Understanding Eating Disorders

Every year, on 2 June, we observe World Eating Disorder Action Day, an initiative driven by individuals impacted by eating disorders, their families and the medical and health professionals supporting them. The day aims to increase global awareness of these disorders, spread accurate information, eradicate myths, and advocate for resources and policy change. The theme for 2024 is ‘Hope, Recovery, and Science for Eating Disorders’.

Eating disorders carry the highest mortality rate among all mental illnesses.¹ This stark reality highlights the urgent need for greater understanding, support, and access to effective treatments for those affected by these complex conditions.

Eating disorders

The three main eating disorders – anorexia nervosa, bulimia nervosa, and binge eating disorder – each present distinct patterns of disordered eating behaviour and can have serious physical and psychological consequences. Take a look at this clip for an overview of these eating disorders. There is also a rise in the frequency of ‘orthorexia’, an eating disorder characterised by the obsession of health/healthy eating.

Mental Health Minute: Eating Disorders (1.17)
bit.ly/EatingDisordersMentalHealthMinute

The nine truths explained³  

In 2015, several organisations agreed on nine eating disorder truths backed by science. These truths are based on the work of Cynthia Bulik, a psychologist best known for her clinical work and research on eating disorders. Let’s take a closer look:

Truth #1: Many people with eating disorders ‘look healthy’, yet may be extremely ill. Outward appearances can be deceiving and people with an eating disorder may be battling severe physical and mental health issues.

Truth #2: Families can be the patients’ and providers’ best allies in treatment. Family members can encourage their loved ones to seek help and support them during their recovery journey. Recovery from an eating disorder is difficult, but entirely possible, especially with the support of family and the ongoing help of trained medical professionals.

Truth #3:
An eating disorder diagnosis is a health crisis that disrupts personal and family functioning. Eating disorders impact everything from your ability to carry out your day-to-day activities to your relationships.

Truth #4: Eating disorders are complex diseases with multifactorial causes. One common myth is that eating disorders, and especially anorexia in women, are ‘caused’ by the societal pressures for women to be thin.⁴ While it is important not to diminish the impact of media and societal pressure, these are environmental factors. We are all exposed to this negative environment. Yet, only some people develop an eating disorder. Other factors influencing eating disorders include genetic, biological, behavioural, psychological and social factors. Further research is needed to better understand what places some individuals at higher risk of developing an eating disorder.

Truth #5: Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations and socioeconomic statuses. Remember to avoid making any assumptions.⁵

Truth #6: Eating disorders carry an increased risk for both suicide and medical complications. Eating disorders carry the highest mortality rate of all mental illnesses.¹

Truth #7: Genes and environment play important roles in the development of eating disorders.

Truth #8: Genes alone do not predict who will develop an eating disorder.

Truth #9: Full recovery from an eating disorder is possible. Early detection and intervention are important.

Treatment for eating disorders⁶

It is important to understand that eating disorders are complex mental health conditions. An approach that only focuses on rectifying the disordered eating will most likely not cover the deeper issues that gave rise to the eating disorder in the first place. This is why a multi-pronged approach is essential.

Understanding that eating disorders are not just about food or weight, but are rooted in deeper psychological, emotional, and social factors, is crucial. Seeking professional help and support is essential for recovery, and early intervention can significantly improve outcomes.

Treatment plans often include psychotherapy, medical care and monitoring, counselling, medications or a combination of these approaches. Often, a co-occurring condition such as depression or anxiety will need to be addressed as part of the treatment plan.

Eating disorders and control

Many individuals with an eating disorder describe their eating disorder as a coping mechanism. Actress Gabourey Sidibe, for example, shares: ‘It was about me surviving the day; a self-defence mechanism: that’s what bulimia was for me. It wasn’t about losing weight, it wasn’t about controlling my appetite. It truly was about how it stopped me from crying. It felt like I was controlling my emotions.’ The desire for control amidst life’s uncertainties can lead individuals to use disordered eating behaviours as maladaptive coping mechanisms.

