This week is national charity B-eat’s Eating Disorders Awareness Week. B-eat aims to challenge stereotypes and increase understanding for the 6.4% of the adult population who show signs of an eating disorder, as well as their friends and families.
When attempts to diet get out of hand, and the pattern with food impacts on other areas of life, such as friendships, relationships, health, work or study, people are often thought to have an eating disorder. Usually people with eating disorders worry a lot about the physical appearance of their bodies.
Many of those experiencing eating disorders are students. In fact, First Step (Bristol’s primary care eating disorder service) receives more referrals from the Students’ Health Service than any other surgery in the city.
First Step is a free specialist service for people with eating disorders, including anorexia and bulimia. We offer advice and Cognitive Behavioural Therapy (CBT) sessions at Hampton House.
‘Over-evaluation of weight or shape, and their control’
Eating disorders have been characterised by Christopher Fairburn as an over-evaluation of weight or shape and their control. This state of mind is maintained by behaviours such as dieting, bingeing, exercise, purgeing, body checking and avoidance. The associated consequences of these behaviours, such as weight changes, preoccupation and social withdrawal tend to further increase the degree of importance given to body image and the need to control it.
One of the early challenges for people with eating disorders who are doing CBT is to experiment with eating three balanced meals and snacks per day. As other behaviours are reduced and consequences change, body weight and shape usually begin to feel less important. Body image dissatisfaction is also directly addressed in CBT.
So, we must love our bodies…?
One of my early lessons when training as a therapist was not to expect anyone to do anything that I wouldn’t be willing to do myself. I have endeavoured to carry on this ethos throughout my practice.
Last year, on a workshop with about 200 therapists, we were asked to raise our hands if we loved our bodies. One person raised their hand. It wasn’t me. This highlighted to me the danger of thinking of body dissatisfaction as a ‘symptom’ confined only to those with a diagnosable eating disorder.
‘Over-evaluation of weight or shape and their control’ is also not about vanity or a personal failing. It is a reflection of the culture that we live in, where the media links ever changing and increasingly unrealistic ideas of beauty to our fundamental human need for connection and acceptance from others. If everyone believed that they looked fine, and would be loved regardless of appearance, the diet and fashion industry would go under and the economy would take a serious hit.
So, you weren’t designed with an inbuilt immunity to the messages around you? Try not to beat yourself up about it. Neither was I. Feeling displeased with aspects of our appearance is a pretty normal reaction to our current times. People with eating disorders have often had these messages reinforced either subtly or explicitly by events in their lives.
Think you might have an eating disorder?
You can talk with your doctor at the Students’ Health Service about your situation and about referral to First Step. Choosing to do treatment is rarely easy, but it might be one of the most important things that you ever do.