So said Dr Peter Clark from the eating disorders clinic at a Sydney hospital in 1996. Fifteen years later the situation has become even worse, while in general our population has become fatter.
We don’t actually know the exact statistics on eating disorders, which is telling in itself, but the numbers we do have point to an epidemic that crosses borders, economic and social status, and educational levels. Eating disorders are more common than Alzheimers and if as many people had bird flu there would be world-wide panic because vast numbers of women and girls, and increasingly boys, are dying every day from these conditions.
There are four main types of diagnosable eating disorder, with others emerging. Official Australian figures say:
1 in 100 adolescent girls and 1 in 1000 boys develop Anorexia. It is the third most common illness for girls of this age. Anorexia is defined as an extreme fear of gaining weight, self-starvation, and a distorted view of body image. The average age of anorexia onset is 17, though girls as young as 5 have been diagnosed. More people will die from anorexia than all other mental illnesses, and suicide rates amongst sufferers are 32 times higher than the general population, and 1.5 times more likely than people suffering major depression. On average the disease lasts for seven years with treatment, though most suffers never return to good health and have shortened overall life expectancy. Recovery is defined as normal weight, normal eating and return of normal menstrual cycle. Less than half of anorexia sufferers recover fully, one third recover partially, and for the remaining sufferers, recovery never happens.
5 in 100 women suffer from Bulimia. But scarily, several studies have shown that most people with bulimia never seek treatment, it is the great unreported epidemic. When we look at estimated numbers, up to half of women suffer from this disorder and it often begins in late teens or early 20s and lasts for many years. Symptoms of bulimia include binge eating and then purging using laxatives and diuretics, diet pills, or over exercising. This needs to happen at least twice a week for a diagnosis. Along with bulimia we see a huge range of physical symptoms such as hair loss, problems with the throat and vocal chords, osteoporosis, irregular heartbeat, dry skin, insomnia, hormonal problems, immune system damage, severe dental issues caused by stomach acid, and psychological problems like anxiety, depression, avoiding others, mood swings, being unable to eat with others, and poor body image. Up to 19% of diagnosed sufferers die, though 70% of people who seek treatment have good outcomes.
The third of the diagnosable eating disorders is Binge Eating Disorder. Around 4 in 1000 people, male and female equally, are estimated to suffer from this disorder and it is most likely to develop in late adolescence and the early 20s. This is bingeing without purging at least twice a week. Most often the bingeing happens when alone. Physical conditions such as obesity, diabetes, high blood pressure, heart disease, and gallbladder disease are likely to develop, along with depression, anxiety, and low self-esteem.
And the emerging eating disorder is called Eating Disorder Not Otherwise Specified, or EDNOS. It is the eating disorder most often diagnosed in outpatient settings, and the one most ignored by researchers, so it’s the one we know least about. For example, if you binge and purge once a week instead of twice, or binge once a week, or if you have some behaviours of anorexia and some of bulimia, or binge only in the evenings, or only when alone, or will not eat where others can see you doing so, you would receive a diagnosis of EDNOS. So the physical and psychological effects of EDNOS are as severe as the big three EDs, and sufferers of this may also die.
There is also ongoing discussion that obsessive thinking about food, or choosing to only eat one type of food, or exclude one type of food, and even ’emotional eating’ be classified as diagnosable eating disorders. Why? Because medical insurance will pay for treatments where there is a legal diagnosis.
One common factor in all these eating disorders is that most people are likely to deny they have an eating disorder.
In my practice I know that many of the women who come to see me for weight loss or body image issues have never ever discussed their thoughts and feelings about their bodies with anyone, and often they’ve also never told anyone that they have problems with food. There is a huge degree of shame and secrecy attached to eating disorders, though almost all women have at least some symptoms of eating disorders.
One of the biggest risk factors for developing one of these ‘official’ eating disorders is dieting, and as a Holistic Counsellor – and recovered dieter – I think there are a whole swag of reasons we develop a disorder:
Feeling and thinking negatively and critically about our bodies – negative body image – often fed by womens’ magazines, television, and the weight loss industry
Severely restricting what we eat, and counting calories, carbs, proteins, fat, or the ‘points’ for each food type
The quality of the food, or should I say food-like substances, that we voluntarily eat because we want to lose weight, or stay thin
The imbalance in our BodyMind that keeps us locked into these painful patterns of self loathing and self abuse.
A further layer of complication is that eating disorders are only part of negative body image, which itself has a whole set of descriptions and causes life-limiting issues.
Over the next months we’ll be talking about different aspects of negative body image, and how you can immunise yourself and those you love against this nasty and very sad epidemic that is sweeping us away from the robust good physical and emotional health that is normal for humans.
Action step: when you see a women whose body seems to be the perfect look that you want, and maybe you even send out some resentment to that woman, remember that she might be a woman who puts her fingers down her throat to maintain that look. Instead you might send her some love and compassion, and then fill yourself with the same lovely feelings.
Because everything is perfect, and I’m convinced that this is the generation we finally deal with and heal negative body image, and step into our true selves as powerful women.