Body beautiful: eating disorders
It’s difficult to know how many people are living with an eating disorder in Australia – some put the figure as high as 16% of the population, whilst others put it at 4%. Even more people experience disordered eating behaviours, such as binge eating, vomiting, and laxative use, that do not meet the criteria for an eating disorder, according to research. Broadly speaking, eating disorders are typically characterised by disturbances in our thoughts, feelings, and behaviours in our eating habits, body weight, or shape.
Either way, eating disorders are very serious mental illnesses that can be complicated and, without the right support, life-threatening. The causes are varied, but genetic, physical, social, and psychological factors may contribute to the development of an eating disorder, and does not discriminate as it can impact anyone of any age, weight, size, cultural background, or socioeconomic background.
Let’s talk about it – and let’s explore all things eating disorders, like how many types there are, the warning signs, how to get treatment and where to get help.
How many types of eating disorders are there?
There’s a common misconception that eating disorders fall into two broad categories: people either have a problem eating too much, or they eat too little.
This is a dangerous misconception and it fails to recognise the complexity of eating disorders and the number of different kinds of eating disorders.
There are around six common forms of eating disorders, each with their own distinct warning signs that you should watch out for.
Today, our eating disorder psychologists explore some of these eating disorders, with the help of National Eating Disorders Collaboration (NEDC), an online site that provides people with accessible health and wellness information.
Anorexia nervosa
Anorexia nervosa is perhaps the best-known eating disorder. People with anorexia often find themselves with a significantly reduced energy that leads to low body weight. This is often paired with intense fear of weight gain and body image disturbance.
If you have anorexia nervosa, you may find yourself constantly checking your weight, avoiding food and restricting the number of calories you’re eating.
Common symptoms of anorexia nervosa can include restricted eating patterns, an intense worry of putting on weight and a constant pursuit of thinness.
Bulimia nervosa
Another common eating disorder, bulimia nervosa is often characterised by a lack of control in eating that is followed by strong feelings of guilt or shame.
This is followed by extreme efforts to get rid of the food, such as the person purging, fasting or over-exercising.
These behaviours can become more compulsive and uncontrollable over time and, ultimately, can lead to an obsession with food, weight loss and body image.
Common symptoms of bulimia nervosa include recurrent episodes of binge eating, recurrent purging behaviour and a fear of gaining weight.
Binge eating disorder
Binge eating is perhaps the most common form of eating disorder, and it involves eating large amounts of food, similar to bulimia nervosa.
People with a binge eating disorder often find themselves with a lack of control that can lead to a high level of distress.
However, unlike people with bulimia nervosa, people with binge eating disorder don’t usually take part in purging behaviours, such as self-induced vomiting.
Common symptoms include eating large quantities of food – often in secret, feeling out of control and feeling shame when thinking about binge eating behaviour.
Pica
People with a pica disorder may find themselves eating items that aren’t typically considered food or that don’t provide any nutritional value.
Many people who live with pica will crave non-foods such as ice, dirt, hair, cornstarch and other non-foods that contain no nutritional value.
The main symptom of pica is eating non-food substances outside of an age where it is developmentally appropriate. For example, it’s normal for teething children to put objects in their mouths.
Rumination
Rumination involves a person regurgitating food they have chewed and swallowed, before they re-chew it and then either swallow it again or spit it out, usually within 30 minutes of eating.
The condition can be dangerous to both adults and children. People with rumination disorder can find themselves limiting the amount of food they eat, leading to severe weight loss.
Common symptoms include regurgitation – often quickly after eating, pain that is relieved from regurgitation and bad breath.
Avoidant/restrictive food intake
People with avoidant/restrictive food intake disorder (ARFID) may find their eating disturbed – from lack of interest or a distaste for certain aspects of food, such as smells and tastes.
Previously called “feeding disorder of infancy and early childhood”, the disorder often causes significant weight loss and nutritional deficiency.
What are the warning signs?
People with an eating disorder might notice things like their behaviours, thoughts and attitudes to food, eating and body weight or shape changing.
One thing is certain, eating disorders can have a significant negative impact on a person’s wellbeing and can result in serious physical and mental consequences.
Take a look at some of the most common warning signs or symptoms that our eating disorder psychologists see for each of the main types of eating disorder.
