Looking after yourself

They are several types of eating disorders. The most common are:

1. Binge eating disorder — This is when a person regularly eats a large amount of food in a short time period even if they are not hungry or are already full. Because of their feelings about food, people with a binge eating disorder choose to eat alone and in secret. It can be used as a way to avoid thinking about other problems or a way to cope.
2. Bulimia nervosa (aka bulimia) — This is when a person eats large amounts of food quickly in a way that feels out of control, and then tries to ‘get rid’ of (purge) the calories they’ve consumed. This is usually by vomiting, taking laxatives, or exercising excessively. Bulimia is an unnatural and unhealthy way to control weight, or manage overwhelming feelings of anger, depression, stress or sadness.
3. Anorexia nervosa (aka anorexia) — This is when a person believes their body looks different to what it actually does, and they gave ab excessive fear of gaining weight. Often people with anorexia believe they need to loose weigh, even when they are severely underweight. This condition leads people to restrict the amount of food they eat, refuse to eat or increase their levels of exercise. The term anorexia refers to self-starvation.
4. Other specified feeding and eating disorders (OSFED) – This is when a person has some symptoms of disordered eating but not all the symptoms related to a specific eating disorder. OSFED is still serious and is the most commonly diagnosed eating disorder.

It’s estimated that around 9% of Australians have an eating disorder.[i] That’s around 2.25 million people. Eating disorders can occur at any stage of life but most commonly start in childhood and youth (between 12-25 years).[ii] Around 2.4% of young people aged 11-17 have problematic eating behaviours.[iii] Females are twice as likely as males to have an eating disorder. [iv]

[i] Australian Institute of Health and Welfare, Australia’s Health 2018, Eating disorders, https://www.aihw.gov.au/getmedia/ab86db9d-410a-4c93-89c4-99c8bdbdf125/aihw-aus-221-chapter-3-13.pdf.aspx

[ii] Orygen, Nip it in the bud: Intervening early for young people with eating disorders, https://www.orygen.org.au/Policy/Policy-Reports/Young-people-and-eating-disorders/ORYGEN-Nip-it-in-the-bud?ext=.

[iii] Australian Institute of Health and Welfare, Australia’s Health 2018, Eating disorders, https://www.aihw.gov.au/getmedia/ab86db9d-410a-4c93-89c4-99c8bdbdf125/aihw-aus-221-chapter-3-13.pdf.aspx

[iv] Royal Australian and New Zealand College of Psychiatrists, Your Health in Mind, Eating disorders, https://www.yourhealthinmind.org/mental-illnesses-disorders/eating-disorders

There is no one cause of eating disorders. While they often begin with dieting, not everyone who goes on a diet develops an eating disorder. Things that contribute to eating disorders include:

• family factors where there is a history of eating disorders or mental illness
• external factors which might include family and relationship problems, trauma, abuse, loss of a loved one, social pressure to look a certain way for a career or sport
• personality factors like low self-esteem, poor body image, or perfectionism (wanting everything to be perfect)
• biological factors like genes.

There is a lot of pressure for young people to look a certain way, in order to fit in with their peers. Young carers may feel added pressure to fit in, because their responsibility as a carer can make them feel different to other people their age.

While it’s normal to want to feel like you belong, sometimes the pressure to look a certain way is too much, so you may try to fit in by changing your eating habits to lose or gain weight. Sometimes, you may eat to soothe your feelings of anxiety or sadness, or as a way to ‘switch off’ from the pressures of everyday life.

These are all unhealthy ways of dealing with underlying issues and can lead to an eating disorder. Those who care for someone with an eating disorder or other mental health condition may also be at higher risk of developing an eating disorder themselves.

Everyone has unhealthy eating habits from time to time. It’s normal to not feel hungry at times, or to eat more food in a single sitting than you need to eat. However, key signs that can indicate an eating disorder :

Feelings:

 thinking about your appearance, food and worry about gaining weight are at the forefront of your mind

• hating your body, or feeling ashamed, sad or angry about your body
• believing your life will be better at a certain weight or if you achieve the ‘perfect body’
• being excessively afraid of gaining weight (primarily female)
• feeling you need to be leaner and more muscular (primarily male)
• wanting to lose weight, even when friends or family think you’re underweight
• letting other people around you think you’ve eaten when you haven’t
• being secretive about your eating habits
• feeling guilty, ashamed or anxious when you eat
• feeling out of control around food
• thinking about exercise a lot or over exercising
• feeling anxious if you can’t exercise.

