Eating problems
Food plays an essential part in everyday life and changing your eating habits from time to time is normal.
An eating problem is any relationship with food which you find difficult. This could be; restricting what you eat, eating in secret, feeling anxious about eating, emotional eating, purging, eating inedible substances or being scared of eating in public. You don’t have to be over- or under-weight to have a problem with eating.
When food and eating begins to interfere with your everyday life, professional help can make all the difference.
Eating problems can affect your day to day life in a variety of ways. You may:
- Find it difficult to concentrate or feel tired
- Find that food has become the most important part of your life
- Feel depressed or anxious
- Feel worried or guilty about hiding it from others and about them finding out
- Feel a distance from friends or family
- Avoid social situations where you will be eating in public
- Finding it difficult to be spontaneous
- Finding that other people comment on your appearance or that you feel differently about it
- Developing physical health problems
- Dropping out of school, college or work and avoiding your usual hobbies
- Feeling like you are being bullied or teased
Eating problems vs Eating disorders
An eating problem is any relationship with food that you personally find difficult. These can be difficult to live with and can affect the way that you live your life. For some people an eating problem can be a form of self-harm related to your body image and self-esteem. Others eating problems can arise from phobias of certain foods.
An eating disorder is a medical diagnosis which is based on your eating patterns, medical test, your weight, blood and body mass index (BMI). There are 5 main types of eating disorder; bulimia nervosa, anorexia nervosa, binge eating disorder, other specified feeding or eating disorder and other diagnoses related to disordered eating. It is possible to experience the symptoms of more than one disorder or to experience symptoms which don’t fit into any of these diagnoses.
If you are experiencing binge eating disorder you may feel that you can’t stop yourself from eating despite trying. Eating might be used to make your feel better or hide difficult feelings.
Feelings:
- Out of control
- Embarrassed or ashamed
- Lonely
- Depressed
- Unhappy about your body
- Stressed
- Anxious
Behaviours:
- Picking at food throughout the day
- Eating large amounts at once – binging
- Eating whilst distracted
- Eating for comfort due to other emotions
- Eating unhealthy food regularly
- Hiding how much you are eating
- Eating until you feel sick or uncomfortable
- Trying to diet but finding it difficult
Physical symptoms:
- You may put on weight
- Problems associated with being overweight e.g. diabetes, high blood pressure, joint or muscle pain
- Breathlessness
- Feeling sick
- Experiencing sugar highs and crashes
- Health problems such as acid reflux or irritable bowel syndrome (IBS)
Experiencing anorexia usually involves not eating enough food to function in your usual manner or stay healthy. It is often connected to feelings of low self-esteem, negative self-image and feelings of intense distress.
Feelings:
- Thinking about nothing but food
- That you need to be perfect but aren’t
- Lonely
- That eating is losing control
- That you are fat
- Frightened of putting on weight or that someone might find out
- Depressed, tired, anxious, or tired
- A sense of achievement from not eating or over-exercising
Behaviours:
- Reduce your food intake or stop eating
- Count calories
- Hide food or secretly throw it away
- Avoid certain foods
- Cook elaborate meals but not eat them
- Use appetite suppressants
- Think about losing weight constantly
- Exercise a lot with strict guidelines
- Makes rules about food
- Have rigid eating times
- Check your weight and body
Physical symptoms:
- You will lose weight very fast
- You may become physically undeveloped
- You may feel weak and move slowly
- Feel cold
- Periods may become irregular or stop
- Hair may become thin or fall out
- Fine fuzzy hair may develop on your arms and face (lanugo)
- Loss of interest in sex
- Difficulty concentrating
- Bones may become fragile
Experiencing bulimia usually involves a cycle of eating large amounts of food (binging), followed by feeling guilty or ashamed and wanting to be rid of what you have eaten (purging).
Feelings:
- Ashamed/Guilty
- Feelings of hatred about your body
- Scared of being discovered
- Depressed or anxious
- Lonely
- Low or upset
- Rapid mood changes
- Out of control
- Numb
Behaviours:
- Eating a lot in one sitting – Binging
- Cycles of eating, feeling guilty, purging, hunger & eating again
- Eating foods you feel are bad for you
- Starving yourself between binges
- Eating in secret
- Cravings
- Purging – by making yourself sick, using laxatives or exercising excessively
Physical symptoms:
- Staying the same weight or going from being over- to underweight often
- Dehydration
- Irregular periods
- If purging by making yourself sick – problems with your teeth caused by stomach acid or a sore throat
- If purging using laxatives – developing irritable bowel syndrome (IBS), stretched colon, constipation and heart disease
Other specified feeding and eating disorder (OSFED)
This is a diagnosis which is given when you have an eating disorder but do not clearly meet the criteria of anorexia, bulimia or binge eating disorder. You might experience any combination of the feelings, behaviours or physical symptoms of these disorders. Previously, you may have received a diagnosis of eating disorder not otherwise specified (EDNOS).
Other diagnoses related to disordered eating
Rumination disorder – this involves regularly regurgitating your food (without a physical health reason for doing so). You may then re-chew, swallow or spit out this food.
PICA – this is eating inedible substances which have no nutritional value. This could be potentially harmful.
Avoidant/restrictive food intake disorder (ARFID) – a very strong need to avoid food or just certain foods due to their smell, taste or texture. The idea of eating these foods can cause anxiety.
Causes of eating problems
There is no clear cause for eating problems. In most cases the difficulties will arise as a result of a combination of environmental and biological factors. This could include; habits and traits, difficult life experiences, family issues, social pressures, physical and mental health problems, biological and genetic factors or specific triggers or “at risk” times. Sometimes it may be difficult to establish the causes of your eating problems.
Treating eating problems
NICE guidelines suggest that Cognitive Behavioural Therapy (CBT) or family therapy are best practice for the psychological treatment of eating problems. However, there are also a number of other approaches which can be helpful, particularly when symptoms/behaviours are milder in nature.
If an eating disorder isn’t treated, it can have a negative impact on someone’s job or schoolwork and can disrupt relationships with family members and friends. The physical effects of an eating disorder can be fatal.
Treatment for eating disorders is available, although recovery can take a long time. It’s important that the person affected wants to get better, and the support of family and friends is invaluable. Treatment usually involves monitoring a person’s physical health while helping them deal with the underlying psychological causes. This may involve:
- using self-help manuals and books, possibly under guidance from a therapist or another healthcare professional
- cognitive behavioural therapy (CBT) – therapy that focuses on changing how a person thinks about a situation, which in turn will affect how they act
- interpersonal psychotherapy – a talking therapy that focuses on relationship-based issues
- dietary counselling – a talking therapy to help a person maintain a healthy diet
- psychodynamic therapy or cognitive analytic therapy (CAT) – therapy that focuses on how a person’s personality and life experiences influence their current thoughts, feelings, relationships and behaviour
- family therapy – therapy involving the family discussing how the eating disorder has affected them and their relationships
- medication – for example, a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia nervosa or binge eating