Anorexia nervosa
- Extreme weight loss
- Fatigue
- Insomnia
- Restricting food intake
- Excessive exercise
- Bingeing/self-inducted vomiting
- Fear of gaining weight
- lack of emotion
- Irritability
Bulimia nervosa
- Forcing yourself to vomit
- Fasting
- Restricting calories
- Fear of gaining weight
- Loss of control during eating
- Preoccupied with your body shape and weight
Binge eating disorder
- Eating unusual amounts of large food
- Feeling your eating is out of control
- Eating, even when you’re full
- Eating quickly during binges
- Eating until you become uncomfortably full
- Eating on your own or in secret
- Feelings of depression and shame
Pica
- Persistent eating over the period of at least one month
- Eating things that are not culturally or socially normal
- Eating things like paper, soap, cloth, hair paint, metal or pebbles
Rumination
- Effortless regurgitation, often within around 10 minutes of eating
- Stomach pain
- Pressure relief after regurgitating
- Bad breath
- Feeling full
- Nausea
Avoidant/restrictive food intake
- Significant weight loss
- Dressing in layers to hide weight loss or stay warm
- Constipation, stomach pain, lethargy
- Consistent, vague gastrointestinal issues
- Only eating certain textures of food
- Fear of chocking or vomiting
- Lack of appetite or interest in food
Treatment
If you have an eating disorder, you might feel like it’s never ending, but there are ways to improve your condition and make a full recovery.
Treatment options can vary, but some of the common approaches include psychotherapy, self-help, nutritional management, medication or a combination of these.
Psychological treatment for eating disorders
Eating disorder psychologists use a variety of approaches to treating eating disorders, but some common types include Cognitive Behavioural Therapy – Enhanced (CBT-E), Family Based Treatment (FBT), Specialist Supportive Clinical Management (SSCM), and Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA).
CBT-E is a manualised treatment and addresses features of anorexia nervosa, bulimia nervosa, binge eating disorders, and other specified eating disorders. CBT-E focuses on addressing disruptions in eating habits and attitudes that exacerbate their eating disorder.
FBT is designed for treatment for adolescents with anorexia nervosa and bulimia nervosa, with an aim to empower the family and parents to bring recovery in their child with an eating disorder in the family home.
SSCM is an outpatient psychological treatment for adults with anorexia nervosa, which consist of clinical management of normal eating behaviours and supportive psychotherapy.
Finally, MANTRA is an alternative form of treatment, based on cognitive-interpersonal methodologies with a focus on cognitive, emotional relational, and biological factors, for adults with anorexia nervosa.
These are just some of the treatments eating disorder psychologists have access to. The exact treatment you receive will depend on your unique case and needs.
Self-help
The Royal Australian & New Zealand College of Psychiatrists has outlined some self-help tips that you can try to help boost your recovery from an eating disorder.
One method the College highlights is continuing to talk about your problems to friends and family members who love and support you.
Another thing you can do is join an eating disorder group. This is a great way to talk freely about your disorder and get advice and support from people with similar experiences.
Making sure you’re sticking with your treatment plan is another way to look after yourself. Follow the recommendations from your health team to make sure you’re getting the most out of your treatment.
Medication
Medications are sometimes used with specific types of eating disorders, but these will only be prescribed by a registered healthcare professional. For example, some forms of antidepressants are used to treat binge eating disorder, helping to boost your mood to help against binges.
It is important to note that medication alone should not be considered as the sole form of treatment in eating disorders given that psychological therapies have been shown to have the greatest impact on reducing eating disorder symptomology. As such, medication should be considered as an adjunct to psychological therapy.
Nutritional management
Nutritional management is provided by a dietician, often as a complimentary aspect of another form of treatment.
The dietician will often design a plan that makes sure you’re receiving the right level of vitamins and minerals and following normal eating habits.
Dieticians who provide care for people with eating disorders should have completed education on eating disorder treatment as well as suitable supervision.
Need help? Talk to our eating disorder psychologists
If you want talk to a psychologist near you, get in touch with Access Psych. Our mission is to make getting mental health support as easy as going to the gym, with 80+ practitioners nationwide with experience in a range of different mental health areas and a range of face-to-face or telehealth options.
Alternatively, speaking with your General Practitioner for eligibility for an Eating Disorder Treatment and Management Plan (EDP) with subsequent access to qualified eating disorder psychologists may be useful. If you have any questions about Access Psych and what else we can do for you, visit our Frequently Asked Questions.
When you’re ready, you can book an appointment online, speak to one of our friendly team on 1800 277 924 or email info@accesspsych.com.au to see how we can help you.
The information provided in this document is general in nature and is intended to be used for information purposes only. While we have tried to ensure the accuracy of the information published, no guarantee can be given that the information is free from error or omission or that it is accurate, current or complete.
The information published is not, and should not be relied on as, health or treatment advice. The diagnosis and treatment of any mental illness requires the attention of a physician or other properly qualified mental health professional. If you are seeking diagnosis or treatment of any other mental illness, you should consult a physician or mental health professional. You should not delay in seeking, or disregard, professional health advice because of something you have read in this document.
