According to ‘the eating dis-ordered website’, at least 1.1 million people in the United Kingdom suffer an eating disorder, with young people, especially girls, from fourteen to twenty-five years old, being most at risk of developing them.

So what is an eating disorder? Is normal eating when the only purpose of ingesting the food is to receive the optimum nutrition for metabolism? Does this mean that those people eating chocolates given with love for Valentine’s Day have an eating disorder? Not at all – in fact a new type of eating disorder has been identified called orthorexia, whereby the diagnosis is made when a person becomes obsessed with eating healthily. Eating is a very complex behaviour which is associated with pleasure, comfort, self-control, socialisation etc. There are many types of disorder e.g. there are people who will only eat one variety of food such as bread but, for the purposes of this article only three main ones will be explored – anorexia nervosa, bulimia nervosa and binge eating.

Anorexia nervosa is a serious psychological condition characterised by the person eating progressively less and less, losing weight but still perceiving themselves as overweight. They usually think about food most of the time and will often prepare food for others. If ignored, the person diets ever more strictly and their weight plummets. As their Body Mass Index (BMI) becomes lower their bodies may be covered with fine downy hair called lanugo and, if female, they are likely to suffer from either primary or secondary amenorhhoea i.e. their periods will not start at all or, if they have started, will cease. Some sufferers will vomit after eating, take laxatives and most will exercise vigorously in order to burn off more calories. As the person starves they may have a heart attack as their potassium levels are low. This can be a fatal condition.

However, there are treatments available and some people recover completely while for others, they have fluctuations for many years. Psychological treatments include cognitive behaviour therapy, individual and group psychotherapy and person centred counselling. Some believe that the condition can be prevented but the cause is not clear and there are a collection of risk factors so this is not simple. Social pressure is one such factor and certainly the incidence is higher amongst models and dancers. Depression, low self-esteem, a troubled family life, a desire for perfection, a wish for control whilst feeling powerless, a family history of eating disorders and the promotion of slimness by the media are all considered to promote the likelihood of the condition developing.

Bulimia nervosa is an eating disorder where the sufferer is also very concerned about their weight. However, unlike someone with anorexia, they are likely to be of normal weight. This is because they have some occasions of binge eating followed by self-induced vomiting. They may also take laxatives. As people with the condition are often secretive about their behaviour it is often dentists who first diagnose the problem as the enamel of the teeth is worn away by the acid in the vomit. People with this condition often feel intense shame so cover up their behaviour. This can result in difficulties in establishing long term permanent relationships – it is not easy to hide binging and vomiting when living with someone. There is also a risk of damage to a person’s physical health – there have been occasions, albeit rare, when stomachs have burst due to being over-stretched and the vomiting can lead to electrolyte inbalance with potentially fatal consequences. The risk factors are similar to those for anorexia nervosa. Stress is also likely to exacerbate the condition increasing the frequency of episodes of binging and vomiting. As with anorexia, counselling and cognitive behavioural therapy are effective treatments. Antidepressants may be given if needed.

Binge eating is a condition similar to bulimia nervosa except the person only binges but does not vomit. Consequently they tend to be overweight. The frequency of the binges varies according to the mental well being of the person. For some people the binges are spontaneous when they start to eat and find it difficult to stop. For others it is planned well in advance with special trips to the shops (sometimes several different groceries to avoid suspicion). The treatments and causes are similar to the other eating disorders. Generally the physical consequences of binge eating are less severe than for anorexia and bulimia nervosa.

In conclusion, eating disorders are relatively common. They are associated with physical ill health and even fatal consequences unless treated. They are also associated with psychological ill-health and can cause feelings of intense shame and low self-esteem. Fortunately treatment is available and the earlier the conditions are identified the more positive the outcome.

For further information please contact the Eating Disorders Association – Beat on

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