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Eating disorders are closely associated with deep-seated feelings of shame, secrecy and denial. They typically develop from the age of 14, at a time when young people become increasingly independent in their eating patterns, which can make it harder to identify changes and problems.

Understanding Eating Disorders

In order to be able to recognise an eating disorder, it is necessary to begin with some understanding of what they are and how they develop. There are different types of eating disorders and they all have distinctive characteristics and behaviours. However, they do have one core feature in common - they are not first and foremost about food. They are disorders which develop when a person cannot cope with painful feelings and emotions and uses food as a means of expressing that difficulty. For example, an affected individual may say: “My life felt out of control and I was really unhappy at school. Losing weight was the one thing I was successful at and became the only thing that I could control.”

Expressions of eating disorders vary. In anorexia nervosa, the individual severely restricts her food intake in order to lose weight and may also control her weight with other behaviours such as self-induced vomiting, misuse of laxatives or excessive exercise. He or she will have an overwhelming fear of being a normal weight and feel ‘fat’ despite having a low Body Mass Index. The typical age when anorexia develops is between the aged of 15 to 19, although people of all ages can be affected.

In bulimia nervosa, the individual eats a very large amount of ‘forbidden’ or high carbohydrate food in a very short time, known as a binge, when they experience painful or difficult feelings. They then have a deep sense of shame about this behaviour and try to compensate for the binge by vomiting, misusing laxatives, excessive exercise or restricting food intake. Bulimia tends to affect people of a slightly older age, from the ages of 18 to 22, although like anorexia, it can develop at any age.

The Signs Of An Eating Disorder

Every individual is different - their route to the development of an eating disorder will reflect a range of unique factors in their own life. Equally, affected individuals show different signs and some behaviours may reflect general difficulties associated with adolescence, rather than an eating disorder. However, these are some key indicators to be aware of:

Anorexia

-Does your friend lie about eating meals - regularly claiming she has already eating when you know she has not?
-Does your friend frequently refer to herself as fat and seem obsessed with weight and diets?
-Has your friend started to wear baggy clothes?
-Does she have difficulty concentrating and complain about feeling cold?
-Does she exercise obsessively, regularly and for long periods, even if she is tired, doesn’t enjoy it and gets upset if she misses a session?
-Has she confided in you that her periods have stopped? This is a physical side-effect of anorexia.
-Has your friend become more withdrawn, secretive and prone to sudden mood swings?

Bulimia

People with bulimia often feel intense shame about their condition and go to great lengths to hide it. A key behaviour in bulimia is vomiting after eating, although it is important not to jump to conclusions and believe going to the toilet after a meal is necessarily a sign of the condition.

You may notice that your friend eats large quantities of food without gaining weight. However individuals almost always binge secretly and on their own, so you may not be aware of bingeing behaviour.

There are some serious physical side effects of bulimia which you may notice. They may of course be caused by other factors, but key side effects include - a persistent sore throat, stomach pains, irregular periods, mouth infections, difficulty sleeping and sensitive or damaged teeth.

In common with people who have anorexia, people with bulimia are prone to severe mood swings, depression, anxiety and anger.

Getting Help For Your Friend

Your concern for your friend and whether he or she has an eating disorder shows that you care deeply about them. You should discuss your concerns with them, but do so carefully and be prepared for them to respond in a negative way. Many people with eating disorders are very resistant to recognising their problem and changing because they do not have any other way of coping with difficult feelings. They may feel angry that you are bringing up a subject which is painful for them and may have a deep sense of shame about their behaviour around food. Remember, if they have an eating disorder, it will have a profound effect upon them and will change them. Some friends describe how they lost the person they once knew as the eating disorder took hold.

However, it is well known that it is best to treat eating disorders at an early stage, before behaviour becomes very entrenched and resistant to change. Therefore it is important that you have concerns and are prepared to raise them with your friend, even if that is a difficult thing to do.

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