Frequently Asked Questions

Eating disorders typically fall into one of four diagnostic types: anorexia, bulimia, binge-eating, and other forms of disordered eating. All are mental illnesses that can have devastating physical, emotional, and social consequences.

• Anorexia entails a refusal to maintain normal body weight, an intense fear of gaining weight or becoming fat, a distorted sense of one's own body weight or shape, and denial as to the seriousness of being underweight. Anorexia can but does not always include binge/purge behaviour. Sufferers of anorexia are typically below 85% of the normal expected weight for someone of their age and height. For women, this extremely low weight results in the loss of their menstrual cycle.

• Bulimia entails many of the same characteristics of anorexia, including a distorted self view of one's own shape and body weight, but involves a greater sense of loss of control. Bulimia can involve recurring episodes of binge eating, and/or compensatory behaviour to prevent weight gain -- including self-induced vomiting; mis-use of laxatives, diuretics, enemas, diet pills, fasting, or excessive exercise.

• Binge eating entails recurring episodes of binge eating without the compensatory behaviours of bulimia.

• Illness diagnosed as "other disordered eating" includes some but not all of the symptoms associated with anorexia, bulimia, and binge eating. While there can be some distortion in self image, weight loss is not as significant and binge/purge or other compensatory behaviours to prevent weight gain do not occur as frequently.

Eating disorders are mental illnesses that can have serious physical, emotional, and social consequences:

Physical consequences can include:

• Dry skin
• Hair loss on scalp or increase in body hair
• Brittle nails
• Yellowish skin
• Cold intolerance
• Slow or reduced cellular growth
• Delayed sexual development
• Increased fatigue
• Dizziness or fainting
• Bloody diarrhea
• Muscle loss, weakness, or spasms
• Tooth discolouration or sensitivity
• Difficulty concentrating
• Loss of (or irregular) menstrual periods

Emotional consequences can include:

• Anxiety
• Irritability
• Sadness or depression
• Significant mood fluctuations
• Difficulty getting to or staying asleep
• Frequent crying spells
• Loss of interest in previously enjoyed activities
• Thoughts of self harm
• Strong feelings of guilt and shame
• Obsessive thinking about body image
• Eating to fill an emotional void
• Irrational fears
• Ambivalence about change
• Social consequences can include:
• Withdrawal from friends and family

Social consequences can include:

• Withdrawal from friends and family
• Anxiety in social situations
• Vulnerable to peer pressure
• Feeling overwhelmed by the demands of daily life
• Choosing to isolate oneself

No one thing causes an eating disorder. Rather, there are contributing factors -- societal factors, peer pressure, family influences, and individual factors -- which can combine to cause an eating disorder.

Societal factors can include:

• Unrealistic gender roles and expectations
• Cultural preoccupation with body image and perfection
• Fashion, media, and diet industry messaging promoting thinness as ideal
• Prejudicial judgments against weight gain and obesity

Peer pressure can include:

• Peer-group weight concerns
• Pressure to be thin or "buff"
• Teasing, bullying, or social isolation
• Pressures to control weight during extra-curricular activities (e.g. ballet, gymnastics, athletics)
• Loss of friends and familiar circumstances due to move or change of school

Family influences can include:

• A history of mental illness (e.g. depression, addiction, obsessive-compulsive disorder, etc.)
• Unpleasant mealtime experiences
• Family attitudes toward eating and weight
• Difficulty communicating or resolving conflict
• Parental over-protectiveness
• High parental expectations (perceived or real)
• Neglect or abuse

Individual factors can include:

• Drive for perfection
• High levels of self control
• Low self esteem
• Poor body image
• Fear of maturation
• Identity concerns
• Childhood obesity
• Difficulty functioning independently

Eating disorders can affect anyone - regardless of age, gender, race, income level, religious affiliation, or sexual preference. More women than men are affected, although the incidence among men is increasing. Children and youth are particularly vulnerable.

There are many possible warning signs. Some -- such as overly self-critical comments, obsessive mirror-checking, excessive exercise, and frequent "do I look okay" remarks -- are actually quite common among people who don't have an eating disorder. Others are more telling:

• Signs of binging eating or hoarding food
• Evidence of laxative or diuretic use
• Preoccupations with muscle tone and fitness
• Use of steroids or overuse of health supplements
• Excessive weight loss and/or large weight fluctuations
• Leaving the table immediately after meals
• Excessive efforts to cover up one's body
• Creating a complex life style, schedule, or rituals to avoid eating, or to make time for binge/purge episodes
• Obsessive exercising
• Indications that weight loss, dieting, and control of food and eating are primary concerns

Be gentle with yourself. You haven't done anything wrong; you are not to blame. When you're ready, take the first step away from your eating disorder:

• Talk to someone you trust. Be as clear and as honest as you can about what is going on with you. Ask them to help.
• See your doctor. Ask for their help in referring you for the treatment that is appropriate for you.
• Don't lose heart. There are people who do care and will help you.

We at the Looking Glass Foundation are among them. Call or email us.

Family members, friends, and people who know or work with someone at risk for or already suffering from an eating disorder can help. There are caring, respectful, and meaningful ways to intervene and support those who are struggling with an eating disorder.

Intervening doesn't mean "fixing" the problem. It does mean indicating to someone the true strength of your relationship; that you can be a person they rely on for honesty, support, and encouragement. And it can make all the difference in the world.

The important thing is to initiate a conversation. It can be as simple as picking an appropriate time to say: "Come sit with me and have a cup of tea."

• Express your concerns. Be prepared to "speak the unspoken" - the truth that you might both know, but neither of you want to say out loud
• Encourage dialogue so you can both explore these concerns. Try not to tip-toe around the issue in fear of setting them off. Your discomfort or hesitation can be construed as a reason for the other person to withdraw, and that won't help either of you.
• Avoid placing shame, blame, or guilt. It isn't anyone's place to judge another person, nor is it helpful. Passing judgement, evenly subtly, will push someone away rather than draw them near
• Avoid asking for explanations. This isn't something you need to completely understand, nor is the other person accountable to you for answers.
• Avoid giving simple solutions. However well meaning, attempts to gloss over or put a positive spin on the situation isn't actually helpful and can actually feel dismissive or diminishing to the other person.
• Express your continued support. This is the most valuable thing you can offer - and deliver on.

There are a variety of treatment options available for people with eating disorders, including:

• Individual, group, and family therapy
• Psychiatric counselling
• Peer and group support
• Nutritional guidance
• Meal planning and support
• Expressive and recreational therapy
• Pharmacology

Usually, recovery comes from experiencing several of these kinds of support - often over time, and always with the genuinely caring support of other people.