First Steps out of Eating Disorders

Kate Middleton, Jane Smith

• Publisher: Lion Books
• Year: 2011
• ISBN:
  9780745959887
• Edition: 1
• Topic: Personal Development
• Subtopic: Self Improvement

First Steps is a new series of short, affordable self-help on a range of key topics. In First Steps out of Eating Disorders, Kate Middleton and Jane Smith draw on their extensive experiences as psychologists working with eating disorders. They explain what constitutes an eating disorder, common issues those with eating disorders face, and what to do about getting better. The book is written primarily for sufferers but with carers in mind, so it should be useful for both alike. Other titles in the First Steps series include: Anxiety, Bereavement, Depression, Gambling and Problem Drinking.

1

About “eating disorders”

Before we look at how to work your way out of an eating disorder, we need to look at how the eating disorder developed in the first place. Think of an eating disorder as a bit like setting out on a road trip – and ending up somewhere you never wanted to be. It’s difficult to work out how to get home without first understanding where you are now and how you got there.

So let’s start by making sure that we actually understand that basic term “eating disorder”. Definitions vary, but most specialists would agree that an eating disorder occurs when disordered eating patterns – whatever they are – start to have a serious impact on a person’s emotional and/or physical health.

Emotional impact…

What we mean by this is that your eating and any issues to do with it really bother you. An eating disorder has a big impact on how you are feeling day to day. Sufferers describe how simple things like the weight shown on the scales in the morning when they get up can have the power to destroy their day.

What people say…

The anticipation is there from the moment I wake up. I always weigh myself first thing, after I have got up and gone to the loo. Walking over to the scales I feel really nervous. I know that whatever happens next will define my day – whether I will feel good about myself, happy and confident, or be demoralized, depressed and find it hard to even get dressed and face work. I know my eating will be affected, whether it’s that I set myself strict rules for the rest of the day and try to eat very little, or that I lose control and overeat. I know my relationships will be affected because my husband hates it when I get obsessed by my weight. And most of all I know, deep down, that my life is being ruined by this because every day has the potential to be ruined just by the numbers on that machine when I stand on it.

Emma

Physical impact…

Whether it is under-eating or overeating, the chaotic patterns which eating disorders trigger are damaging to your health. There is no debating this. Some health effects are short term, others are long term, but the uncomfortable truth is that eating disorders can and do take people’s lives.

What people say…

When she died we were utterly stunned. We knew that she had been having problems. A bit of overeating, a bit of under-eating – we thought it was just a phase. But it turns out it was much more. I wish there was some way we could go back in time and help her before it was too late. Because we’re not even sure that she realized just how serious things were.

A parent

Mythbuster

Only women get eating disorders.

No! It’s very important that we set the record straight on this one immediately. Although most experts agree that eating disorders are more common in women, there is also a clear trend for more and more men and boys to be struggling. Eating disorders can affect anyone – the young and the old, boys and girls, men and women.

 

There are three main eating disorders – defined in the next chapter – but it is important to remember that not everyone will receive a clear-cut diagnosis of one of these. Many people struggle with their eating, but never develop a problem serious enough to be diagnosed as a clinical eating disorder. Others have serious problems which affect their life and health, but may not fit into a clear category for one of the eating disorders or may swing between different eating disorders. Perhaps the largest numbers of sufferers, however, are those who never seek help. Shame, guilt or fear about what they are experiencing means that they never get diagnosed and instead suffer in silence. If this is you then take heart – you are not alone. Your eating problems do not mean that there is something wrong with you. They are simply a sign that you have become caught up in a vicious cycle which can be very hard to break out of.

The good news – recovery is possible!

The good news – and in fact the most important thing to remember from this chapter is – that it is possible to recover from all of these eating disorders! Eating disorders can bring with them overwhelming feelings of despair and hopelessness. Often people have tried to break out of them, but because they tend to repeat the same patterns again and again, they set themselves up to fail. Good support and specialist treatment can be hard to find, but really can transform people’s lives. We’ll talk much more about recovery and what it really is in Chapter 5.

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Over to you

Throughout this book you will see there are opportunities for you to apply what has been said to your own situation. If you are struggling with an eating problem yourself, you may find it helpful to get a notebook or diary where you can write your responses to these sections, and work through the exercises suggested. For those who are concerned about someone else, don’t just skip these sections. You should find them interesting, and also useful in helping you understand why your friend or loved one is struggling. You may also be able to work through these sections with them at a later date.

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I think I might have an eating disorder…

If you yourself are struggling with what may or may not be an eating disorder, it can be very hard to admit to yourself just how bad things are. Realizing that the cycles you are caught in are actually not helping you, but making things worse, is very scary. Most people develop an eating disorder because they are desperately trying to hold things together, not to let people down, to keep going. To admit that this has gone badly wrong is not easy. So if this is you, well done for even reading this book. It will have taken a lot of courage, and we want you to know that we understand that. Try to give yourself time to read the whole book and think through what’s inside. But do realize that this book is a starting point, not the whole solution. It will give you some of the tools you need to get started on working towards recovery, but you will need good support from family and friends who care for you, and often from professionals too. Don’t try to do this on your own – you will need some help. You deserve to live life to the full – not restricted by the prison of an eating disorder.

