It is difficult to say exactly what "normal eating" is as every single one of us has different eating habits. Some of us have three meals a day while others snack throughout the day. Some people eat more at night while others are hungry in the morning. These eating styles are all normal and help us maintain good nutritional health. From time to time our eating patterns and habits may change due to a variety of factors including personal reasons, wanting to eat healthier foods, holidays etc. Our eating is also affected when we feel under pressure or stressed. We may feel that we eat significantly more or less. We may crave certain foods such as chocolate or crisps. After the stressful time has passed, however, we normally return to our usual eating habits. If we do not go back to our normal eating habits after a period of time, we may be in danger of developing eating disorders. This is when food becomes a central part of our everyday lives in that we eat too much or too little, we may constantly worry about our weight or when food is the first thing on our minds

. It is important though to realise that this constant worry is not just about food or weight but about difficulties in our lives that we cannot control. At their core, eating disorders involve distorted, self-critical attitudes about food, weight and body image. It is these negative thoughts and feelings that fuel the damaging behaviours. People with eating disorders use food to deal with uncomfortable or painful emotions, restricting food as a method of gaining control. Overeating temporarily soothes sadness, anger or loneliness. Purging is used to combat feelings of helplessness and self-loathing. Over time people with eating disorders lose the ability to see themselves objectively and obsessions over food and weight come to dominate everything in life. Eating disorders are complex, life-threatening conditions that can affect anyone.

People experiencing an eating disorder may experience the following characteristics:

• Low self-esteem
• Difficulty expressing needs
• Difficulty talking about problems
• Extreme concern with body image
• Mood swings

Types of eating disorders

There are three main types of eating disorders. These are:

Anorexia - People with anorexia restrict food out of an intense fear of becoming fat. They will be preoccupied with thoughts of food and the need to lose weight. They may also exercise excessively, use diet pills and may engage in purging behaviours. Anorexia most commonly occurs amongst adolescent girls and young women in the early twenties. However, an increased incidence of anorexia has been noted amongst young men and children.

Bulimia involves a cycle of overeating and binging followed by behaviours aimed at compensating for the binges. These include fasting, forced vomiting, use of diet pills and laxatives and excessive exercise. Most people with bulimia maintain a body weight within the healthy range for their age, sex and height. As a result people with bulimia can keep the condition a secret for longer.

Binge Eating Disorder involves compulsive overeating but without purging. Despite feelings of shame and guilt over these secret binges, people with the disorder feel unable to control their behaviour or stop eating when they are uncomfortably full. Over time binge eating disorder can result in significant weight gain. Binge Eating Disorder is thought to be as common amongst men as women.

What causes eating disorders?

It is difficult to pinpoint an exact reason for the development of an eating disorder. The cause is related to a combination of factors including biological, familial and sociocultural factors that combine to increase vulnerability to developing an eating disorder. Some other suggested factors include the following:

Social pressure: In a time when beauty is perceived and advertised alongside slim models and celebrities, it can sometimes be difficult to see the two as separate issues. Newspapers, films and magazines all falsely depict slimness as beauty. As a result, many people are influenced to desire this idealised body shape that is often unrealistic and unhealthy.

Control: We often lead lives that are influenced by many factors outside of our control. Weight loss and the feeling of control associated with it can make us feel good.

Stress: It is common for an eating disorder to develop after a period of great stress in a person's life e.g. life difficulties, physical illness, upsetting events, sexual abuse. The distress felt will relate not only to the current upset but also to a store of past upsets that have never been expressed.

Low self-esteem: For some people, losing weight can be perceived as a method of obtaining a degree of self-respect and self-worth.

Warning signs of eating disorders

Most people will have times when they feel conscious about their weight or body image. This is especially true for teenagers and young adults who face extra perceived pressure to fit in and look attractive when their bodies are changing. So it can be difficult to pick up on the early signs of an eating disorder but as the disorder progresses the warning signs are present even though the person with the eating disorder may try to hide their condition. Some of the most common eating disorder warning sign include the following:

Restricting food or dieting by skipping meals, taking very small portions and counting calories.

Bingeing: especially late at night in a private hiding place. Other signs of bingeing include empty food wrappers and packaging and hidden stashes of high calorie foods.

Purging: for example throwing up, fasting, excessive exercising or using diuretics or laxatives. Common behavioural signs include leaving the table to go to the toilet straight after a meal, running water while in the bathroom to muffle the sound and the constant use of mints, mouthwash and perfume.

Altered appearance as a result of substantial weight loss or weight gain. A person with an eating disorder may also wear baggy clothes to disguise weight loss or as a result of their belief that they are overweight.

What is the treatment for eating disorders?

There are many different treatment plans for individuals dealing with eating disorders. These treatment options will vary depending on the individual's needs, symptoms and severity of eating disorder. All treatment options will aim to treat the physical and psychological aspects of the condition. Elements of a treatment programme could include the following:

• Residential care, e.g. if the severity of the condition poses serious threats to the person's life.
• Nutritional advice around obtaining and maintaining healthy diet and healthy eating for overall health and well-being.
• Psychotherapy - this involves the exploration of underlying causes of the problem and developing healthy ways to deal with stressful events and methods to rebuild self-esteem and confidence.
• Support groups where peers can give support, help and advice.

What should I do if I have an eating disorder?

Overcoming an eating disorder is not just about gaining weight or giving up unhealthy eating patterns. Overcoming an eating disorder is about learning to listen to your body, to your feelings, learning to trust, accept and love yourself. In order to do that the followings steps are useful.

Find an eating disorder specialist. Contact Bodywhys (1890 200 444) for a list of GPs with a special interest in eating disorders.

Address urgent health problems first then tackle underlying emotional issues.

Contact an eating disorder support group for peer support on dealing with your condition and emotional support in the form of understanding and advice.

Learn new coping skills - eating disorders are more about emotional issues than food. Disordered eating is a coping mechanism to deal with painful emotions such as anger, self-loathing, fear, guilt and vulnerability. You can learn new coping strategies when you feel painful emotions. Pick a healthier coping strategy that suits you such as writing your thoughts in a diary,having a healthy amount of exercise, painting or listening to music.

Try to improve your self-image - when you base your self-worth on physical appearance and body size alone you fail to see the other qualities that make you who you are. In order to positively influence your self-worth:

• Make a list of your positive qualities; ask your friends and family to help you.
• Challenge negative self-talk. See the module on noticing unhelpful thinking in the "Self Help" to help with this task.
• Focus on what you like about yourself and your body.

Learn healthy eating habits - this may be difficult if you have spent a good amount of time focussing on calories and weight but is a very important step in recovery from eating disorders. Try to eat foods that you like and make meals an enjoyable part of the day by spending them with family or friends or in a location you enjoy.

Identify your triggers - if possible learn to identify situations that make you want to revert back to unhealthy eating patterns. Once you notice these triggers, have a plan in place that gives you extra support. This could be attending a support group more often, talking with family or friends or writing your thoughts in a diary.

How can you help a friend or family member who has an eating disorder?

Learn about eating disorders so you can understand the struggles and difficulties your friend or family member is going through. Have patience and compassion; there is no quick fix for eating disorders but encouragement will impact positively.

Be a good role model for healthy living and eating

Accept your limitations

Take care of your own health

For more information on eating disorders and support contact, Bodywhys on 1890 200 444