Signs and Symptoms Below are some signs and symptoms to look out for. A young person suffering from an eating disorder may not exhibit all of these but any should be noted and raise your suspicion. Food and eating Someone with an eating disorder may: become excessively busy on purpose to avoid food, hunger and meals; may throw large amounts of food away or never fully finish a meal; may hoard or secretly hide uneaten food in bags, pockets, or under beds; may enjoy watching others eat and encourage them to do so; may cook elaborate meals but not take a mouthful themselves; may taken a sudden interest in cooking and food preparation and hover around the kitchen while another family member prepares a meal, or show a great interest in ingredients or in how a dish is cooked: steaming or boiling giving them reassurance, roasted or fried prompting trepidation; may ‘read’ packets and count and note calories or talk of calories in foods. may study recipe books and food magazines laboriously, and watch cookery television programmes; may make excuses for not eating – ‘I ate earlier’ or ‘don’t worry I’ll have something later’; may adopt dangerous and altered food habits – pile their plate high with vegetables, almost to the exclusion of protein and carbohydrates, and have a fear of fatty and indulgent foods – no cheese, butter, salad dressings or mayonnaise, and certainly no chocolate, biscuits or cake; constantly chews gum or consume vast amounts of diet drinks,coffee or green tea to distract themselves from feeling hungry. Self-perception People with eating disorders have low self-esteem. They constantly doubt themselves and at any opportunity put themselves down. They are highly self critical and always dissatisfied with their achievements. This dissatisfaction runs beyond body size and weight, shape and figure. They find it difficult to cope with themselves both physically – despising their appearance, the way they dress and look – and as a person. ‘I’m rubbish’, ‘I’m stupid’, ‘I’m such a bitch’, ‘I’m lazy’, ‘I’m such a freak’, ‘I’m useless at that,’ are common thoughts. Relationships, mood and behaviour An individual may seem distant and disinterested in others – food, meals, exercise and weight are their only interests. They may be difficult to live with – experiencing low mood, anxiety, or frequent, unpredictable fluctuations in temperament. Alternatively they may be numb – emotionless – rarely showing anger, joy, sadness, pleasure, anxiety or pain. They may be restless, continually on the go, unable to sit still and insist on rising early. An eating disorder takes precedence over everything and everyone. It is an individual’s one and only priority, a full time occupation. People with eating disorders forget hobbies, cut off their friends and social ties. They prefer isolation. About the home Important signs at home include: sinks and toilets blocked with vomit; smell of vomit. large quantities of food going missing from cupboards; empty food packets; disappearing after meals and making excuses – ‘I’m just going upstairs for something,’ ‘I’m just going to the toilet.’ Some people enjoy cleanliness and neatness, spending time dusting, hoovering, or going to great lengths to ensure tidiness. They may become distressed or agitated if someone else interferes. Their personal hygiene may of great importance: they may incessantly wash their hands or shower several times a day, particularly after meals. Changes in interests An individual will reorganise their life around weight control –After eating, they will compensate or purge by fasting, exercising or taking laxatives. Often, someone previously uncommitted to sport develops a strict, regular and fierce exercise routine. Solitary exercise is preferred – running or gym sessions as opposed to team sports. They may choose to walk everywhere, even inconceivable distances, and in all weathers, sometimes at night. They will experience extreme panic, fear and distress when the schedule is broken or if their calorie count for the day is altered. Appearance Above all, watch for overt, sometimes rapid weight loss in someone who has anorexia. Often some of the signs will have been present for a considerable period of time. Weight loss could be considered as the final sign, proof that previous suspicions were correct. Treatment and recovery Recovery from an eating disorder will never be easy, never short, and never painless. The strength and mental will power an individual needs to break free from their illness is immense. An individual cannot recover without support and guidance. Breaking free from an eating disorder may be the hardest things in life they will ever have to face. This will inevitably make a sufferer feel alone and vulnerable. Recovery is complex. Not only does an individual have to recover physically, they also have to rebuild themselves psychologically. They have to find the necessary skills and tools to cope with life and its resulting emotions without depending on their eating disorder. A regular and balanced eating pattern needs to be established and underlying emotional problems may need to be addressed. Regain of weight in anorexia, or breaking the binge-purge cycle in bulimia, are both long processes. Relapse is common but full recovery is possible. The longer an individual lives in secret with their illness, the higher the chance it will plague them for the rest of their lives and that treatment will be less successful. With time, distorted body image and low self-esteem become deep- rooted behaviours and habits become ingrained, and feelings and emotions fixed. The treatment response of adults with anorexia is much less positive than for adolescents: only about a third are in remission after one year of specialist outpatient psychological treatment and up to 50 per cent of those who remit, relapse, many within the first year after treatment. Adolescents have the greatest chance of making a full recovery from an eating disorder. Guidelines on treatment for eating disorders provided by the National Institute for Health and Clinical Excellence tell you what you can expect from the NHS. To find out more, visit www.for a downloadable leaflet about what the Guidelines say.
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