I am really worried about someone else

Trying to support someone else as they work towards recovery from an eating disorder can be really hard. Chapter 7 in particular looks at the many challenges of caring for someone else, and at what you can do to really make a difference and help someone break out of their eating disorder. As for the rest of the book, you may find that some sections are written from a sufferer’s perspective. Do read these sections – they will help you to discover the kind of thinking processes that your loved one is experiencing and you can help them to understand these and work towards recovery. You might be able to use some of the exercises, questions or sections with the person you are caring for. Do also check out the suggestions for getting more support. Many carers say that it is not they who need support but the sufferer. But the more support you get, and the more you understand, the more expert your support will be – and that is good for everyone.

Mythbuster

You have to be skinny to have an eating disorder.

This is a really important misconception. Many people, including some sufferers, get caught in the mistaken belief that to be taken seriously, or to be diagnosed and given help, they have to be skinny. You can be suffering with an eating disorder at any weight, and even when weight loss does occur it may not be obvious.

2

The road to an eating disorder

Whether you are reading this book for yourself, or for someone else, the chances are that you are experiencing behaviour around food which seems pretty illogical. At the same time, even if you are not a sufferer, most people admit that eating disorders may feel uncomfortably familiar. Anyone who has ever felt bad about a bit of weight gain, gone on a diet or overeaten after a loss of control or willpower understands some of the feelings involved. But for those caught up in an eating disorder it has become something altogether more powerful and more difficult to escape from.

There are hundreds of theories about why and how people develop eating disorders. Here is an “in a nutshell” summary of the road to an eating disorder. Remember everyone is different – but the chances are you will recognize some of these stages:

Stage 1: Chasing the illusion – if only I were thinner…

An eating disorder begins when someone who is struggling with other things in their life starts to look to controlling their weight in order to try to sort things out. Our society constantly feeds us the message that being thin equals being successful. For some people – when life has dealt them some serious blows or when they find it hard to like anything about themselves or their circumstances – the lure of this apparent “cure-all” solution is irresistible.

“If only I were thinner,” they think, “things would be different and I would feel better.” For some people this isn’t a conscious decision, but more a sense of becoming overwhelmed with an inner “need” to lose weight, perhaps seeing fat as evidence of “bad” in them and something they need to change by losing weight. Still others may have lost weight as a result of something else – illness or other emotional problems – and suddenly find that they have developed a fear of gaining weight – and the desire to lose more.

And this is the lie that is at the root of most eating disorders. Whatever the tough stuff in their life that people are trying to escape or change, they fix on their eating and weight because it offers something that they can or should be able to change – and which they believe will make them happier. Their weight becomes the scapegoat – in their mind it is the cause of all that is wrong with their life.

Stage 2: Setting limits

The next step in developing an eating disorder is to resolve to restrict their eating. They set limits or restrictions on what they do and do not eat, following diet plans or making a list of “bad” foods to be avoided at all costs. Some aim to eat as little as possible, counting calories or fat grams or perhaps going on a “detox”. Strict rules are set – and they have every intention of following them precisely – because this is what they have pinned their hopes on to make everything better.

Stage 3: Success or failure?

Some people find – perhaps due to some features of their personality or more practical things such as whether they can avoid eating family meals or food planned and cooked by someone else – that they are successful at controlling what they eat. They lose weight, perhaps quite fast. This immediate feedback is powerful. It shows that they are getting somewhere, and it motivates them to keep going. But in spite of this success, they still feel just as bad. So they persist with their plan – perhaps even stepping up the control and taking more things out of their diet. Some may have moments when they do eat – or even when they lose control and overeat – but overall they keep up the strict dieting. Weight loss continues, and their resolve never drops.

This is the slippery slide into anorexia nervosa. Here the drive to keep on losing weight becomes so powerful that even the bodily warning signs are ignored, signs that the body is struggling to exist at such a low weight. Anorexia causes someone to be single-minded and utterly determined. Sufferers often become so convinced that losing weight is the solution that they feel they are fat even when the reality is that they are dangerously thin. They may resort to over-exercise and may make themselves sick as well in order to lose as much weight as possible, and as a result may become at risk of serious physical problems.

A second group of people try just as hard, but cannot sustain their restrictive eating patt...

Table of contents

• Cover
• Dedication
• Title Page
• Copyright
• Contents
• Introduction
• 1 About “eating disorders”
• 2 The road to an eating disorder
• 3 Eating disorders – the dark side
• 4 Why do people develop eating disorders?
• 5 All about recovery – where do you want to get to?
• 6 Finding help
• 7 The role of other people in recovery
• 8 Getting back in control
• 9 What about purging?
• 10 Recovery – so much can change…
• For the family
• Useful resources
• Also currently available in the “First Steps” series