Why we should all be having conversations about eating disorders and disordered eating

Food is everywhere. For many people, it is a source of pleasure. We meet over food, we celebrate with food, and we buy cookbooks by the truckload. But what happens if your relationship with food is ambivalent, or even downright dangerous?

ANAD estimates that approximately 9% of the global population will be affected by an eating disorder in their lifetime. While this is shocking enough, these statistics exclude the many people experiencing ‘disordered eating’ patterns. While disordered eating may not meet the criteria of a specific eating disorder such as anorexia nervosa, bulimia nervosa or binge-eating disorder, they share many characteristics and are concerning and potentially dangerous.

So when does an interest in food and dieting become something we should be concerned about?

According to the Academy of Nutrition and Dietetics, some of the signs and symptoms of disordered eating (which can be precursors to an eating disorder) may include:

• Frequent dieting, anxiety associated with specific foods or meal skipping
• Chronic weight fluctuations
• Rigid rituals and routines surrounding food and exercise
• Feelings of guilt and shame associated with eating
• Preoccupation with food, weight and body image that negatively impacts quality of life
• A feeling of loss of control around food, including compulsive eating habits
• Using exercise, food restriction, fasting or purging to “make up for bad foods” consumed

They go on to suggest that the consequences of disordered eating can include ‘a greater risk of obesity and eating disorders, bone loss, gastrointestinal disturbances, electrolyte and fluid imbalances, low heart rate and blood pressure, increased anxiety, depression and social isolation.’ If disordered eating becomes an eating disorder, there are many additional risks for both physical and mental health.

Why do I need to be thinking about this in my work?

Eating Disorders Victoria says that at any given time, approximately 16% of people are experiencing an eating disorder or disordered eating patterns.

Let’s break that figure down a bit further.

That means that in every classroom of 25 students, 4 of them (on average) will have an eating disorder or disordered eating patterns. It means that approximately 1 in every 6 people has either an eating disorder or is experiencing disordered eating at any given time. Those people are our daughters, our sons, our sisters, our work colleagues, our students. Based on these figures, everyone is likely to be directly or indirectly impacted by an eating disorder or disordered eating at some point in their lives.

What can I do to support people if I suspect they have an eating disorder or disordered eating patterns?

The lead author of Eating Disorders & Other Shadowy Companions, Danni McDougall, an art therapist and senior mental health practitioner, says that we need to build our understanding of the actual experience of having an eating disorder. In order to develop that understanding, we need to start by listening.

‘Many people say that having an eating disorder is like being stuck in a prison of your own mind that feels impossible to get out of. I believe that this experience needs to be heard and validated before the focus can shift to recovery’.

‘An eating disorder is an illness, like a broken leg. No-one feels shame about breaking a leg or how long it takes to heal. In creating these cards, I wanted to open up conversations about what it’s like to have an eating disorder, and challenge some of the isolation and shame that people living with eating disorders often feel.’

NEDA suggests that if we are concerned about someone’s eating patterns, we can start by learning as much as we can about eating disorders and disordered eating. They go on to say that we should be honest with the person about our concerns, use respectful and supportive language that avoids stigma, encourage the person to get help and tell someone who has the knowledge to support us (there are many services available who can provide that support).

Prevention is better than cure

The Butterfly Foundation believe that there are also many things we can do to support people to develop a healthy self-image and reduce the risk of eating disorders developing, including encouraging them to:

• Focus on body function (how their body is useful) and practice body gratitude
• Be media savvy, limit exposure to highly stylised and flawless images of fitness, beauty and appearance and diversify what they see
• Combat unhelpful and toxic negative body talk
• Resist the temptation to engage or buy from the diet industry
• Nourish their body in ways that make them feel good
• Be realistic: No one feels great about their body all of the time. Poor body image moments happen but they don’t need to respond to negative feelings with unhelpful behaviours.
• Nurture the whole self and value the whole person: Practice body kindness, mindfulness, and self-care. Encourage people to notice the qualities, talents, strengths and attributes that make them who they are, and celebrate and nurture the things that are important to them.

How the Eating Disorders & Other Shadowy Companions cards can help

While the Eating Disorders & Other Shadowy Companions cards have been designed to be used primarily with people experiencing an eating disorder—any eating disorder—they can also be used to have conversations about body image, ideals of beauty, the impact of the media on our sense of identity, dieting and our relationship to food. They can also be used to talk about other ‘shadowy companions’ like anxiety or depression.

As psychologist, Adrienne, says about the cards:

‘I like how they are gender neutral and open to be used to people of any age. I think there is so much body obsession and weight focus in society that people who don’t have an eating disorder will also find them helpful. They relate to other mental illnesses such as anxiety, depression, trauma.’

Eating Disorders & Other Shadowy Companions includes a comprehensive booklet of suggested activities and tips for creating safe and inclusive conversations in a range of settings; one-on-one sessions with counsellors, psychologists or other health professionals, with families around the kitchen table, in secondary and tertiary settings, within family and community services, workplaces and groups.