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Expert Guide on Identifying Eating Disorders & Time to Take Action

By Harriet Frew

Harriet Frew, an Eating Disorder Therapist and trainer in eating disorders and body image, promotes a healthy relationship with food and your body.

Women Fitness Team got in touch with her to gain answers to questions frequently asked on eating disorders- link to BMI, identifying signs and seeking guidance. We hope they serve you well.

 Anorexia nervosa, bulimia nervosa and binge-eating disorder are the three main eating disorders. Can you highlight a generic difference between the three and its relation with BMI?

An eating disorder is a serious mental health condition which describes behaviour that focuses on an individual’s abnormal relationship with food and is usually accompanied by a strong desire to change weight and body shape. Self worth has become disproportionately valued around ability to control weight and shape and restrict food intake.

Again, binge eaters aim to eat a restrictive diet which is often unsustainable, and this is commonly followed by bingeing (eating quickly, large quantities of food in a discrete period of time, usually in secret). This behaviour usually involves a great deal of shame and anguish. Someone with binge eating disorder does not purge and can experience intense weight fluctuations.

BMI Range With Eating Disorders

How can a teenager or woman identify the early signals that they have an eating disorder?

Signs and symptoms of anorexia: –

Someone with anorexia may also develop certain behaviours and show particular attitudes to keep their eating disorder secret. Typical examples include:

People with bulimia will often try to hide their illness, but will identify with some of the following signs and symptoms: –

People with binge eating disorder will often try to hide their illness, but you may identify some of the following signs and symptoms: –

When is the right time to accept and reach out for help from a health expert to take control over disordered eating.

If symptoms are impacting daily life and wellbeing. For example: physical effects such as lack of energy or poor concentration; physical impacts of weight loss, purging or binge eating; social impacts such as isolation or avoiding social events with friends due to rigid routines and anxiety around food; emotional impacts such as low mood, high anxiety and preoccupation with food.

How far is lifestyle & stress responsible for one’s body weight?

Stress can definitely impact weight in either direction through restrictive eating or overeating. Acute stress often causes the fight/flight response with adrenaline release and may result in loss of appetite. Chronic stress tends to be more often linked to overeating/emotional eating through increased cortisol production.

Good self-care through lifestyle is likely to help people sustain a healthier weight. This can include: eating regularly and a balanced diet; getting good sleep; managing alcohol; taking exercise; having good relationships and a purpose.

As an eating disorder therapist please share your piece of advice for people suffering with eating disorders & family to help an individual overcome it. 

How significant is the role of BMI in health evaluation.

BMI definitely has its limitations when looking at individuals. For example: someone with a high muscle body composition or very tall, or larger boned may appear to have an overweight BMI, which does not reflect their overall health.

BMI can also be limiting between different cultural groups. For example: Asian people may have lower BMIs naturally for genetic reasons and having a smaller body frame.

BMI does offer a guide to understanding body size in populations and has some generic value. It definitely needs approaching with caution and to look at the individual circumstance.

BIO – Ms. Harriet Frew is an experienced counsellor specialising in eating disorders and body image. She has worked in an NHS Adult Eating Disorder Service and private practice since 2003.  Has personal experience of bulimia nervosa and have been fully recovered for many years. She’s passionate about eating disorders and enjoys writing, filming and creating information through my podcast and social media, to help and support others.

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