Eating Disorders: Under the Radar & Under-diagnosed

How often do you compare yourself to others in terms of appearance and weight? How often does the talk of weight come up in a conversation? How often have you tried to lose weight striving to look better rather than feel and be healthy?

We have become a society where our focus has shifted from health to appearance and this is something I come across quite often at work. Yes, our world has created this societal taboo towards people who do not fall under the “skinny”, “toned” or “muscular” category which causes a person to have a distorted perception of their own body! Having a distorted body image can eventually lead to destructive behaviour such as excessive dieting, fasting, smoking and even using laxatives or drugs. This could all spiral downhill where a person could eventually end up in the “Eating Disorders” pit and from experience in my line of work, coming back up is definitely not an easy climb.

Body image problems also affect men where the desire to fit the ideal image of lean muscularity is on the rise. Excessive exercising, use of steroids and other “body enhancers” are frequently being used, even by those as young as 16.

Now another trend that has been on the rise as well is what I would like to call – “glorifying big”. Plus size models are attempting to promote a “healthier” body image as opposed to their skinny counterparts, but again, we are still focusing on image!

This brings us to the topic of eating disorders.. Eating disorders can be described as being in a state where eating, body image, exercise and weight become an unhealthy preoccupation of someone’s life and mind. Eating disorders are psychological illnesses that exist in different forms and most common ones are Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Bare in mind that a person can also progress from one eating disorder to another. For example, a person suffering from Bulimia Nervosa can eventually develop Anorexia or Binge Eating Disorder and vice versa.  The following points will provide you some insight on the different eating disorders people can develop:

Anorexia Nervosa (AN)

An eating disorder characterised by extreme low body weight and body image distortion where an extreme reluctance or fear of gaining weight exists. It often involves very high activity and exercise levels. AN is believed to be one of the most serious psychiatric illnesses as the condition can lead to extreme starvation and malnutrition which subsequently leads to severe consequences such as death. Psychological effects of Anorexia can include clinical depression, low self esteem & extreme obsession with food and weight. Common symptoms of AN often result from malnutrition and can include symptoms such as:

  • Frail appearance
  • Extreme loss of muscle mass along arms and legs
  • Dry skin
  • Bruising easily, anaemia and brittle fingernails
  • Headaches
  • Cessation of periods in girls
  • Constipation

 Bulimia Nervosa (BN)

People with BN have often reported that initial stages involved yo yo dieting and an ongoing pursuit for thinness. This eating disorder is characterised by consuming large amounts of foods in a short period of time (i.e. binge eating) followed by compensatory behaviour such as purging (self-induced vomiting) or over-exercising. People with BN often appear to be of average weight, at times either slightly over or under which makes it slightly unrecognisable. For this reason, BN is an eating disorder that is usually missed and goes under the radar. Some physical symptoms the sufferers may experience include:

  • Tooth decay (common symptom due to purging)
  • Stomach ulcers, heart burn
  • Indigestion, sore throat
  • Irregular heartbeat
  • Dehydration

Common psychological effects of BN include depression, anxiety, feelings of guilt & sensitivity to references about weight. Fluctuations in weight and frequent trips to the bathroom right after food consumption are also common behavioural effects of BN.

 Binge Eating Disorder (BED)

BED is an eating disorder which is similar to Bulimia Nervosa, however, is characterised by an absence of purging. BED involves bingeing on large amounts of food followed by feelings of guilt and depression. Sufferers will often undergo strict dieting and fasting as a response to the negative feelings which follow the episode of bingeing. Symptoms of BED include weight gain which can lead to obesity, elevated cholesterol levels, irregular periods and hypertension. The psychological impact of BED involves low self esteem, extreme distress and guilt after a binge episode, depression and self loathing.

 What are the warning signs?

 It is important to know the warning signs of an eating disorder in order to pick it up early and undergo proper management for recovery. Be aware that such warning signs may not be as easy to identify. Eating Disorders Victoria are an Australian support group for all aspects of eating disorders that provide a great illustration of common warning signs as listed below: (

  • Constant or repetitive dieting
  • Evidence of binge eating (eg. disappearance of large amounts of food from the cupboard or fridge)
  • Evidence of vomiting or laxative abuse (eg. frequent trips to the bathroom during or shortly after meals)
  • Excessive or compulsive exercise patterns * Making lists of ‘good’ and ‘bad’ foods
  • Development of  patterns or obsessive rituals around food preparation and eating (eg. insisting meals must always be at a certain time; only using a certain knife; only drinking out of a certain cup)
  • Avoidance of all social situations involving food
  • Strong focus on body shape and weight
  • Deceptive behaviour around food, such as secretly throwing food out, eating in secret
  • Sudden or rapid weight loss
  •  Increased preoccupation with body shape, weight and appearance
  • Intense fear of gaining weight
  • Constant preoccupation with food or with activities relating to food
  • Extreme body dissatisfaction/ negative or distorted body image

My message to those who believe they might be suffering from an eating disorder is simple: Please get the help you need early. Your team should include a psychologist/psychiatrist and a qualified dietitian as well as other health professionals required. The early the intervention, the more successful the recovery.

At the end of the day, a person has to be at a stage where their health is not at risk. For this reason, we need to look at the bigger picture – not just at weight. My take away messages are the following:

  • If you are trying to lose weight – your goals should have one focus – HEALTH!
  • DO NOT COMPARE YOURSELF TO OTHERS in terms of appearance.
  • Happiness does not = skinny or muscular.
  • You are a whole person and not an individual body part.
  • Be good to yourself and respect your body. Treat it well!
  • Remember…health comes in all shapes and sizes!

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