Eating Disorders

In the last few decades, there has been a notable increase in the incidence of eating disorders in the Western world. It is, however, uncertain if this is due to an increase in the number of people developing the disorders or because improved recognition has led to more cases being diagnosed. The term, 'eating disorders', is also being more widely used to not only describe conditions like anorexia nervosa and bulimia nervosa but compulsive eating, obesity and even some dieting behaviours. Therefore, it is difficult to gain an accurate picture of the number of people who have eating disorders.

Currently, most of the data on the incidence of eating disorders in Australia is from hospital admission records. However, the number of people admitted to hospital for an eating disorder represent only a small percentage of the people affected. What is clear is that the majority of those developing eating disorders are female and in their teenage years. So, why are young women so much more likely than any other group to develop eating disorders?

It is now acknowledged that anorexia nervosa and bulimia nervosa are extremes in a range of eating behaviours which affect most women living in societies where thinness is the ideal. Various risk factors which contribute to the development of eating disorders have been identified. These include society's emphasis on thinness, the impact of the media, stress, violence against women, the poor self image associated with adolescence and low self esteem.

Some facts and figures

• It is estimated that anorexia nervosa and bulimia nervosa affect 0.5% and 0.5%-1% of the Australian population respectively (1).
• Women with bulimia nervosa typically keep their disorder hidden for five years before seeking treatment (2).
• In 2004-05, 14% of all hospitalisations for mental and behavioural disorders in women aged 12-24 were due to eating disorders (3).
• In 2003, anorexia nervosa and bulimia accounted for 4 639 DALYs for females aged 15-24 (DALYs are a measure of the years of healthy life lost due to illness or injury) (4).

What is anorexia nervosa?

Anorexia nervosa is a disease characterised by deliberate self-starvation resulting in severe weight loss (usually over 25% of normal body weight), fear of gaining weight, low self esteem, extreme dieting, distorted perception of body shape and amenorrhoea (loss of periods).

Behavioural symptoms can include: over-exercising; vomiting; laxative abuse; use of diuretics and/or appetite suppressants; deceitful behaviour to avoid eating; a relentless pursuit of thinness; poor body image; low self esteem; depression; perfectionism; and obsession with food, body weight and shape. Not everyone who suffers from anorexia nervosa will experience all of these symptoms.

The physical consequences of anorexia nervosa can include: marked weight loss; skeletal appearance; vitamin and mineral deficiencies; starvation; loss or thinning of hair; pigment changes and skin and nail damage; osteoporosis or bone wastage; loss of periods; sensitivity to cold; growth of body hair; constipation; insomnia; hallucinations; and ultimately, in some cases, death.

How can anorexia nervosa be treated?

Obviously, the best way to cure anorexia nervosa is to recognise it and treat it as early as possible. Since the causes of anorexia nervosa are not only physical but also social and individual, a holistic approach is most effective. While medical treatment for the physical effects is crucial, dealing with the psychological effects of the disorder are equally important. Individual, group or family therapy, dietary advice, counselling, medication, and support from family and friends can all aid in the recovery process. Hospitalisation may be necessary if a person has reached a dangerously low body weight.

What is bulimia nervosa?

Bulimia nervosa is a disease characterised by uncontrollable binge eating followed by purging behaviour. Food is purged through vomiting, or laxative and diuretic abuse. Bulimics often over-exercise, over-diet, fast, and abuse diet pills. Many believe that the problem of bulimia nervosa is more widespread than anorexia nervosa. Like anorexia nervosa, bulimia nervosa is known to be far more common among young women, as well as among women employed in occupations where slimness is expected (modelling, acting). People who are bulimic display many of the symptoms of anorexia nervosa, including: guilt and secrecy; social isolation or withdrawal; weight fluctuations; dieting; mood swings; irritability; constant preoccupation with food; and low self esteem. However, unlike anorexics who often gain a sense of control from their disordered eating, bulimics feel that their eating is out of control.

The physical consequences of bulimia nervosa can include: puffy cheeks caused by swollen salivary glands; damage to teeth, mouth, throat and gullet from forced vomiting and stomach acids; gastrointestinal damage; diarrhoea; constipation; poor nutrition and iron deficiency; skin, nail and hair problems; fatal stomach rupture; and heart attack.

How can bulimia nervosa be treated?

Like anorexia nervosa, bulimia nervosa is a condition marked by social, psychological and physical factors. Treatment for bulimia nervosa should attempt to address all these areas.

What causes eating disorders?

Eating disorders are extremely complex problems and, therefore, do not have one single cause. Instead, there are a number of identified factors that may contribute to a person developing an eating disorder. These include: personality/psychological factors (particular personality traits, low self esteem); precipitating/situational factors (stressful life events such as relationship breakdown, unemployment, death of a loved one); family factors (attitudes and communication); biological factors (genetic predisposition); and socio/cultural factors (idealisation of thinness by media, peers and/or family) (5). It is thought that a combination of these factors may cause eating disorders in some people.

In looking at causes and treatment it is essential to consider social, personal and family factors, as well as the crucial physical health issues. Understanding the pressures and conflicts of young women may help to understand why so many have such a problematic relationship with food and their bodies.

References

1. Gilchrist P et al. Eating disorders revisited. I: anorexia nervosa Medical Journal of Australia 1998 Vol 169 No 8 p438-441
   Hay, P. et al. Eating disorders revisited II: bulimic nervosa & related symptoms Medical Journal of Australia 1998 Vol 169 No 9 p448-91
2. Ford, S. Understanding and treating eating disorders InPsych Highlights December 2003 http://www.psychology.org.au/publications/inpsych/12.2_46.asp date accessed: 11th October 2005.
3. Australian Institute of Health and Welfare. Young Australians: The Health and Wellbeing 2007 Canberra: AIHW 2007 26
4. Australian Institute of Health and Welfare. Ibid p5
5. Eating Disorders Foundation on Victoria. Information on Eating Disorders for Families, Partners and Friends (booklet) 2000 p7-11

For further information sources on this topic see our Internet resources for assignments page.

This student factsheet is one of a series produced by Women's Health Queensland Wide. They have been developed in response to students' most frequently asked questions and reflect a range of topics examined by high school and tertiary students. It has been reviewed by our Editorial Committee. This factsheet is designed for student assignment purposes and, therefore, may not be an appropriate source of information for personal use.

Back to the top

Last Modified: October 30, 2007