotional hungers, rather than the physical ones. It’s about not being able to allow them, and needing to control the noise inside your head. There can be all sorts of triggers for this, including trauma, conflict, life experiences or relationships. It’s unique to the individual, which is why individual treatment is so important.
Diagnosing an Eating Disorder
Eating disorders of any form are a significant medical condition, and usually require treatment to improve. The first step towards getting help for any eating disorder is to visit your GP and talk about your concerns. If they agree, then they will refer you to the appropriate eating disorder specialist for assessment and treatment.
That said, there are some things that can help support your journey to recovery. Meditation, emotional freedom technique, mindfulness and mindful eating and nutritional education have all been proven to help in recovery from eating disorders, and are often used alongside psychiatric treatment. If you feel like you need extra support in your recovery, or know someone who would benefit from the help these therapies can provide, just get in touch with the team for a free, confidential consultation, or use the Melp app.