Eating Disorders

Anorexia nervosa is an illness in which people keep their body weight low by dieting, vomiting, or excessively exercising. The illness is caused by an anxiety about shape and weight that originates from a fear of being fat or from wanting to be thin.

How people with anorexia nervosa see themselves is often at odds with how they are seen by others, and they will usually challenge the idea that they should gain weight. People with anorexia nervosa can see their weight loss as a positive achievement that can help increase their confidence and self- esteem. It can also contribute to a feeling of gaining control over body weight and shape.

Anorexia nervosa is, however, a serious condition that can cause severe physical problems because of the effects of starvation on the body. This can lead to loss of muscle strength and reduced bone strength in women and girls; in older girls and women their periods often stop. Men can suffer from a lack of interest in sex or impotency.

The illness can affect people’s relationship with family and friends, causing them to withdraw; it can also have an impact on how they perform at school or in a workplace. The seriousness of the physical and emotional consequences of the condition is often not acknowledged or recognised, and people with anorexia nervosa often do not seek help.

Anorexia nervosa in children and young people is similar to that in adults in terms of its psychological characteristics. But children and young people might, in addition to being of low weight, also be smaller than other people their age, and slower to develop.

Bulimia nervosa is an illness in which people feel that they have lost control over their eating. As in anorexia nervosa, they evaluate themselves according to their body shape and weight. Indeed in some instances (although not all), bulimia nervosa develops out of anorexia nervosa. People with bulimia nervosa are caught in a cycle of eating large quantities of food (called ‘binge eating’), and then vomiting, taking laxatives and diuretics (called ‘purging’), or excessive exercising and fasting, in order to prevent gaining weight. This behaviour can dominate daily life, and lead to difficulties in relationships and social situations. Usually people hide this behaviour from others, and their weight is often normal. People with bulimia nervosa tend not to seek help or support very readily.

People with bulimia nervosa can experience swings in their mood, and feel anxious and tense. They may also have very low self-esteem, and might try to hurt themselves by scratching or cutting. They may experience symptoms such as tiredness, feeling bloated, constipation, abdominal pain, irregular periods, or occasional swelling of the hands and feet. Excessive vomiting can cause problems with the teeth, while laxative misuse can seriously affect the heart.

Bulimia nervosa in children and young people is rare, although young people may have some of the symptoms of the condition.