Eating disorders

Eating disorders are conditions in which someone’s behaviour towards food can make them ill. They stem from psychological difficulties that manifest in unhealthy eating trends.

  1. Often associated with feelings of self-loathing and low self-esteem
  2. The two most common conditions are anorexia and bulimia
  3. Can be treated with counselling and psychotherapy

Eating disorders can put a serious strain on your physical health. Overcoming a condition such as bulimia or anorexia can be a difficult process, but our doctors may be able to help. There is no medication as such that can be offered for eating disorders; however, you can consult with a UK doctor via our online video consultation service. Depending on your circumstances, they may recommend being admitted to hospital.

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What are eating disorders?

Eating disorders stem from a psychological difficulty that leads to an unhealthy eating habit. The most common types of eating disorders are bulimia and anorexia, but there are others, such as binge eating disorder and atypical eating disorders, which have similar symptoms but do not meet the diagnostic factors.

What causes eating disorders?

There is no specific genetic cause of an eating disorder; it's thought that they are rooted in a combination of biological and environmental factors. Certain personality traits can have an influence on developing an eating disorder, such as impulsivity, perfectionism and a history of depression.

The media's construction of a 'perfect' body shape is often thought to serve as a potential trigger for eating disorders, particularly amongst adolescent females. If there is pressure from elsewhere, for example from friends and family, this can also make someone more susceptible to developing an eating disorder.

It is thought that people are more likely to binge-eat when they have reduced self-esteem, and if they feel that they are being pressured into being a certain weight. The acts performed to compensate for the eating habits, such as vomiting, using laxatives and exercising too much, reinforce those habits because of the fluctuations in weight that they can cause. It can become a 'vicious circle'.

Who gets eating disorders?

For all eating disorders, there is a higher prevalence in women. In anorexia, the ratio of diagnosed cases of women to men is 10:1 and the age of onset is usually in adolescence. Eating disorders are the third most common chronic illness for adolescent females. The lifetime prevalence of bulimia in women is around 2%, and it's more common in the western world. Like anorexia, bulimia is most common in adolescent females. Extensive figures for prevalence are difficult to substantiate, as many people with an eating disorder remain undiagnosed. For binge eating disorder, the yearly prevalence in females is around 16 per 1,000, according to the American Psychiatric Association.

Typical complications of anorexia include the gastrointestinal tract slowing down, as a consequence of limited diet and use of laxatives, which improve once weight is gained. Anorexia can also cause amenorrhoea, which's when the menstrual process ceases. It may lead to infertility if it's not resolved. Bulimia can often result in a general loss of fluids from vomiting and erosion of the teeth from the stomach acids, which is why dental hygiene is extremely important if you have the condition.

If you have been diagnosed with an eating disorder or are concerned that you may have symptoms of bulimia, anorexia or binge-eating, you can consult one of our UK doctors online via our video service. They will be able to help you with any queries you may have about treatment, and can refer you to a specialist mental health team for psychotherapy.

Page last reviewed:  12/06/2020
Diagnosis and treatment

How does someone know they have an eating disorder?

Someone may be able to identify that they have an eating disorder from the clinical symptoms that they are presenting. However, people may not always recognise the condition in themselves, as the problem is psychological. 

A family member or close friend may be able to help you talk about your behaviour with food. 

Some questions that someone can ask themselves to help explore the possibility of having an eating disorder include:

  • Do you worry about your weight?
  • Have you lost more than a stone in a period of three months?
  • Do you compulsively binge-eat?
  • Do you ever intentionally vomit because you feel too full?
  • Do you ever think you have lost control over the amount that you eat?
  • Do you think that you are too fat, when others say that you are too thin?

How is an eating disorder diagnosed?

A doctor is likely to ask some of the above questions to get more of an idea of a person’s medical history. They will then assess symptoms specific to the condition.

In the case of anorexia nervosa, a person with the condition will weigh around 15% or more below the average weight for their expected BMI. There is also a characteristic avoidance of foods that are deemed to be fatty; this is often accompanied by self-induced vomiting, and over-exercise.

The person may also be striving for a perceived ideal of thinness, and be oblivious to the serious impact that this has on their health. They may find it hard to acknowledge that they could have a problem and resistant to changing their habits.

Bulimia can be characterised by repeated episodes of binge-eating, where there is no self control. In order to fulfil the diagnostic factors, this behaviour has to occur once a week for at least 3 months. Psychological symptoms can include the fear of gaining weight, a sense of guilt and self-loathing of the behaviour.

Do eating disorders require treatment?

Eating disorders do require treatment, but the first step is getting the person to admit that there is a problem that needs addressing. This can be particularly difficult if the person is private about their eating disorder and sensitive about the subject.

However, with the right support and long-term treatment from a specialist, a full recovery can be made.

What treatments are there for eating disorders?

If someone is diagnosed with an eating disorder, it is likely that they will be referred to a mental health team. They will help to formulate a dietary plan to follow, and assign regular intervals to be weighed, which can help to establish an understanding about the relationship between eating and the effect on someone’s weight.

There are many different psychological therapies that can be implemented. The two most commonly used are cognitive behavioural therapy and the maudsley model of anorexia nervosa treatment for adults (MANTRA). These sessions are taken over several months, and will allow the person with anorexia or bulimia to communicate reasons as to why they may have become anorexic or bulimic, with a view to adjusting their perceptions on weight loss.

Page last reviewed:  12/06/2020
Questions and Answers

What should I do if I think I may have an eating disorder?

If you think that you may have an eating disorder, you should contact your local GP to talk them through your symptoms. They will ask you some questions to help formulate a suspected diagnosis. They can refer you to a specialist mental health team who will construct a treatment plan for you.

Are there side effects of eating disorder treatment?

There are unlikely to be any side effects of therapy for eating disorder treatments, as it is a condition which is treated with talk-led counselling. Although it may be a difficult process to accept, the condition can worsen if the habits governing it aren’t addressed.

Can I consult a doctor about eating disorder treatment online?

Our doctors are available to consult with online by using our private video consultation service.

Once you have booked an appointment, you can speak to a doctor at a time convenient for you. They will be able to refer you to a specialist and explain the importance of a regular diet, and seeking help from family members and close friends.

Page last reviewed:  12/06/2020

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