On the surface, eating disorders are about food, body and weight. The underlying causes of a person developing an eating disorder are often more difficult to spot.

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What is an eating disorder?

Eating disorders are a collective term for several conditions or disorders with related characteristics.

A person has an eating disorder when thoughts, feelings and behavior in relation to food, body and weight begin to limit the unfolding of life and impair the quality of life. The person becomes over-concerned with body, weight, appearance and food intake.

The line between a strained relationship with food, body and weight and having an eating disorder is slippery. It is normal to have periods where you are dissatisfied with your own body, sloppy with your food or are extra focused on the "right" diet. We first talk about eating disorders when thoughts, feelings and behaviors related to food, body and weight overshadow everything else, and degrade the quality of life.





Some common signs of eating disorders

 

  1. Weight loss or weight gain
  2. Over-obsession with weight and body
  3. Stress and guilt after eating
  4. Development of abnormal eating habits, such as avoiding meals or certain types of food, or consuming large amounts of food
  5. Exercise is characterized by stress and coercion
  6. Contempt for one's own body, shape and appearance
  7. Mood swings and difficulty concentrating

 

A case example

… I continued my dirty game and the kilos disappeared from my body - and I thrived and lived with this as if it were my own secret bible, a good mother's warm hand to hold on to. And why not let go of the handle that finally appeared in a tidy condition when, after all, it could steer me through the world - however evil and disgusting it was, filled with hatred and shadows and things I did not understand - but the handle was there and helped me, and I decided over my days, I had power and thought in everyone's eyes, despite the fact that I was getting smaller and smaller.





But I did not want to eat, I could not either - the handle had become too big to carry, it still controlled my days, controlled the hours and weeks - everything determined this handle.

 

Various forms of eating disorders

Different variants of eating disorders are distinguished, but in practice there can be very smooth transitions between the different variants. It is also not uncommon to "walk" between the different diagnoses or to have parts of the different forms at the same time. 

 

  1. Anorexia nervosa

    Anorexia neurosis (anorexia) has the following characteristics: Severe underweight; people very actively limit what and how much one eats; is plagued by an intense fear of putting on weight; feel that the body is large and thick, despite being underweight; Some may have excessive exercise, self-induced vomiting and the use of laxatives to keep weight low.

  2. Bulimia nervosa

    Bulimia the following characteristics: Excessive preoccupation with figure and weight; repeated episodes of overeating: ie eating much more food than what others would eat in the same situation and an experience of loss of control over food intake; the episode is followed by self-induced vomiting, laxatives, fasting periods or overtraining to compensate for the large food intake and avoid weight gain.

  3. Unspecified / atypical eating disorders

    This includes variants of eating disorders that do not quite fit into the diagnoses of anorexia and bulimia. Orthorexia is an example of an eating disorder that has received increasing attention recently, and which involves a morbid urge to be healthy. 

  4. Sub-clinical variants of eating disorders: Eating problems

    Even if you do not have such serious difficulties with the body and eating that you meet the criteria for a diagnosis of an eating disorder, you can still have problems related to self-image, your own body and eating. Population surveys show that about ten percent have mild eating problems. For some people, eating problems can be a precursor to an eating disorder, while for others, these can go away without developing an eating disorder.

 

Common comorbidities in eating disorders

Many patients have additional disorders in addition to the eating disorder, so-called comorbid disorders. Most common is depression, anxiety (generalized anxiety disorder, symptoms of obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder), substance abuse disorders and personality disorders.

It also indicates that there is a high morbidity between eating disorders and self-harm, and that both conditions have a common characteristic in problems related to affect regulation, ie the ability to regulate emotions - and where both the eating disorder and self-harm are thus considered coping strategies in the face of emotional chaos.

 

Possible causes of eating disorder

The eating disorder is not incomprehensible, but can be difficult to understand. It is common to distinguish between: 

 

  1. Pre-disposing conditions

    • These are conditions that make a person vulnerable to being able to have an eating disorder at a later stage in life
    • It can include: Genetics, personality (negative self-image, perfectionism), family relationships, trauma and physical / sexual abuse, cultural conditions, such as dieting pressure
  2. Triggering conditions

    • These are conditions that directly trigger the eating disorder, and which must therefore be seen in connection with the underlying vulnerability of the person. 
    • Triggering factors can be major changes in life (eg moving, divorce), loss or conflict, bullying, high performance demands or dieting. Many say that they have been exposed to a lot of special remarks about weight and appearance growing up; that one was overweight as a child; early puberty.
    • Cultural conditions can be important in triggering an eating disorder; for example, that one enters a particular sport that places high demands on a special body shape or size, or where thinness or low body weight is central. 
  3. Maintening conditions

    • These are conditions that prevent the eating disorder from passing away once it has arrived; ie conditions that help to maintain the difficulties associated with the body, self-image and eating.
    • Maintenance factors can be that one experiences the benefit of the symptoms, such as a feeling of better control, an experience of coping, calming inner turmoil or avoiding negative emotions.
    • Other maintenance factors may be family conflicts triggered by the eating disorder, or symptoms triggered by malnutrition or malnutrition.
    • Maintenance conditions are the vicious circles that occur, and which lead to the disease becoming self-aggravating.

 

Instead of studying isolated risk factors, researchers have become more concerned with studying mechanisms and vulnerability models. In these models, eating disorders are seen as a result of the interaction between heredity and the environment. Recent years' research may indicate that there is a genetic predisposition for all eating disorders. It can be the interplay between hereditary factors and the environment that determines whether you get an eating disorder, other mental disorders or both.

Key factors in what leads to an eating disorder can be:

 

  1. Low self-esteem: Low self-esteem is a hallmark of many who develop an eating disorder. The perception of others can govern self-worth. It becomes difficult to like oneself and acknowledge one's own feelings.
  2. A way to deal with emotional chaos: The eating disorder can give an experience of having control and give a feeling of mastery. In transition phases, in case of loss or grief, abuse, anxiety or restlessness, a solution may be to take control of food, body or exercise. The eating disorder therefore functions as a coping mechanism, a protection against the feeling of never reaching, never being good enough, skilled enough or pretty enough.
  3. Uses the body as a language for what one has no words to express: For a person with an eating disorder, the body may have become a language for creating identity and control, as well as regulating emotions, self-esteem and life problems.

 

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