"It's a phase... just something teenage girls get, and they will grow out of it..."
"Its a lifestyle choice, not an illness..."
Really? I'll hold my hands up and say I have heard or, in the past used, phrases like these when the topic of eating disorders came up. Before I knew any better that is...
And while it is true that teenage girls between 15 and 19 years old are at greatest risk of developing eating disorders, it is also true that they can affect anyone regardless of age, gender, race or any other protected characteristic you care to suggest.
Like all mental health issues, if you're human, it could happen to you. The reality is that eating disorders are about far more than the superficial; "just liking what you see in the mirror", and we now understand that they are very serious, life threatening, mental health issues.
Eating disorders claim more lives than any other mental illness.
1 in 5 of the most seriously affected will die prematurely from the physical damage done or suicide.
There are different kinds of eating disorder, and the connection between the mind and the body is especially evident.
I have kept this brief article to the three most common. Bulimia, Binge Eating and Anorexia.
Bulimia is eating and then "purging", or getting rid of the food in any number of ways. Typically a person may force themselves to be sick, take laxatives or exercise excessively. Yep...that's right...exercise excessively.
People may not think they are doing any harm, but they are wrong. The act of purging brings stomach acids up into the throat and mouth, causing damage as it goes, to the throat and teeth. It can also cause a weak heartbeat as a result of dehydration and potentially even heart failure.
Binge Eating is exactly what it sounds like- and there is no purging activity. All the obvious problems here like high cholesterol, blood pressure, the risk of heart disease and type II diabetes. Oh, and fatigue, joint pain and sleep apnea.
Anorexia is starving yourself. As the body struggles to keep vital functions going, it starts to break down muscles as a source of energy. This leads to obvious muscle weakness, and an abnormally low heart rate, blood pressure and fainting. The heart is a muscle after all. It can also bring on osteoporosis, making bones brittle and easy to break.
Of the estimated 725, 000 people affected by eating disorders in the UK, 49% will be affected by Bulimia and 49% Binge Eating. Cases of anorexia are actually rare in comparison, an estimated 6,819 or around 1%.
72% of people with an eating disorder will self harm in other ways
15-19yr old females are at most risk of developing eating disorders
Anorexia is the rarest but arguably most life threatening of the conditions, and it's not always brought on by a desire to be the next supermodel cover star, or even ignorance of the condition.
Consider for example, the desperately sad case of Laura Charles, a nurse who specialised in the treatment of eating disorders and who battled anorexia herself, until she tragically lost her life, aged just 29. After a suffering a burst gastric ulcer in 2013, medical professionals advised her to cut out certain foods. That's when her problems began.
Anorexia took hold of her and she would use her knowledge of the system to avoid treatment, like arranging appointments with medical professionals in public places to prevent more thorough examinations. Her weight fell from a healthy 10st, to just 5st 6 (36 kg's) when she was found dead in her home in March 2016. Laura wasn't a teenage girl trying to look like a catwalk model.
Her story also highlights a key factor in why the identification and treatment of eating disorders can be so difficult.
Laura didn't believe there was anything wrong with her.
Eating disorders are often a way of dealing with some deeper emotional or anxiety related issue. As with self harm, it is if you like, an attempt to cope with those underlying pressures. And these "coping strategies" can actually affect brain chemistry, making the pattern even more difficult to break free of.
The obvious parallel is to OCD (Obsessive Compulsive Disorder). The obsession in this case being body image, and the compulsive behaviour being focused on all things food related.
Like most mental health issues, there is no single cause. It's different for everyone and very often the eating disorder will be one of several mental health issues a person may be struggling with, such as anxiety, depression, OCD, personality disorder and substance misuse.
So "Snap out of it and get a good meal inside you" will probably not be such helpful advice.
We do however know that certain thought patterns, experiences and personality types may present a higher risk of developing eating disorders. Obvious risk factors include being subjected to bullying or criticism about weight or having grown up in environments of high expectations and excessive pressure.
But what about the not so obvious...
When we describe someone as a perfectionist it is usually meant as a compliment. But this character trait can actually be a weakness- especially when it comes to mental health. If you have a need to be in control, or a tendency to view the world in black and white you may be at higher risk.
Recognising the early signs and getting treatment to prevent things taking a firm hold is essential. This is made all the more difficult by a general lack of understanding among medical professionals.
These conditions can be treated, and people can and do recover with the right support and treatment.
Kat Manzullo for example, barely survived on just one protein shake a day (300 calories) and weighed just 6 stone. Her insurance company stopped paying for treatment saying her that her condition was down to "lifestyle choice" and she was so malnourished that nurses mistook her for a cancer or AIDS patient.
But she recovered. and is now helping those in the position she was.
This week is Eating Disorders Awareness Week and the key message that I want to get across is that you are NOT alone and there is help out there!
If you, or someone you know is struggling with an eating disorder, or you would just like more information, check out these websites:
Terry is Director and Head of Training at Oakwood. He helps clients promote a proactive, rather than reactive approach to both personal safety and the positive mental health of their staff. He has over 12 years teaching experience in these areas, and advises organisations in the development of appropriate risk assessment and policy.