Contents:
- What are eating disorders?
- Prevalence
- Causes & risk factors
- Main types
- Symptoms: how to tell if I might have an eating disorder
- How are eating disorders treated?
- Ce să fac dacă am simptome?
- Guide for loved ones: what should I do if I notice signs in a loved one?
What are eating disorders?
Eating disorders are medical conditions that manifest as altered eating behavior, such as overeating or under-eating, usually accompanied by negative self-image and obsessive thoughts about your body or weight.
NB: eating disorders are often extremely serious and can be life-threatening. They are NOT a personal lifestyle choice. Educating yourself can help you spot the signs of a potential eating disorder and seek help early. It will also give you a better understanding of and support for those who suffer from the condition.
Prevalence
There are no statistics on eating disorders in Romania. Estimates based on studies in the UK and the US show that in both countries, around 2% of the population, or 1 in 50 people, suffer from an eating disorder [1,2]. This corresponds to about 400,000 Romanians (a similar estimate has been made by APTTA [3]).
Causes & risk factors
It is not known exactly what causes eating disorders, but it is thought to be a combination of biological, psychological and social factors. Some of the risk factors identified so far are family history, sexual abuse, bullying, lack of confidence & self-esteem, perfectionism, problems at school/work, criticism from others about weight and external pressure to have a perfect body. People with eating disorders often suffer from other mental health problems too, especially anxiety and depression.
It’s important to realize that despite stereotypes, anyone can develop an eating disorder, regardless of gender, age or family background. Although statistics show that the group most at risk is young women, the prevalence in men and older people may actually be higher than estimated, due to their lower propensity to talk openly about their mental health.
Main types
- anorexia nervosa: when you have a very low weight and try to keep it off by starving yourself and/or exercising intensely, you are extremely afraid of gaining weight and feel that you are never thin enough
- bulimia nervosa: when you have a normal weight but go through cycles of overeating and binge eating, and then try to compensate by vomiting, taking laxatives and/or excessive exercise
- binge eating disorder: when you regularly go through short periods of binge eating and then feel guilty and/or upset.
- other specified feeding or eating disorder (OSFED), when you have ‘atypical’ symptoms that don’t clearly place you in any of the three categories above, but you are in an equally serious condition
Symptoms: how can I tell if I might have an eating disorder?
- An eating disorder can manifest in many different ways, depending on the person and the type of eating disorder (see above). However, the following symptoms are common in one form or another:
- you spend a lot of time worrying about your own body weight and shape, and/or have a distorted perception of your own body or a fixation on certain body parts
- you eat very little food or eat a lot of food in a short period and in an uncontrolled way
- you feel the need to ‘make up’ for how much/what you’ve eaten, so you make yourself vomit or take laxatives after eating or exercise excessively until you’re exhausted
- you are very underweight or overweight for someone of your age and stature, or you notice that your weight fluctuates a lot
- your mood fluctuates a lot
- you avoid social contexts, especially where food is present
- you have very specific rituals around eating, you feel a strong repulsion towards ‘forbidden’ foods
- you feel guilty about feeling hungry or what/how much you eat
- you weigh yourself very often or count calories obsessively
- you have digestive problems (constipation, stomach pain)
- you often feel tired, dizzy or even faint
- for girls and women: you are not menstruating
How are eating disorders treated?
Eating disorders are treatable. The primary goals of treatment are to normalize the eating behavior and attitude towards body weight, and to address the medical and cognitive consequences of malnutrition. Patient management is ideally achieved through collaboration between several types of specialists: family doctor, nutritionist, psychiatrist, psychologist and other specialties, depending on the associated medical complications.
If left untreated, eating disorders can have a negative impact on people’s physical health as well as their personal and professional lives. In extreme cases, the physical complications can be fatal: eating disorders have high mortality rates, with anorexia having the highest mortality rate among psychiatric conditions. Recovery can take a long time, so the support of family and friends is essential.