While they feel like they have no control over the difficulties in their lives, individuals feel they can control their eating and body shape. This provides the individual with a false sense of competency in their lives, only to realise that what they thought helped them cope, now is yet another problem to deal with. It is important then to find ways in which individuals can develop competencies in their lives and tackle problems head on. Most important, however, is to try and find the reasons individuals feel powerless in their own lives.

Disordered eating and body dissatisfaction 

Disordered eating is when a person engages in abnormal eating patterns, despite not having specific food intolerances or health problems that require a specific diet. There are many different presentations, including night eating syndrome, atypical bulimia and atypical anorexia. These do not meet the full criteria of anorexia nervosa and bulimia nervosa but remain serious. Disordered eating and poor body image can cause feelings of shame and guilt, making it difficult for people to seek help. However, it is important to find help and prevent disordered eating from developing into an eating disorder.

Body dysmorphia

Body dysmorphia (the perception that one’s body is deformed or ugly) is a main feature of all eating disorders. Individuals lose the ability to judge their bodies accurately and always feel dissatisfied with what they see. Although causes of eating disorders are varied, the concept that our desirability or worth as humans, are tied in with how we look, becomes one of the hardest ideas to challenge in treatment. The reason for this is that the emphasis on appearance is present in so many parts of our society. Developing individuals’ self-worth in areas unrelated to their bodies and appearance is crucial in providing a balance to their perceptions of themselves.

The Impact of social media 

There is no single cause of body dissatisfaction or disordered eating. However, the National Eating Disorder Association documents that ‘research is increasingly clear that media does indeed contribute and that exposure to and pressure exerted by media increase body dissatisfaction and disordered eating.’⁷

Even if individuals are not necessarily consuming social media that focus on appearance, the focus on appearance is hard to avoid with the proliferation of filters and photoshop on social media. It provides individuals with an unrealistic body-standard; one that is impossible to attain and engenders feelings of worthlessness.

Tips for being a savvy consumer of media

While it may be difficult to avoid social media and other advertising altogether, there is much we can do to protect our self-esteem. We can maintain our body confidence despite the narrow definition of beauty that the media promotes.

1. Recognise that most media images and messages are constructions. They have been created to elicit a certain feeling or response. They are not representations of reality.
2. Be critical. Try to unpack the message and understand the call to action.
3. Remember that the media’s definitions of beauty and success do not have to define your self-image or potential.

This content has been consulted by an expert psychologist.

REFERENCES

1. Terblanche, K. (2021), ‘Eating Disorders – Let’s be curious’, Mental Health Matters, [Online], Available:  ly/SADAGEatingDisorders[10 May 2024].
2. World Eating Disorder Action Day, [Online], Available: ly/EDActionDay2024[10 May 2024].
3. Spotts-De Lazzer, A. (2022) ‘9 Commentaries on the 9 Truths About Eating Disorders’, Psychology Today, [Online], Available: ly/PsychologyToday9Truths[10 May 2024].
4. Tarr, P. (2022) ‘Rethinking Eating Disorders’, Brain & Behavior Research Foundation, [Online], Available: ly/RethinkingED[10 May 2024].
5. Yu, Z and Muehleman, V. (2023) ‘Eating Disorders and Metabolic Diseases,’ National Library of Medicine, PubMed Central, [Online], ly/3UHO7jO[10 May 2024].
6. ‘Eating Disorders: About More Than Food’, NIH (National Institute of Mental Health),[Online], Available:  ly/3yjb853[10 May 2024].
7. Baker Dennis, A. ‘Media and Eating Disorders’, NEDA (National Eating Disorders Association), [Online], Available: ly/3wyxDSO[10 May 2024].

If you are using the Achieve Careers English LO Programme, the following information and activities are recommended:

• GR 7 LO Manual – Module 1 (Self-esteem and self-awareness)
• GR 7 LO Manual – Module 2 (Health and well-being)
• GR 8 LO Manual – Module 1 (Self-esteem)
• GR 8 LO Manual – Module 2 (Social Media for Social Media Day)
• GR 10 LO Manual – Module 2 (Community service for World Environment Day and World Oceans Day)
• Teacher’s Flash Drive – LO Resources – folder on Disordered Eating and Eating Disorders