Society today is bombarded with messages and pressures about looking a certain way, often with the promise that you will feel better by changing your body. These influences – from the media, social media, the diet and fitness industries, and from families and peers– have contributed to disordered eating becoming widespread in Canada and around the world. The most extreme forms of disordered eating can result in diagnosable eating disorders. This section will look at what eating disorders are, some signs and symptoms, and what treatment options look like.
Eating disorders are a group of complex and serious mental health disorders. They have both psychological and physical effects, some of which can be permanent or even fatal. Many things can cause an eating disorder to develop and despite what some believe, people do not choose to have them. The unhealthy eating behaviours that characterize eating disorders often develop as a coping mechanism to help deal with underlying emotional issues. Eating disorder treatment includes nourishing the body appropriately, minimizing/eliminating compensatory behaviours, and psychological treatment. Compensatory behaviours are things that people with eating disorders do to try to prevent weight gain. With early treatment and support, many people can fully recover and live healthy lives.
Eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder, among others. There is another category that is often used by health care practitioners called other specified feeding and eating disorders (OSFED).
Anorexia nervosa (AN) is characterized by restriction of food intake relative to the body’s needs. Symptoms include ongoing behaviours that can lead to a significantly low weight, an intense fear of weight gain or of becoming fat, and an inability to recognize the seriousness of their condition. People with AN may not see or experience their body weight and shape the way others see them. They may also place undue influence on body weight or shape in their assessments of themselves. AN has some variations:
- Restricting subtype: when restrictive eating is the only symptom
- Bingeing/purging subtype: when compensatory behaviours also occur. See below for examples of compensatory behaviours.
Symptoms of bulimia nervosa (BN) include recurring episodes of binge eating, recurring inappropriate behaviours that follow binge eating meant to prevent weight gain (self-induced vomiting, excessive exercise, restrictive eating/fasting, and misuse of laxatives, diuretics, or other medications), negative self-evaluation of body shape and weight, and high importance of shape and weight.
Symptoms of binge eating disorder (BED) include recurring episodes of binge eating but does not include inappropriate compensatory behaviours as in bulimia nervosa. Someone with binge eating disorder also feels a lot of distress about the binge eating and the episodes are associated with three or more of the following:
- Eating very quickly.
- Eating until feeling uncomfortably or painfully full.
- Eating large amounts of food despite hunger/fullness cues.
- Eating alone because of embarrassment about the amount of food being eaten.
- Feeling disgusted with oneself, very guilty or depressed.
Other specified feeding and eating disorders (OSFED) is related to anorexia nervosa, bulimia nervosa, and binge eating disorder however the symptoms do not meet the full criteria for one of the others. An example would be a situation where the frequency of bingeing and purging is lower than that specified in the bulimia nervosa diagnosis. People who have OSFED can also experience distress and significant impacts on their health and their lives such as in their relationships, jobs, or education.
Anyone can develop an eating disorder. It is not your fault if you do. People do not choose to get eating disorders. Though more commonly found in women, they can affect males and people of different genders, as well as people from various cultures and socioeconomic positions. They most commonly begin during adolescence but can develop at any age.
There are a number of predisposing factors that are believed to set people up to develop an eating disorder. These include genetics, environmental factors, and individual personality traits such as perfectionism, anxiousness, and low self-esteem, among others.
Effective treatments are available for eating disorders. Treatment can involve individual appointments with a clinician or with outpatient care teams, outpatient group-based programs, and inpatient hospital programs. At a minimum, receiving services from a mental health clinician, a dietitian, and a medical professional is recommended for people with eating disorders.
Since an eating disorder can affect all areas of a person’s life, the best treatment can happen when an interdisciplinary team is involved. A team like this could include a psychologist, a dietitian, an occupational therapist, a physiotherapist, a social worker, a nurse, a nurse practitioner, a doctor, a psychiatrist, and a peer supporter.
Eating disorders are treated using a variety of methods including cognitive behavioral therapy, dialectical behavioral therapy, family-based therapy, nutrition, and medical care.
Because eating disorders are complex illnesses, treatment can also be complex. You may feel conflicted about reaching out for help. There are services available that can help you or someone you know learn more about eating disorders and explore treatment options that may be right for your situation. Often, outcomes are more positive the sooner a person receives the treatment that is right for them.
The Eating Disorder Foundation of Newfoundland and Labrador offers support and direction for those with eating disorders. You can contact them in St. John’s at 709-722-0500, toll-free at 1-855-722-0500, or by email at firstname.lastname@example.org. Check out their website at https://edfnl.ca.
The National Eating Disorder Information Centre (NEDIC) is also a great resource. You can contact their helpline toll-free at 1-866-633-4220 (Monday to Friday). NEDIC also has an online instant chat resource (Monday to Friday) that you can access from their website at https://nedic.ca/.
There are 3 provincial programs/resources for people who have a diagnosis of anorexia nervosa, bulimia nervosa or other specified feeding and eating disorders (OSFED), located in St. John’s. For adults age 18 and up, there are 2 services: The HOPE Program (Healthy Opportunities for People with Eating Disorders ) and EDIP (Eating Disorder Inpatient Program). For more information, please call 709-777-2041. To refer to either program, please fax your referral to 709-777-2042.
For children and adolescents, the Adolescent Medicine Team at the Janeway Children’s Health and Rehabilitation Centre provides care for patients with eating disorders. For more information regarding referrals for children and adolescents less than 18 years of age, please call 709-777-4963. Referrals can be sent by fax 709-777-4726.
Yes. Families and loved ones can all be affected in many ways by an eating disorder. Loved ones can benefit from education about eating disorders and from receiving support themselves. Often, this helps them become a better support for you in your treatment and recovery journey.
Provincially, help is available to caregivers through the Eating Disorder Foundation of Newfoundland and Labrador (EDFNL). They offer support as well as excellent programing including:
• Bridge to Hope: Education and Support Group
• Parents of Hope Monthly Group
• Sibling Group
• Emotion Focused Family Therapy – 2 day workshop for carers
• Emotion Focused Family Therapy Refresher Group
• Family and Carers Information Sessions
• Family and Carers Education Sessions
Some other national and international resources include:
• National Eating Disorder Information Centre: http://nedic.ca/
• Feed Your Instinct: http://feedyourinstinct.com.au/
• Mental Health Foundations: https://www.mentalhealthfoundations.ca/
• National Initiative for Eating Disorders: https://nied.ca/