In recognition of World Eating Disorders on Saturday June 2, we spoke to Dr Phillipa Hay, director of the Eating Disorders Centre at Wesley Hospital in Sydney, to understand more about this deadly mental illness and how we can help those around us who are affected.
1. Mortality rates are almost double for those with eating disorders
“As eating disorders are a mental health condition which predominantly have a preoccupation with food, weight, shape and eating that leads the individual to engage in extreme behaviours such as starvation, the physical consequences that result from these behaviours can endanger the heart and cardiovascular system,” says Hay.
Individuals with eating disorders are also profoundly distressed and often have difficulty accessing support due to heavy stigma, which is another reason Hay says sufferers sometimes don’t survive an eating disorder.
2. Eating disorders affect 10% of the population
On their prevalence, Hay says eating disorders are very common and affect around 10 percent of the population.
“1 in 10 Australians in their lifetime will experience an eating disorder, with higher rates for some groups such as women.”
However, eating disorders can affect people in all genders, age ranges and socioeconomic groups.
“They’re not discriminatory, they occur across people from all walks of life,” says Hay.
“Eating disorders run across the entire spectrum of the community… we will all know someone close to us, if not ourselves, who’ve struggled with an eating disorder.”
3. Binge eating is different from overeating
According to Hay, the defining feature of binge eating is the inability to stop, resulting in a loss of control.
“It’s a psychological way of eating that’s very aversive, causes a lot of stress, and it’s not enjoyable at all in any way - nothing like the sort of overeating or over indulgence people may engage in at the end of Ramadan or on Christmas day.”
4. Food anxieties or sensitivity to certain smells, sights or tastes that stop a person from eating is also an eating disorder
Instead of being focused on body image concerns like other eating disorders, Avoidant/Restrictive Food Intake Disorder (AFRID) is often due to difficulty digesting certain foods, avoiding certain colours or textures, or being afraid to eat after a scarring episode of choking or vomiting. It currently affects 82,000 Australians.
“People affected by AFRID do not have the same levels of preoccupation of weight, shape and body image that are often concerns of anorexia nervosa and bulimia nervosa, but they do have very similar extreme behaviours around food and eating, like highly restrictive eating, avoidance of certain foods, and a lot of anxiety and distress around eating,” Hays says.
5. The signs of an eating disorder can be easier to detect than you might think
“The most common feature is that they start to eat in different ways,” says Hays.
An avoidance of eating or social occasions where there’s food are signs that someone might be struggling. More obvious signs such as skipping meals, avoiding eating meals with family members or rapid weight fluctuations can also indicate there’s something wrong.
General distress, dysphoria, anxiety or low mood, and a sense of preoccupation are also signs that an eating disorder is taking over the individual’s thoughts and feelings, and becoming a predominant issue in their lives.
6. Treatment doesn’t always mean hospitalisation
“The primary treatment is usually psychological therapy, delivered by people who are trained in the area of eating disorders,” Hays says. Alongside this, nutritional therapy from registered dietitians, physical care from family practitioners or a physician, and weekly or twice weekly treatment with a therapist are other forms of treatment.
Inpatient therapy in a facility like a hospital allows for greater support around nutrition and eating habits, as well as more intensive care. “Someone may come to hospital for 4 to 8 weeks out of the total length of care which may be 6 months or longer.”
7. Helping someone with an eating disorder can be as simple as listening to them
“There’s nothing that can beat listening, I think,” says Hays. “There’s an old saying that ‘a problem shared is a problem halved’, so having people you can confide in, who you can trust, who will listen to you, by encouraging people to talk and just to be there and listen.”
“It’s important for people having eating disorders to talk, to have people they can confide in, people they can trust.”
Supporting someone you know through an eating disorder can also mean being with them when eating.
“So much of our lives revolve around eating, and just being with people when they’re eating, encouraging them to come to social occasions and encouraging them to eat with family is important,” Hays says.
Encouraging without being critical or disparaging is equally important.
“Being supportive… when you notice that they didn’t eat, or they disappear from the meal and you think maybe they’ve gone to vomit or something during the course of meal. Just reaching out to them when they come back and appear distressed, just being supportive and listening.”
If you’re concerned a friend may have an eating disorder, Hays says it’s best to first consult online resources, like the National Eating Disorders Collaboration, which provides specific information to read before approaching the individual.
A straightforward approach is what Hays recommends, as there is a lot of shame and guilt that the person might be experiencing.
“There’s still a lot of stigma, anxiety and fear for people to disclose their eating disorder. Sometimes they encounter negative responses when they do disclose. So by being very validating and supporting….going with the person, be with them in the waiting room, and be there when they come out [of an appointment] and supporting them in that way, I think that’s the single most useful thing you can do to help someone, as well as being accepting.”
Hays also notes that sometimes it can be quite a journey to navigate the health system and different therapists, so encouraging a friend in this sense can also be helpful.
“Encourage them to seek out people who have expertise and can provide that help is appropriate, because there are treatments available.”
8. World Eating Disorders Day is this Saturday, June 2
Hays says it’s a good opportunity to use the day to reach out people.
“Maybe someone you know has been struggling with an eating disorder, reach out to them and just be supportive, say ‘Hi, how’s it going’. If someone’s in recovery, reach out to them and congratulate them on having recovered or having passed through their journey.”
You can also use this day to eat well yourself, be with family, and encourage others to do the same.
If you are worried about yourself or someone in your care, the best thing you can do is talk to someone. Please contact the Butterfly Foundation 1800 33 4673 or chat online.