Loganholme Psychologist Dr Amanda White has provided this general overview of eating disorders, including statistics, risk factors, and how to improve the chances of recovery …
Eating disorders are classified according to specific abnormal eating habits that may involve restricted or excessive intake of food, as well as the range of physical and psychological health issues that co-occur with these disorders. In addition to abnormal eating habits, there are often cognitive biases changing the way a person perceives their body image, weight, and shape. Abnormal eating is not a diet, fad, phase, or lifestyle choice.
The more commonly discussed eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. The DSM5, the current Diagnostic and Statistical Manual listing psychiatric illnesses, also includes eating disorder diagnoses which may be more frequently evident in young people: pica, rumination and avoidant/restrictive food intake disorder.
Beyond the DSM5, there has been an emerging trend of abnormal eating termed Orthorexia Nervosa, which may be considered as a type of not specified eating disorder (EDNOS).
Australian Statistics
In Australia, statistics show one in twenty people either currently fulfil – or have previously met – criteria for diagnosis of an eating disorder. Onset of an eating disorder can happen at any age, but the most frequently reported age of onset is during adolescence.
Eating disorders may be more strongly associated with women, with approximately 15% of Australia women meeting criteria for diagnosis across their lifetime, but this is an issue which also increasingly effects men.
Duration of an eating disorder varies, but it can go on for many years, especially if left without appropriate intervention. A challenging first step for eating disorder treatment can be recognising the need for help. It can be the case that the symptoms of an eating disorder are concealed by the person experiencing them (denying, hiding, or disguising their external behaviours or internal belief systems), thus delaying treatment. Such concealment can be a complicating factor, as early diagnosis and intervention has been shown to reduce both the severity and duration of an eating disorder.
Eating Disorder Reality Check
Eating disorders can and do have serious consequences. There is wide ranging impact on the body. For example, malnutrition negatively affects soft tissue, like internal organs, as well as bone density and cognitive functioning. Also, eating disorders have a high rate of co-occurring mental health issues including anxiety, trauma, depression, substance misuse, and personality disorders.
Perhaps given the complexity of presentation, the hard facts show eating disorders to have the highest mortality rate across all adult mental health disorders. The mortality rate is more than twelve times greater than for people living without an eating disorder. Getting support, putting change management into practice, and aiming for sustained recovery is of clear priority for those experiencing an eating disorder.
Certain risk factors potentially increase the chance of Eating Disorder onset:
- Personality Traits: obsessive-compulsive presentation, neuroticism, harm avoidance, also perfectionism;
- Low self-esteem;
- Predisposition from a genetic vulnerability – this is currently an area of research interest;
- Extreme weight loss behaviours: certain diets, fasting, self-induced vomiting, smoking;
- Socio-cultural setting: in Australia, the thin ideal for women and lean/muscular ideal for men can be internalised, promoting body dissatisfaction.
Other factors are protective, they may reduce the chance of Eating Disorder onset:
- Wellbeing: including emotional fitness, high self-esteem, and realistic body image;
- Effective communication, problem solving, social, and coping skills;
- Media literacy: being able to critically evaluate media imagery, eg advertising;
- Having family and social relationships that don’t overstate the importance of weight and physical appearance;
- Membership of groups (eg sports) and workplaces or industries that also don’t overstate the importance of weight and physical appearance.
The good news is: you can recover from an eating disorder.
Whilst recovery is different for different people, there may be common elements that strengthen this process. These elements include acceptance of the need for help, accessing appropriate treatment, seeking treatment sooner rather than later, developing high quality social and familial supports, self-care, as well as a strong personal commitment to the recovery process.
Author: Dr Amanda White, PhD, B Psych (Hons), B Beh Sc, DipH, MAPS.
Amanda is not currently taking bookings, however, we have a number of clinicians available for bookings.
To make an appointment please visit our webpage here to learn about our highly qualified clinicians, or call M1 Psychology Loganholme on (07) 3067 9129.
References
- Button, E.J. et al. (1997). Self-esteem, eating problems, and psychological well-being in a cohort of schoolgirls aged 15-16: a questionnaire and interview study. International Journal of Eating Disorders, 21 (1), 39-47.
- Kaye, W.H. et al (2004). Comorbidity of anxiety disorders with anorexia and bulimia nervosa. American Journal of Psychiatry, 161, 2215-2221.
- Lee, C. (2001). Women’s Health Australia: What do we do? What do we need to know? Progress on the Australian Longitudinal Study of Women’s Health 1995-2000. Brisbane, Australian Academic Press.
- Lindberg, L . & Hjern, A. (2003). Risk factors for anorexia nervosa: a national cohort study. International Journal of Eating Disorders, 34 (4), 397-408.
- Rosenvinge, J.H., Martinussen, M., & Ostensen, E. (2000). The comorbidity of eating disorders and personality disorders: A meta-analytic review of studies published between 1983 and 1998. Eating and Weight Disorders, 5, 52-61.
- Shisslak, C.M., & Crago, M. (2001). Risk and protective factors in the development of eating disorders. In J.K Thompson & L. Smolak (Eds), Body Image, Eating Disorders, and Obesity in Youth: Assessment, prevention, and treatment (pp.103-125). Washington, American Psychological Association.
- Sullivan, P. (1995). Mortality in Anorexia Nervosa. American Journal of Psychiatry, 153, 1073-1074.
- The Australian Longitudinal Study on Women’s Health. (1996). Universities of Newcastle and Queensland.
- The National Eating Disorders Collaboration. (2012). An Integrated Response to Complexity – National Eating Disorders Framework 2012.
- The National Eating Disorders Collaboration (2010). Eating Disorders Prevention, Treatment & Management: An Evidence Review.
- Wade, T. D. (2014). Genetic influences on eating and the eating disorders. In W. S. Agras (Ed), Oxford handbook of eating disorders. New York, Oxford University Press.
- Wade, T.D. et al. (2000). Anorexia nervosa and major depression: shared genetic and environmental risk factors. American Journal of Psychiatry, 157 (3), 469-71.