Introducing Eating Disorders
There are many types of eating disorders and people with an eating disorder will have their own unique story behind it and the disorder will manifest itself in different ways.
Anorexia Nervosa is characterised by weight loss to at least 15% below expected weight for height and age, or failure to gain weight in a child. The weight loss is self-induced through food restriction, over exercise, self-induced vomiting or laxative misuse for example. The sufferer will usually have a distorted body image, seeing themselves as bigger than they are, bigger than others see them and have an extreme fear of weight gain. They may well also have stopped menstruating.
Bulimia Nervosa is characterised by craving for food, particularly high fat and high sugar foods, regular episodes of bingeing (at least once a week eating significant amounts of food in a relatively short period of time) and then use of behaviours to compensate, such as self-induced vomiting, laxative misuse and food restriction, in between binge episodes. People who suffer from Bulimia Nervosa often have a fear of gaining weight but are usually at a normal weight.
Binge Eating Disorder is characterised by episodes of bingeing at least once a week. The bingeing may leave a sufferer with a sense of lack of control. There are usually no behaviours used to compensate, such as are used in Bulimia Nervosa and people with Binge Eating Disorder are commonly well above the normal weight range for age and height.
There are also a number of eating disorders that may be as severe as other eating disorder diagnoses but do not meet all the essential criteria for a diagnosis of Anorexia or Bulimia Nervosa. They are not less worthy of treatment because they don’t fit neatly into the diagnostic category of a classical eating disorder, so it is important to seek assessment and treatment for these as well.
What causes eating disorders?
It is not possible to identify a single cause for the development of an eating disorder. Research studies have shown some evidence for genetic factors but an eating disorder will not be inherited by the next generation, in the same way as eye colour for example. There are many other factors involved, including social, cultural and spiritual factors, family relationships and dynamics, abuse and personality traits/types such as perfectionism, obsessive compulsive, dependent and avoidant personalities in particular. These factors are likely to interact with each other and rarely will one factor be enough to cause an eating disorder.
How can they be treated?
Most people with eating disorders can be treated in an outpatient setting. This will first involve an assessment with their GP who may need to do some physical monitoring and refer for psychotherapy within primary care if the eating disorder is mild. If the eating disorder is moderately severe or severe, the GP is likely to refer the person to a local eating disorder service (sometimes via a community mental health team). They will then do a comprehensive psychological and relevant physical assessment (may include weight, height, bloods, blood pressure, pulse rate, ECG, referral for a bone density scan for example). Treatment usually involves physical monitoring and psychological therapy. Cognitive behaviour therapy (CBT) may often be used for a person with Bulimia Nervosa and varying types of outpatient psychotherapy for a person with Anorexia Nervosa. Family therapy is particularly important for children and teenagers with eating disorders. If outpatient care is not possible, due to physical or psychological risk, day care or inpatient care may be used, most often for the treatment of Anorexia Nervosa.
Recovery from an eating disorder involves weight restoration and stabilisation of weight where necessary. It involves psychological recovery leading to freedom from body image distortion and a fear of weight gain. Recovery also means freedom from the self-destructive eating disorder behaviours that may have served as coping strategies and finding alternative, healthy coping strategies to take their place.
Eating disorders and faith
Many Christians suffer from eating disorders as well as other mental health problems. Jesus shared in all our pain on the Cross, both mental and physical pain and God is desperate to bring light into the dark places and desperate for us to understand how He sees us - our identity in Him. He loves us whatever we are going through and has a plan and purpose for all of us, that He wants to see fulfilled.
--‘The Lord is close to the broken hearted and saves those who are crushed in spirit’ Psalm 34:18
Some people with eating disorders feel very far from God and may feel deeply ashamed. They may be unable to meet and socialise, particularly where eating and drinking with others is involved, leading them to feel isolated from their church community. It is really important for people with an eating disorder to know that they are prayed for, accepted, supported and loved by their church community. It is important that they are included and encouraged to serve as God calls them and as they feel ready.