What are the most common types of eating disorders?
The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder. More recently avoidant restrictive food intake disorder (ARFID) has been included associated clinical pathways are being considered.
What are the symptoms?
The general symptoms will differ depending on diagnosis. Anorexia nervosa is diagnosed when someone is below a BMI (body mass index) of 18.5 and there are no other identified physical health or social circumstances that could explain weight loss. There is significant active dieting behaviour in which a person will not be receiving sufficient nutrition to maintain weight and a determination to continue weight loss despite concerns from others. Outside of dieting behaviour an individual may use other compensatory behaviours to support their weight loss trajectory, for instance purging, excessive exercising, diet pills, laxatives etc
With bulimia nervosa there will often be a similar weight loss aim and the person will often be on a diet in order to lose weight. However, this is not sustainable and the person will also engage with binge/purge behaviours. A binge is defined as someone eating a significant amount of food in a short space of time, it will often be frenzied and feel out of control and associated guilt will lead to compensatory behaviours such as purging, over exercising, further restriction of food intake, laxative use etc. The person diagnosed with bulimia nervosa will generally be in the healthy weight category.
With binge eating disorder there is less regularly a pattern of active weight loss behaviour. However, as with bulimia nervosa there will be regular binge eating episodes but without necessarily the compensatory behaviours for the binge eating. Patients referred with binge eating disorder will often be in the overweight range as a result of binge eating.
This week is Eating Disorder Awareness Week. How important is it to raise awareness?
It is vital that we continue to raise awareness of these serious, life limiting conditions that are dangerous to health. Anorexia nervosa has the highest rate of mortality for psychiatric illnesses so early detection and intervention is essential. Both bulimia and binge eating disorder contribute to significant physical health problems; patients with bulimia can develop significant electrolyte disturbance and other serious physical health concerns and patients with binge eating disorder can be more susceptible to type 2 diabetes among other conditions.
All the eating disorders impact significantly on a person’s quality of life and an overevaluation of self, based on weight, shape and their concerns can significantly affect self-esteem and sense of self-worth.
What should someone do if they are worried that someone they love might have an eating disorder?
Talk to them. Start a conversation. Express concern and work to assist your loved one in receiving help in a timely manner. The person may well try to say there is not a problem and try to conceal the extent of their suffering so remain open and continue to talk about your worries even when your loved one rejects this.
When should people see a GP?
People should see their GP as soon as possible, as soon as they recognise the problem in themselves so as to receive help in a timely manner. Often someone will have wavering motivation and so reaching out at that moment of clarity that there is potentially a problem is exceptionally important so as to gain access to specialist support and intervention. It is important to remember that there are significant physical consequences of these disorders and so receiving regular check ups is an essential part of the recovery process.
What other help and support is available?
BEAT is a charitable organisation that has lots of helpful resources and support for individuals and their friends and family.
How are eating disorders typically treated?
Eating disorders are generally treated on an outpatient basis, either in individual or group therapy formats, depending on the needs for the individual as identified in the assessment. If someone is too compromised to work within an outpatient setting and depending on the local service, day patient treatment may be offered for those suffering with more severe anorexia nervosa. Where there is a risk to life patients with anorexia would be treated in a time limited manner within a specialist eating disorder inpatient unit.