Eating disorders

Food becomes a problem when it's used to help you to cope with painful situations or feelings, or to relieve stress, perhaps without you even realising it.

It is unlikely that an eating disorder will be the result of one single cause. It is much more likely to be a combination of many factors, events, feelings or pressures that lead to you feeling unable to cope. These can include: low self-esteem, family relationships, problems with friends, the death of someone special, problems at work, college or at university, lack of confidence, or sexual or emotional abuse. Many people talk about simply feeling ‘too fat’ or ‘not good enough’.

People with eating disorders often say that the eating disorder is the only way they feel they can stay in control of their life. But as time goes on it isn’t really you who is in control – it is the eating disorder. Some people also find they are affected by an urge to harm themselves or misuse alcohol or drugs.

If this is how you deal with emotions and feelings and you are unhappy about it, it's important to talk to someone you trust. Try not to bottle things up. This is not helpful to you or to other people around you, it won’t make you feel any better and the problem is unlikely to go away.

Anyone can develop an eating disorder, regardless of age, sex, cultural or racial background. But the people most likely to be affected tend to be young women, particularly between the ages of 15 and 25.

Research has shown that your genetic make-up may have a small impact upon whether or not you develop an eating disorder. In situations where there are high academic expectations, family issues or social pressures, you may focus on food and eating as a way of coping with these stresses.

Traumatic events can sometimes trigger an eating disorder: bereavement, being bullied or abused, an upheaval in the family (such as divorce), long-term illness or concerns over sexuality. Someone with a long-term illness or disability (such as diabetes, depression, blindness or deafness) may also experience eating problems.

Has my friend got an eating disorder?

Is your friend or relative acting differently or do you feel they have changed? Do you have a friend who is often talking about weight and shape? They might say things like, "I need to lose weight" or, "If I was slimmer, I'd be happy."

Some of these attitudes and behaviours may indicate that your friend has a problem with food or may have an eating disorder. People with an eating disorder may eat too much, eat very little, or refuse to eat. This is often because they feel unhappy, angry or distressed.

What is anorexia?

Anorexia nervosa means 'loss of appetite for nervous reasons'. In fact, people with anorexia nervosa may have a normal appetite. But they have lost the ability to allow themselves to satisfy their appetite. They probably:

• restrict the amount they eat and drink, sometimes to a dangerous level,
• exercise to burn off what they perceive to be excess calories, or
• focus on food in an attempt to cope with life (not to starve themselves to death).

Anorexia is a way for someone to demonstrate that they are in control of their body weight and shape. Ultimately, however, the disorder itself takes control and the chemical changes in the body affect the brain and distort the person's thinking. It makes it almost impossible to make rational decisions about food.

As the illness progresses, a person with anorexia will suffer from the exhaustion of starvation. Occasionally people die from the effects of anorexia, especially if it's untreated.

What is bulimia?

The term bulimia nervosa means literally ‘the nervous hunger of an ox’. The hunger, however, is really an emotional need that cannot be satisfied by food alone. After binge-eating a large quantity of food to fill the emotional or hunger gap, there is an urge to immediately get rid of the food by vomiting or taking laxatives (or both), by starving or reducing food intake, or by working off the calories with exercise in an attempt not to gain weight.

Bulimia is more difficult to notice as someone with bulimia will tend not to lose weight dramatically, or their weight will fluctuate. You may not recognise the illness in a friend, so it can persist for many years undetected.

As with anorexia, people who develop bulimia become reliant on the control of their food and eating as a way of coping with emotional difficulties in their life. They may also become obsessed with maintaining their weight.

How can I stop worrying about my friend?

The truth is, you will worry, but the important thing to remember is that if you have noticed something is wrong, others will probably have noticed, too. It's not all your responsibility. Don’t let your friend’s illness take over your life.

Try to enjoy your usual activities, with or without your friend. They may have changed and may not be the way they used to be, but it could be the eating disorder that's making them behave differently.

You can contact beat for more information about eating disorders and to speak in confidence to an adviser - see The beat for young people in Useful links.

It's important to look after your own needs and not allow your own health and wellbeing to be affected.

Should I tell my friend's parents?

If you feel concerned about your friend’s safety, tell an adult you trust, perhaps your own parents/carers. The adult you tell may decide they must tell your friend’s parents. If they do, let your friend know that they intend to do this and perhaps give them the chance to tell their parents themselves first.

You may have to face the fact that your friend may not like what you've done. Eating disorders involve secrecy and denial, so they may be quite angry with you, even if you did it because it was the best thing to do for your friend. In time, they will probably be glad of your care and friendship.

I'm not sure if I can handle this.

You may be feeling lots of mixed emotions. You may decide it’s too hard to stay around somebody who is recovering and that you would rather avoid them. That is your decision and you should not feel guilty about this.

You may feel angry and frustrated. Nobody wants to see someone they care about being unhappy. Be honest about how you feel. Perhaps you could talk to somebody and get some support yourself. It isn’t easy, but you are valued and important, even though sometimes it doesn’t feel like it.

For advice on ways to help a friend and information on treatment for eating disorders, see Treatment for eating disorders, in Useful links.

University student Katie Metcalfe, now 21, was diagnosed with an eating disorder at age 14. She talks about her five-year battle with anorexia.