Our relationship with food can be a complex one. Food should be enjoyed in moderation and be a normal, routine part of our day. Sometimes, when we don’t feel great about the way we look, we starve ourselves. We think that being ‘thinner’ will mean that we will be happier, more accepted and more desired. The feeling of control that the restriction gives us, makes us feel as if we have some form of control over our chaotic, unhappy lives. Food and self-loathing starts to take over our lives and we lose all concept of what is healthy, appropriate, moderate eating. Sometimes, when we feel that we can no longer starve ourselves, we impulsively binge which may or may not be followed by purging or excessive exercise
Symptoms will vary, depending on the type of eating disorder. Anorexia, bulimia and binge-eating are the most common eating disorders.
Eating disorders are complex illnesses and require a multidisciplinary team approach. The first step is to take a history and examination to establish whether there are any medical concerns associated with low weight, nutritional deficiencies and repeated vomiting. If weight is dangerously low or there are any life-threatening conditions, an admission to a medical facility may be warranted. The multidisciplinary team involves a dietitian, psychologist and myself, working closely with each other. The dietitian will take a full food history and suggest a more balanced eating plan, the psychologist will explore stressors, poor self-image, control issues and any associated relational difficulties. I will oversee the whole process, decide what investigations are appropriate, prescribe medication such as certain anti-depressants that help with obsessional thinking and treat co-morbid anxiety and low mood. In addition to working with the client, the family are also involved and supported throughout this process.