Frequently Asked Questions about Eating Disorders
Can eating disorders be prevented?Can people get better from eating disorders?
What is BMI?
Can eating disorders be prevented?
The simple answer is, no, given the inevitable occurrence of vulnerability factors and triggers for all eating disorders in our culture. But sensible prevention measures include:
- raising children and adolescents in environments that promote healthy acceptance of normal body image and a non-dieting approach to healthy eating
- teaching young people to question and reject images of unrealistically thin people such as those used in advertising , television and cinema
- teaching young people to question the "healthy" message used to market "diet" foods (such as non-fat or artificially sweetened foods, diet brands and so on)
- helping children and young people to value positively adaptive personality traits and talents in themselves and others rather than appearance or weight
- encouraging young people to get involved in non-competitive socially engaging activities and community citizenship
Can people get better from eating disorders?
The simple answer is, yes, recovery is possible and about half of all people who get treatment eventually become fully free of eating disorder symptoms. Those who recover generally regain full physical and emotional functioning. About a third of those who receive treatment improve overall but may continue to experience some symptoms or will have periodic lapses into eating disordered behaviour. About a fifth of those who receive treatment will unfortunately get worse or develop a chronic eating disorder. A small proportion, primarily those with anorexia, will eventually die of complications from starvation, purging or suicide.
There is sparse research on what happens to people who don't get treatment. Due to inadequate treatment provision in the UK, plus the tendency for some individuals with eating disorders to avoid treatment, a larger proportion of those with eating disorders never access treatment that those who do. There is a suggestion that some people who don't receive treatment improve by themselves or with the help of their families, but there is an "invisible" population of people with eating disorders that little is known about, but who inevitably suffer debilitating effects on their health and social functioning.
Research does show us that specialist care teams tend to be more effective in treating eating disorders than generalist care teams. However, no particular method or theory of treatment appears to be superior. The three main factors influencing positive outcomes in eating disorders treatment are:
1) the eating disorder is detected within a year or two of onset and good quality, timely treatment is accessed.
2) the person with eating disorder possesses motivation to recover.
3) the person with eating disorder belongs to a supportive familial or social network.
What is BMI?
Body Mass Index is a simple way for health professionals to measure a person's weight in proportion to their height. The formula is: (weight in kilograms) divided by (height in meters squared), or kg/m2. These days electronic BMI calculators are often built into bathroom scales, and handy online BMI calculators are easy to find with Google
Normal weight is considered to fall with the range of BMI 19 - 25. Underweight individuals are likely to experience increasing symptoms of anorexia the further their BMI falls beneath 19. If weight falls below BMI 17.5 a formal diagnosis of anorexia may be made although people can suffer all the symptoms of anorexia at higher weights depending on their weight when weight loss commenced.
BMI must not be the sole criterion for making clinical decisions on the intensity of treatment required. A thorough assessment of all features of the eating disorder and related symptoms must be conducted, covering medical, dietetic, psychiatric and social circumstances. One person may maintain a very low BMI while remaining medically and psychiatrically stable. Other person may have a less alarming BMI but be losing weight rapidly, or have chaotic patterns of binge eating and purging, or suffer medical consequences of starvation or purging, or have a concurrent psychiatric illness such as depression, anxiety, OCD or post traumatic stress which puts them at risk.