Better Living - Anorexia Nervosa and Bulimia Nervosa
Everyone needs food to survive. But for some people, food can become an overwhelming and destructive force that can
completely dominate their thoughts, feelings and actions. People can be said to have eating disorders when their life
revolves around food and they take extreme measures to control what they eat. Anorexia nervosa and bulimia nervosa are
two common eating disorders, and affect women in particular.
What is the difference between anorexia and bulimia?
Anorexia is an illness that occurs mainly in teenage girls, although increasingly boys suffer from it too. People with
anorexia are obsessed with being thin and are terrified of gaining weight. As a result, they starve themselves
(especially avoiding high-calorie foods), and exercise obsessively until they become extremely thin and well below the
normal weight for their age and height.
Bulimia usually affects women in their early to mid-twenties. People with bulimia are also terrified of gaining weight,
but they can usually keep within a normal weight. This is because they eat very large amounts of fattening food (called
'bingeing'), but then get rid of that food by vomiting or by taking laxatives.
Why do people get these eating disorders?
It is not know exactly what causes anorexia or bulimia. Many explanations have been suggested, although the precise
reasons may be different for each person. A fear of not being able to cope or feeling overwhelmed are common among
people with anorexia or bulimia. For instance, adolescence is full of major changes - both physical and emotional - and
some teenagers may be confused or uncertain. Denying themselves food may be one way to establish some control in their
lives. Others may resort to food to block out disturbing feelings. People with bulimia are often unsure of themselves,
lack confidence in their abilities or suffer from depression. Binge eating may be one way to cope with these unhappy,
Today's 'thin is beautiful' image may be a contributing factor. The waif-like ideal promoted through the media can put
pressure on women of all ages to diet, sometimes to excess. Other triggers of eating disorders may include upsetting
events, such as divorce, or difficult or abusive family relationships.
What health problems do anorexia and bulimia cause?
Anorexia can cause many serious health problems. Usually women stop having their menstrual periods. Dry skin and
thinning hair on the head are common, although fine hair may grow on other parts of the body. Other complications
include difficulty sleeping and concentrating, constipation, depression, frequently feeling cold, getting ill often,
brittle bones that break easily (osteoporosis) and weakened muscles. If severe anorexia isn't treated, the person may die.
Bulimia may be less noticeable as sufferers usually keep a constant weight. However, continually vomiting and/or taking
laxatives causes other health problems, which include a puffy face and swollen fingers, muscle weakness, stomach pains,
long-term constipation and tooth decay as, over time, the stomach acid brought up by vomiting dissolves the tooth enamel.
How are these eating disorders treated?
Recognising an eating disorder quickly is vital to recovery. A person with an eating disorder can be helped much more
easily if the problem is identified and treated early. The first port of call is usually the family doctor, who may
refer the person to a counsellor, psychiatrist or psychologist who is trained in treating people with eating disorders.
For most people with anorexia, the weight loss is not too severe and they do not need to be treated in hospital.
However, for treatment to be successful, they must want to change, and accept professional help and support from
family and friends. The first treatment step is to bring the person back to, or near, an acceptable weight. This means
making sure the person has regular meals with the family and eats enough calories to gain weight.
With bulimia, the priority is to re-establish a consistent pattern of eating, with three meals a day at regular times.
Keeping a diary of eating habits and learning about healthy eating and sensible weight control are often helpful.
Medication, such as antidepressants or tranquillisers, may be prescribed in the short term to help people through a
distressing time. Be sure to ask your doctor about possible side effects. For many people, therapy with a professional
and trusted counsellor or therapist is helpful for providing a 'safe' way to talk through the issues that may be
upsetting them and that may lie at the heart of their eating disorder.
Self-help groups may help too. It is often comforting to talk to other people who have been through the same thing, and
who offer understanding and acceptance without blame or guilt.
How can family and friends help?
It can be upsetting to witness loved ones putting their health and lives in jeopardy. As a member of the family or as a
friend, it is natural to want to help. But unwanted pressure or criticism from others usually makes matters worse. If
possible, accept their behaviour instead of confronting them with it. Unless it's a life-threatening situation, try to
let the person make his or her own choices and let the person know that love and support is consistently there. Once
the person has recognised the problem, offer to help with practical matters such as finding medical assistance,
self-help groups and other resources that may be needed to do battle with the eating disorder.
Is it possible to get over an eating disorder?
Yes - it can be a long and difficult process. Sufferers may need to have psychotherapy for months or years, and
relapses can occur in times of stress. Approximately 50% of people with anorexia who are treated in hospital continue
to have symptoms for many years. An eating disorder is difficult to overcome, but with commitment, patience and support
it can be done.
It is usually very difficult for people with eating disorders to get better on their own. It is important that you find
help and support. There are a variety of ways either you, or someone you care about, can gain support and treatment.
Self Help Groups
Self Help Groups provide a place to share feelings with others who have similar experiences. The Eating Disorders
Association run groups all around the country for people with eating disorders and their families. If you are over 16
years old you can attend a group but you have to take a person who is over 18 years old with you. This does not have to
be one of your parents/carers, it could be an aunt or older cousin or just a friend.
Self-help books can offer more of an insight into your illness and also offer step by step guidance to help you on the road to recovery.
Seeing a GP can be a good start. It is important to have the correct diagnosis. Your doctor can refer you to specialist
professionals like psychiatrists, psychologists, dieticians, nutritionists, and counsellors - it may not be possible to
access this support without seeing a doctor. If seeing a doctor is difficult perhaps you could talk to the practice
nurse or someone at school or college that you trust.
EDA has a range of information leaflets, including three specifically for young people. These leaflets are available
free to young people, 18 and under, who ring the EDA Youthline.
- Eating Disorders in Young People 60p each including p&p - Includes information about eating disorders, discusses
the reasons for eating disorders and gives information on how to get help and what to expect during recovery.
- Confidentiality and your rights 40p each including p&p - Covers legal rights, how to get help and support, what
happens if you tell someone about a problem.
- Helping a friend or relative 40p each including p&p - Gives an insight into some of the issues underlying an
eating disorder, actions to take, and coping with a friends attitude and behaviour.
- Or: 1 each of the above 3 booklets, £1.25 per pack inc. p&p (Single copies are available free to young people who
ring our Youthline.)
The EDA Youthline is available for confidential support and information for anyone in the UK. The service aims to
provide a non-judgemental 'listening ear' to young people who are seeking help to overcome their eating disorder and
for young friends and relatives. EDA will not tell you what to do, but it can help to talk things through and come up
with ideas and options together.
You can call the Youthline on 0845 634 7650 . It is open from 4.00 pm to 6.30 pm Monday to Friday. EDA are able to call
young people back to save your phone bill, but do consider who will answer the phone. They are unable to return calls
from outside the UK.
The Internet can be a valuable source of information about eating disorders and facilities and services available.
Message boards and chat rooms can be used to provide and receive support for each other. Although this can be an easy
and safe way of gaining support, it cannot replace personal and individual help and support. The web cannot replace
contact with your GP or counsellor.