People with eating disorders are preoccupied with food and/or their weight and body shape, and are usually highly dissatisfied with their appearance. The majority of eating disorders involve low self-esteem, shame, secrecy and denial.

Anorexia nervosa and bulimia nervosa are the major eating disorders. People with anorexia live at a low body weight, beyond the point of slimness and in an endless pursuit of thinness by restricting what they eat and sometimes compulsively over-exercising. In contrast, people with bulimia have intense cravings for food, secretively overeat and then purge to prevent weight gain (by vomiting or use of laxatives, for example).

If left untreated, an eating disorder, particularly anorexia nervosa, will begin to dominate an individual’s life. People with anorexia won’t care about education and work, or leisure activities and social engagements, and will isolate themselves from friends and family. Their eating disorder becomes their one and only priority, a full time occupation. Individuals may be difficult to live with because of their anxiety and frequent, unpredictable fluctuations in temperament and mood.

Implications on health.

People with eating disorders can die as a result of the physical health problems caused by their relationship with food. A quarter of people with eating disorders go on to develop a chronic illness. There are higher death rates among people with anorexia than among people with other psychiatric illnesses as a result of either the physical complications or suicide. The risk of death for someone with anorexia is three times higher than someone with depression, schizophrenia or alcoholism.

Food deprivation can result in damage to bones, osteoporosis and fertility problems. Food deprivation and purging can also result in an increased risk of cardiovascular disease, intestinal problems and kidney damage.

The brain too is affected by starvation: it can lead to long term changes in metabolic and physiological processes, and changes in thoughts, feelings and behaviour.

Most of the physical problems are reversed with weight gain, or if weight control practices stop.
So, it is probably that the reproductive system will return to normal if there is full recovery from anorexia, though it may take longer than normal to conceive, and in some cases it may be necessary to have hormonal treatment.

It may take a long time for bones to regain their strength and thickness. Recovery may be incomplete, however, and some sites may be repaired before others. If the bones remain thin, the risk of fracture is increased. If bones in the spinal column are crushed, the spinal curvature and subsequent loss of height are irreversible: this may lead to chronic pain.

Even after recovery from an eating disorder, intestinal problems may remain. Heartburn and stomach ulcers are more common. The bowel can become ‘irritable’ with frequent diarrhea or severe constipation.

Treatment.

Recovery from an eating disorder is not easy, not short and not painless: it is a slow, long and arduous struggle full of emotional turmoil. Breaking free of an eating disorder may be the toughest challenge of an individual’s life and they need support and guidance.

Treatment involves establishing a regular and balanced eating pattern and exploring, addressing and resolving underlying emotional problems. There is a range of treatment approaches to help an individual better understand and process emotions.  New forms of treatment are constantly being developed and tested as our understanding of the different factors involved and causes increases.

The initial goal of treatment is to normalize the eating patterns and develop coping strategies to control the bingeing/compensatory behaviours. As soon as the eating habits are normalized the next stage is to work on both negative self image and weight related self evaluation while establishing what function the eating disorder serves for the individual e.g. escapism, stress release, avoidance of painful emotions. The last stage of recovery is to build on self esteem and to deal with any underlying issues that may have played a role in the development of the eating disorder

"Eating Disorders are treatable".