The do's and don't to prevent Eating Disorder (must read)

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People described how their problems often developed gradually over a few years. Sometimes the development was slow with “on/off” periods and then something would trigger a rapid deterioration. Often people didn’t realise things were getting out of hand and the eating disorder developed “before I knew it”. David said his bulimia nervosa developed over a period of a couple years; “it wasn’t something that I really necessarily noticed; it just started to creep on”. 

“When you’ve been doing that for such a long time, it just becomes habit and routine and you lose sight of why you did it in the first place.” Steph

An eating disorder could also develop quickly, over a course of a few months. Young people we talked with often recalled specific times; holidays, school trips, arguments at school, home or with friends that had happened just before things “flipped over”. Once the eating disorder had “kicked in” in full, people described how things quickly “spiralled out of control”. Soon they realised they had become engrossed in an obsessive routine of behaviours that “took on a life of its own” and which could include:

• restricting or limiting the amount of food they ate 

• bingeing or eating excessive amounts

• purging to get rid of food they had eaten from their bodies

“Once you start doing a lot of things [restricting and exercise] it became easier and easier to fall into habits.” Chloe

Different eating disorders could have different early signs and forms. Something that started as restricting food intake could turn into bingeing and purging, and the other way around. Patterns of eating usually went hand in hand with exercise. People with anorexia nervosa often said how it had started off as just “a health kick”; eating more healthily, or starting a diet to lose a bit of weight. They saw friends or family members dieting and it seemed to be “what everybody did”. Initially people cut out or ate less of particular foods (for example high calorie foods), then they cut out foods or food groups (for example fats or carbohydrates) completely and started to skip meals. The view of what was enough/a lot of food could become distorted.

“I think I just got to a point where I kind of flipped over and then it was literally an apple is too much.” Sara

Some said they went for days without eating, or never ate at school, saving up their lunch money. 

People could develop “fear foods”; foods they became scared of and wouldn’t eat at all for fear of immediate weight gain. Weight gain was also associated with being unhappy, lazy or ‘a failure’. Food and eating were attached with deep-rooted emotions and meanings, and restricting food could become a form of punishment. (For more see ‘What is anorexia nervosa?’).

Bulimia nervosa often started off as a one-off incident of making oneself sick, as an emotional response to an argument, a feeling of having failed at something (for example in school), or after a binge. A couple of people with bulimia nervosa said that since they were little they had always been sick easily, and involuntarily. Elene had very early memories of being as young as eight and making herself sick and Sam initially believed that being sick would make him feel better in the same way as when he had a stomach bug.

Obsessions around food, weight and exercise were also common. People developed different habits such as calorie counting, obsessive weighing many times a day, obsessive exercise and recording and charting everything. Some didn’t need to write any of it down as it was all in their head. Trying to cook meals with as few calories as possible could result to trips to supermarket lasting for hours, carefully checking and comparing food labels. 

Exercise patterns would change; people started exercising more or exercising alone and/or in secret, or, alternatively, some stopped exercising completely. Exercise changed from something that was fun and enjoyable to just a method for losing weight. Roberto had been sporty all his life but after he moved to the United States to study, his motivations for exercising changed. Sport was no longer about enjoyment and wellbeing, it became a response to food; a form of self-management'

“It was a very new thing ‘cos before any of my friends ran or went to the gym like, we do sports but we did it to have fun, not to burn calories. So that was the main difference.” Roberto

People often didn’t want others to find out about their changing habits around eating and exercise and described how they became secretive. (For more see ‘Secrecy and eating disorders’).

As the eating disorder escalated, other behaviour and emotions became more intense. For example, people could feel more isolated or unhappy, or develop obsessions in other areas of life such as school work. They could experience depression and low moods, overwhelming feelings of guilt, anger and upset and want to harm or punish themselves.

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