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What are Eating Disorders?

Eating Disorders are regarded as the most typical female disorder at the end of the 20th and the beginning of the 21st century. Hysteria - the typical female disorder of the ending 19th century and base for the development of the psychoanalysis by Sigmund Freud - has now given way to Eating Disorders.

"Eating Disorders" is actually the wrong term: Eating is not disturbed in its inseparable unit of biological and social function, but eating-behaviour in the form of weight-loss and compensatory behaviours provide a mechanism for dealing with upsetting or traumatic situations in the past.
Eating Disorders are mental disturbances caused by a disturbed self-esteem, a low self-confidence and a disturbed identity. Due to problems in controlling their social relations, the only "object" which is always available, the body (the weight / the figure), becomes main focus.

Eating Disorders must always be considered with social factors. Eating Disorders occur predominately under relative material and nutritional affluence. Therefore Eating Disorders are found in industrial countries (Europe, Northern America, Australia), in all classes of society. The world wide main problem still is hunger and not Eating Disorders or Obesity.

Eating Disorders are a growing health problem for girls and women. In Austria 200.000 women will probably develop an Eating Disorder illness during their life time. Referring to the Austrian population you may take any sample among all 15-20 year old girls, you'll find at least 2.500 girls suffering from Anorexia and over 5.000 girls suffering from a subclinical Eating Disorder ( = a light progressive form). Among 20-30 year old women are at least 6.500 women suffering from Bulimia.

The main reasons for the rising frequency are the diet behaviour caused by the social thinness obsession, the women's social role and the contradictory role expectations on women. Genetic factors are not proved yet, as Genetics can not change within a few decades! Eating Disorders are not a trendy illness! Anorexia nervosa has the highest premature fatality rate of any mental illness (15-20% die after 20 years)!

The mass media use a curious mixture of glamorisation and stigmatisation regarding the presentation of Eating Disorders. On the one hand Eating Disorders are glamorised and satisfy the reader's needs for sensation; on the other hand Eating Disorders are stigmatised like other mental but also physical illnesses and if considered as a mental illness you'll more and more find the prejudice "It's your own fault".

The continuum of Eating Disorders in the population

Concerning Eating Disorders there isn't a Chinese Wall between healthiness and sickness. The population show a continuum reaching from normal eating behaviour to disturbed eating behaviour and Eating Disorders.

1. Normal eating
2. Restraint eating / restraint eating behaviour ("diet")
3. Partial syndrome Eating Disorders (not otherwise specified (NOS))
4. Eating Disorders (Anorexia & Bulimia)

The definition of "normal" is often most difficult. Normal eating or normal eating behaviour (means to eat what you want to eat) includes acquired traditions, individual preferences and social rules. RESTRAINT EATING means a (cognitively = imaginary and affectively = emotionally) restraint eating behaviour and can be used as a synonym for "dieting". "Dieting" means not to eat what you want (for whatever reasons...). The triggers can either be an acute or a chronic disease (e.g. diabetes) or a fixation on a so-called overweight or cosmetic reason. Fortunately most weight & figure oriented diets are maintained only for a few days or weeks.

Experts in Eating Disorders recommend the diagnostic criteria of the "Diagnostic and Statistical Manual of Mental Diseases" of the American Psychiatric Union:
Anorexia, Bulimia and Eating Disorders not otherwise specified (NOS) like Binge Eating Disorder.
[see pdf-file]

Men and Eating Disorders

Not only girls and women are affected by Eating Disorders but the often reported rising frequency concerning men is not scientifically proved. Treatment centres for Eating Disorders report that at most one of 10-30 sufferers in therapy is male. Especially men who must accent their thinness, weight and exterior or their physical appearance for professional reasons, like dancers, wrestlers, long-distance runners, ski-jumpers, top athletes etc. more often tend to the onset of an eating disorder. Men living in a subculture accenting slimness, weight, and physical appearance may rather be predisposed for an Eating Disorder.

As regards the disease and its symptoms, male sufferers from Eating Disorders are very similar to female sufferers. Both, men and women have similar problems to look for conselling and to accept help from other people. However, men additionally are afflicted with the stigma having a so called "typical women's disease".

Therapists treating male patients should know the common ground and the differences between male and female sufferers. It's important to remember that both - men and women - profit from a holistic treatment considering all sides of a human being.