What is an Eating Disorder?
An eating disorder is defined as shape and weight control behaviours that are harmful to physical
and emotional health.
Those most commonly diagnosed are anorexia nervosa, bulimia nervosa, binge eating and obesity.
Binge Eating
Binge eating disorder is probably one of the least understood of the eating disorders. It’s a challenge
to separate binge eating from over-eating, but they are not the same thing. A binge eater will eat a
large amount of food in a short period and will feel usually completely out of control. Binges are
quickly followed by feelings of guilt and shame. Binge eaters hide food and eat alone in secret. A
binge will continue until the person feels uncomfortably full, even sick, however, binge eaters do not
follow up with vomiting or laxative abuse.
Usually binge eaters want to be able to eat normally and not spend all their time obsessing about
food, binge eaters who are obese may also want to diet and lose weight.
Anorexia Nervosa
Anorexia is specifically associated with feelings and behaviours related to the fear of “fatness”. These
feelings include poor body image, phobic feelings about food and an intense fear of being a normal
body weight. The condition usually starts in adolescence and is not exclusive to girls, boys can also
suffer.
Weight is lost by dieting or avoiding foods believed to be ‘fattening’, sometimes dieting is
accompanied by excessive exercise. Low weight is regarded by most anorexics as a positive
achievement, a sign of successful control, as a result, individuals with anorexia will usually deny that
there is a problem despite the physical symptoms.
Anorexia affects both mind and body, memory becomes poor, there is a lack of concentration, hair
becomes thin and brittle, low blood pressure, anaemia, constipation, and gum disease are just a few
of the effects.
Bulimia Nervosa
Bulimia is characterised by recurrent periods of binge eating followed by vomiting, taking laxatives or
diuretics in an effort to avoid weight gain.
The binges of a bulimic are usually of ‘forbidden’ food like biscuits, ice-cream, chocolate, chips, and
cakes. Binges usually happen in private, the food is eaten quickly and without any real enjoyment.
Binges involve feelings of anxiety, guilt, and remorse.
Not all Bulimic behaviour involves binges, sometimes the vomiting or laxative use will follow any
meal or snack.
Overweight and Obesity
Being overweight or obese may be due to an eating disorder or it may not. It is often difficult to tell
the difference, but it is possible to treat the problem and help people back to a healthier weight.
In adults ‘Body Mass Index’ (BMI) is often used as an indicator of overweight and obesity,
‘overweight’ being defined as a BMI of 25 or above and ‘obese’ as a BMI of 30 or above but no
diagnosis should be made using BMI as results can be inaccurate.
Diets are not the answer, as most overweight and obese people will testify – DIETS DON’T WORK!
For people who are overweight treatment must be tailored to individual need and circumstance.
Everyone is different and there is no ‘one-size-fits-all’ approach to weight loss.
It is important to change a person’s relationship with food and to help them to develop new eating
habits and patterns. It can also beneficial to explore the causes of the over-eating and to try to
identify if there is a particular cause or history behind it.
There are no quick fixes for overweight and obesity but once a new relationship with food has been
established weight loss can follow.
Initial Assessment
All clients have an initial assessment session to discuss their needs and expectations and for us
to decide together on the most effective course of action. Prior to an assessment I will ask a client to
keep a diet diary for a week and for eating disorder clients I also provide a lifestyle questionnaire.
Assessment sessions are usually in person and are about 1 ½ hours long, subsequent sessions are weekly and are of 60 minutes duration.
If requested, a brief, weekly session-report, detailing my recommended changes to life-style or eating, can be provided.