Behaviours:

• having a fixation with , which continue even if you reach a certain weight
• having a preoccupation with body building, weight lifting or muscle toning (primarily male)
• using anabolic steroids (primarily male)
• binge eating
• making yourself vomit, using laxatives, or exercising excessively to lose weight
• avoiding social events, especially those that involve food
• wearing different styled clothes, especially baggy clothes
• constantly checking your body by weighing or measuring it.

This example might help make things clearer by putting these symptoms into perspective:

Jenny is 15 years old and cares for her mum who has depression. She often feels stressed trying to balance caring, juggling her school work and doing some of the household chores. She doesn’t talk about her mum much and most of her classmates don’t know she looks after her. Jenny does not like to share this part of her life and often feels she doesn’t fit in with her peers. At the end of each day, Jenny feels quite sad and alone. As a way to feel better, she stops by the shop on the way home from school each day and buys large amounts of junk food like chips, lollies and chocolate. Jenny takes this food home and eats it secretly in her bedroom. While she’s eating, she feels happier and relaxed. However, after she’s finished, she feels guilty and ashamed of herself.

 Even though Jenny is full after her binge, she doesn’t want her mum to know what’s going on, so she still sits down to her evening meal. Afterwards, she makes herself vomit in the toilet, as a way to get rid of the extra calories she’s eaten. She also skips breakfast each morning to make up for what she has eaten the day before. Because she doesn’t want her friends to notice there maybe something wrong, she makes sure she takes a small amount of lunch to school each day, which is usually a salad sandwich or some fruit. However, this only makes Jenny feel more distanced from her friends, especially when she sees her friends enjoying burgers or chips from the school canteen. She wishes that she could eat that food too and be part of the group, but she feels so guilty about her afternoon binges that she doesn’t allow herself to.

 In the example above, Jenny has some normal reactions to her life:

• feeling stressed about caring for her mum and juggling her other responsibilities
• not wanting to tell everyone about her mum
• feeling that she doesn’t fit in
• feeling sad and alone because her friends can’t relate to her.

However, she also has some symptoms of an eating disorder:

• buying large amounts of junk food after school each day
• eating this food in secret
• feeling calm and relaxed while eating the food
• feeling guilty and ashamed after her binges
• not wanting other people to know about her eating habits
• vomiting in the toilet
• skipping breakfast
• pretending that her eating habits are normal with her friends.

While everyone with an eating disorder may experience different symptoms, there is a lot of help available.

One of the first steps is to speak to someone, regardless of how much or little you eat, or how much you weigh. You should visit your as eating disorders are a serious mental illness. You can also talk to a teacher, support worker, counsellor, or trusted friend.  Anorexia has the highest mortality rate of any mental disorder[i] with 20% eventually dying from it, and one in five attempting suicide because of it.[ii] However, with the right treatment, most people with an eating disorder make a good recovery. Treatment may involve speaking to a mental health professional and/or being prescribed medication.

Some things that you can do to help during your recovery include:

• talking to someone about how you feel — the Check-in App allows you to do this online
• writing down your thoughts and feelings
• sharing your own story or reading stories of other young carers to know you’re not alone
• meditation and relaxation (e.g. Calm; Headspace: Guided Meditation and Mindfulness; Smiling Mind)
• doing activities that make you feel happy or fulfilled
• spending time with supportive family and friends
• avoiding people who make you feel bad about yourself, drain you, or encourage your symptoms.

[i] Australian Government Department of Health, Anorexia nervosa – The facts, https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-a-anorex-toc~mental-pubs-a-anorex-1

[ii] Garvan Institute of Medical Research, Anorexia nervosa, https://www.garvan.org.au/research/diseases/anorexia

I think something a bit stronger about involving a health professional, such as your doctor is important. Anorexia has the highest mortality of the mental disorders

There are a lot of people who can help you overcome an eating disorder.

To speak to someone, you can call:

Kids Help Line — 1800 55 1800

Headspace — 1800 650 890 There is also an online chat available.

Lifeline — 13 11 14. You can also ask for help via text message on 0477 13 11 14 or use the online chat function

You can find more information about eating disorders at:

Butterfly Foundation

ReachOut

Youth Beyond Blue

Children of Parents with a Mental Illness