SOAS University of London

Student Advice and Wellbeing

Eating Disorders

An eating disorder involves a distorted pattern of thinking about food and weight: there is a preoccupation and obsession with food, as well as an issue of control around food and its consumption. Problems with food begin when food is used as a means to deal with painful situations or feelings or to relieve stress. Eating disorders are often described as an outward expression of internal emotional pain and confusion. Obsessive thoughts about, and behaviour associated with, food are maladaptive means of dealing with emotional distress which cannot be expressed in any other satisfactory way. The emotional distress is often to do with negative perception of self, relationship or family problems, anxiety or depression, and an overwhelming feeling of being unable to change "bad" things about oneself or one's situation. Food can then be used as an inappropriate way of taking control. Often people with eating disorders say that the eating disorder is the only way they feel they can stay in control of their life. However as time goes on what happens is that the eating disorder takes control of the person.

Anyone can develop an eating disorder, regardless of age, sex, cultural or racial background, although the people most likely to be affected tend to be young women, particularly between the ages of 15 to 25. Increasingly young men are also developing problems with food. Perhaps due to cultural ideas of what constitutes perfection, people and especially young people often feel a strong desire to be thinner than their bodies naturally tend to be - "when I am thin everything will be alright". They confuse who they are with what they look like. As a result they change their eating patterns and may as a consequence be at risk of developing an eating disorder.

There are several recognised eating disorders which can be briefly described as follows:

Anorexia is the name given to a cluster of symptoms relating to severe, sometimes life threatening, weight loss. It is often related to distorted ideas about body weight and size. A person suffering from anorexia persists in thinking they are fat when in reality they are dangerously thin. It can be linked to a perfectionist attitude, with people suffering from anorexia often being high achievers. The most commonly affected by anorexia are young women in education aged between 15 and 25. Sufferers' menstrual periods often stop. Sufferers may also get circulation difficulties and feel cold all the time. Some sufferers enforce excessive exercise regimes on themselves while starving. The longer the condition continues, the more difficult it can be to tackle. In severe cases it can necessitate hospitalisation and can even prove fatal.

Bulimia is a condition in which people develop a pattern of bingeing (eating excessively large amounts of food) and then ridding themselves of it by vomiting or purging themselves with laxatives. People with this illness may be of normal weight, so it may be hard for others to realise what is going on. There are severe health implications, which the person suffering from bulimia may not be aware, such as tooth decay, dehydration, chemical imbalances in the body, serious glandular disturbances, damage to kidneys, stomach and the oesophagus, and even fits and irregular heart beats.

Compulsive eating is when people cannot control their intake of food. An irresistible urge to binge may then be followed by feelings of shame or self-disgust, which usually then leads to a period of rigid dieting and weight loss. This creates a cycle of binging and dieting. Eating is often not in response to physical hunger but of feelings of need and comfort. The person is out of control when it comes to food and then imposes an impossible dieting regime to regain control and to punish them selves for what they see as their "shameful" and "disgusting" behaviour.

Non-specified eating disorders can affect many people and may not be as clear cut as the above definitions suggest. Some people may have differing patterns of eating disorder and behaviours, such as starving and vomiting, or being "anorexic" although still menstruating or their current weight being normal. Others may chew food and then spit it out before swallowing. Anyone suffering from any kind of serious eating disorder can become socially isolated because of the compulsive nature of the rituals surrounding food, which may keep them from enjoying normal social activities or may leave them with little time to do anything else. It is also probably true that all people suffering from serious eating disorders feel an underlying sense of shame and self hatred.

Things you can do to help yourself

Recognising that you have an eating problem is the first step towards helping yourself.

Talk to your tutor or supervisor. Telling someone for the first time can be a huge release and it means that you no longer have to be alone with your eating disorder.

Talk to your GP. The earlier help is sought the easier it is for the eating disorder to be changed. If you are concerned about developing a serious eating disorder and the possible effects on your health, then contact your GP as soon as possible.

Contact the Student Counselling Service to talk to one of the counsellors. All eating disorders are symptomatic of emotional, psychological and social cultural issues. In counselling you can explore and learn to understand the underlying issues in a safe, confidential environment, thus breaking the experience of isolation. You can gain new coping strategies to deal with the driven obsession with food and body image.

The beat (beating eating disorders) website is an excellent source for finding out more about eating disorders and how to deal effectively with this problem.

How to help a friend who has difficulties with food

Remember your friend is a person first and someone who has difficulties with food second. Continue with the normal activities you engage in together and do not allow issues of food to dominate the friendship.

Tell them of your concern, how it makes you feel and be prepared for them to deny they have a problem.

Be supportive and encourage them to seek professional help. However, if they choose not to seek help, that is their responsibility, not yours.

Do not nag about food, spy on your friend or get drawn into becoming some form of monitor or control.

Be available to listen to your friend so they can talk about their feelings, but do not take on more than you can comfortably cope with. Everyone has limits - of knowledge, time, of understanding - so offer the level of support that you can sustain and do not let this take over your life or interfere with your work.

If you feel overwhelmed by your friend's problems, or are very concerned about them, you can contact a professional yourself to get some support and advice.

(Adapted, with permission, from the information provided by the Counselling Service at Royal Holloway, University of London and University College London, University of London.)

Useful Web link to the institute of Psychiatry, the website has been developed by the IoP's Eating Disorders Unit at www.eatingresearch.com

There is, among other things, extensive information about eating disorders including helpline phone numbers and information about a Self Help Network.