What is an Eating Disorder?
An eating disorder is defined as shape and weight-control behaviours that are harmful to physical
and emotional health.
The most commonly diagnosed are anorexia nervosa, bulimia nervosa, binge eating and obesity.
Some eating disorders have been identified and named, such as anorexia nervosa and binge eating,
others are still to be officially recognised and are currently referred to as Eating Disorders Not
Otherwise Specified (EDNOS).
Binge eating disorder is probably one of the least understood of the eating disorders. It’s a challenge
to separate binge eating from over-eating, but they are not the same thing. A binge can be identified
by certain characteristics, a binge eater will eat a larger than “normal” amount of food in a short
period, usually 2 hours or less and during a binge they will feel completely out of control. A binge
can also be characterised by eating very quickly and feelings of guilt and shame. Such feelings often
result in binge eaters hiding food and eating alone and in secret. A binge will continue until the
person feels uncomfortably full, even sick, however binge eaters do not usually follow up with
vomiting or laxative abuse, those who do would usually attract the diagnosis of bulimia nervosa.
Although not all binge eaters have an eating disorder of “clinical significance” many people feel that
their eating is out of control, they may be comfort eating or constantly nibbling and picking at food.
When the food is in control life can be miserable.
Anorexia is specifically associated with feelings and behaviours related to the fear of “fatness”, these
feelings include poor body image, phobic feelings about food and an intense fear of gaining weight.
The condition usually starts in adolescence, it is not exclusive to girls, boys can also suffer.
Weight loss is attained by dieting or avoiding foods believed to be ‘fattening’ and sometimes
accompanied by excessive exercise. Low weight is regarded by most anorexics as a positive
achievement, a sign that they are in control, as a result sufferers usually deny that there is a problem
despite physical symptoms that indicate the contrary to be true.
Anorexia affects the whole body, memory becomes poor, there is a lack of concentration, hair
becomes thin and brittle and skin condition is poor. Additionally, those with anorexia may experience
low blood pressure, anaemia, constipation and bloating.
It is unusual for anorexics themselves to seek help, help is usually sought by concerned family
members or friends.
Bulimia is characterised by recurrent periods of binge eating followed by compensatory behaviour
such as vomiting, taking laxatives or diuretics to avoid weight gain although this behaviour is often
The binges of a bulimic are usually of ‘forbidden’ food, food that they believe to be fattening such as
biscuits, ice-cream, chocolate, chips and cakes. Binges are usually in private, the food being eaten
quickly and without any sense of particular enjoyment or sensation of taste. Binges involve feelings
of anxiety, guilt and remorse and a bulimic then makes efforts to rid the body of the calories by
making themselves sick and/or by taking large amounts of laxatives or diuretics. This behaviour may
also be accompanied by excessive exercise or periods of starvation.
Overweight and Obesity
Being overweight or obese may be due to an eating disorder but it may not, it is often difficult to
diagnose but whether or not someone has an eating disorder it is possible to treat the problem and
help them back to a healthier weight.
In adults ‘Body Mass Index’ (BMI) is often used as an indicator of overweight and obesity,
‘overweight’ being defined as a BMI of 25 or above and ‘obese’ as a BMI of 30 or above but no
diagnosis should be made using BMI alone as it can lead to inaccurate results.
Diets are not the answer, as most overweight and obese people will testify – DIETS DON’T WORK!
For people who are overweight treatment must be tailored to individual need and circumstance.
Everyone is different and there is no ‘one-size-fits-all’ approach to weight loss.
It is important to change a person’s relationship with food and to help them to develop new eating
habits and patterns, it is also beneficial to explore the causes of the over-eating and to try to identify
if there is a particular cause or history behind it.
Nutritional advice, counselling and on-going support are usually necessary over a sustained period if
the problem is to be tackled successfully. There are no quick fixes for overweight problems but once
a new relationship with food has been established weight loss can follow.
All clients are offered an initial assessment session to discuss their needs and expectations and for us
to decide together on the most effective course of action. Prior to an assessment I will ask a client to
keep a diet diary for a week and to have prepared a ‘life-line’ where I feel it will be helpful.
Assessment sessions are in person and are about 1 ½ hours long, subsequent sessions are usually
weekly and are of 50 minutes duration.
Following most sessions I provide my clients with a brief report detailing any suggestions that I have
made regarding changes to life-style, eating or behaviour, it includes a section for the client to make
notes during the week on how effective the changes are being or about problems encountered along
the way, these can then be discussed at our next meeting.
As well as a comfortable consulting room in North Dorset, I also offer online counselling using e-mail.
An initial assessment (approx. 1 ½ hours) costs £55