Eating disorders are quite common. They vary in severity, and only a portion of those experiencing them end up in treatment. The main eating disorders are anorexia, bulimia and binge eating disorder (BED). They occur in 1% to 4% of people at some point in life. Eating disorders typically begin at young age and are much more common in women than in men. Eating disorders may change shape as the condition progresses: for instance, anorexia can often change to bulimia at some point.
Eating disorders may manifest as binge eating, diet restrictions, emotional eating, body image problems or compensating with exercise or vomiting after eating. When assessing eating disorders, the focus is not on how the disorder manifests or shows: it is more important to assess the thinking that controls eating habits, as well as mental, physical and social problems associated with the disorder.
In eating disorders, eating or refusing to eat starts controlling and disrupting normal daily life, such as personal relationships and ability to function. Eating disorders may also result in changes in nutritional status that can in turn cause health problems such as feeling cold, menstrual cycle disturbances or sodium imbalance in the body. Repeated vomiting may damage tooth enamel. There is always a reason behind eating-related symptoms, and it is important to identify and solve the problem. Often those controlling their eating habits attempt to regulate their emotions, modify their body image, punish themselves or aim for the feeling of being in control.
- Do not diet! Dieting often perpetuates eating-related problems.
- Adopt a regular eating rhythm and eat a balanced diet.
- Try to identify whether eating or refusing to eat is your reaction to certain emotions. What emotion do you find hard to face? Could you find other ways to process it?
- Think about the long-term effects of your eating habits. Are your eating habits the cause of mental, physical or social problems?
- What kinds of views do you have on food, eating and your own body? Can you assess how realistic they are?
When should you seek treatment?
When eating or refusing to eat starts controlling your life and you cannot normalise your eating habits by yourself, it’s time to seek help. Reasons to seek help also include significant weight changes, social detachment, eating-related physical and mental effects for over one month, as well as absence of menstruation in women.
When treating eating disorders, it is important to assess both mental and physical health. Treatment goals include normalising eating habits, normalising nutritional status and facing and processing the thoughts and emotions behind the disorder. Treatment is usually multidisciplinary and comprehensive. Treatment methods may include psychotherapeutic interventions, nutritional guidance and psychoeducation.
Treatment is usually carried out in outpatient care, but significant undernourishment requires inpatient care. Medication is used to treat any concomitant conditions and in some cases to reduce binge eating. Physical problems attributable to nutritional status will be monitored and treated as necessary.
Information sources: Käypä hoito – Syömishäiriöt (Current Care Guidelines – Eating disorders), Syömishäiriöliitto – SYLI ry (The Eating Disorder Association of Finland), Mielenterveystalo.fi (MentalHub.fi)
FSHS Psychologist / 03 October 2019