Treatment involves monitoring your physical condition (regular check-ups and weight assessment), accompanied by strategies to alleviate psychological problems, depending on the diagnosis and severity of symptoms. These strategies may include:
- Psychotherapy: such as cognitive-behavioral therapy (which focuses on changing the way a person perceives a situation in order to change the way they act) or interpersonal therapy (which tries to solve interpersonal problems)
- Nutrition counseling
- Self-help
- Support groups
- Medication (medication is not effective in the absence of psychological strategies, but antidepressants may be prescribed to treat depression and anxiety that occur with eating disorders, or medications that can reduce compulsive behavior)
What should I do if I have symptoms?
If you think you have one or more of the above symptoms, it is very important to see your GP (family doctor) as soon as possible. They can also assess your physical condition and issue a referral letter to a psychiatrist. Following a consultation, they will give a diagnosis and advise you on the most appropriate course of treatment. This course may involve direct help from your psychiatrist or a referral to a psychologist or psychotherapist who can support you further. These services can be obtained free of charge on the basis of a psychiatric referral note, if you have health insurance and the specialist in question has a contract with the National Insurance House. (See our page for more information about psychological services in Romania).
If you have the necessary funds, we recommend that you make an appointment directly with a psychiatrist practicing in a private practice or private clinic to get a consultation as quickly as possible. If you feel you are in a severe situation, call 112.
It is important to act quickly if you suspect you may have an eating disorder. The sooner you get support, the better your chances of recovering as quickly as possible and avoiding unpleasant complications. Although it may seem extremely difficult, try to gradually open up to those close to you about the difficulties you’re going through – the support and understanding of those around you can make a huge difference. Don’t let feelings of guilt or helplessness overwhelm you – there are many options to help you overcome difficult thoughts and feelings, and a diagnosis is not a sentence, just a step towards a healthy support system that suits your needs.
Guide for loved ones: what should I do if I notice signs in a loved one?
If you are concerned about someone close to you, the most important step you can take is to encourage them to seek specialized help as soon as possible to ensure the best chance of recovery. It is often difficult for someone with such a disorder to realize that something is wrong, and therefore to accept the need for treatment or comply with it. That is why it is essential to be supportive, compassionate and patient throughout this process. Support their decision to access help or offer to accompany them to the doctor.
Beyond professional treatment, there are many ways you can help someone in this situation:
Give them time, and try to listen without giving advice or criticizing
Although it can be difficult to hear a loved one talk negatively about themselves or food, and it can even be frustrating to feel that your intentions to help are met with reluctance or even rejection, it’s important not to lose patience. You don’t have to have all the answers, but the most important thing is that they know you’re there for them and are willing to listen.
Try to find out more about what an eating disorder involves to better understand what they are going through
Instead of assuming what is best for them, ask questions about how they feel and what they need
Do not make decisions alone about what is best for your loved one – it is important that they feel heard and understood, not treated as helpless.
Avoid discussions about weight, body, food and diets
Even a seemingly neutral conversation can affect them in a negative way and fuel unhealthy perceptions or behaviors.
Help them feel included
Eating disorders can lead to isolation tendencies, especially around meal times. Do your best to make that person feel included and welcome at social activities – even if they say no, the invitation itself can mean a lot.
Remember to look after your own mental health and do not blame yourself for the difficulties of someone close to you
Resources:
GENERAL BIBLIOGRAPHY
[1] Eating Disorder Research UK
[2] Eating Disorders
[3] APTTA Statistics
[5] NHS (British National Health Service)
[6] NIMH (US National Institute of Mental Health)
[7] Psycom
ASSOCIATIONS DEALING SPECIFICALLY WITH EATING DISORDERS
[8] APTTA (Association for the Prevention and Treatment of Eating Disorders) – Romania; NB. We believe that the APTTA website can be useful as a strictly informational resource, but unfortunately we are not convinced that the support resources it offers are still up-to-date.
[9] BEAT(Beating Disorders) – United Kingdom
[10] Eating Disorder Awareness
ARTICLES
[13] Eating Disorders Awareness
VIDEO
[13] Anorexia nervosa
[15] Bulimia nervosa
