This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com
Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au
Eating disorders and body image disorders are serious mental illnesses in which eating, weight or dissatisfaction with one’s appearance becomes an unhealthy preoccupation in a person’s life. Adolescence is the peak period for onset of these disorders and they lead to significant interference with day to day life.
Eating and body image disorders can occur when the expectations of how a young person wants their body to look doesn’t match up to reality. Negative thoughts about body image and self-worth can lead to changes in eating and exercise behaviours or compulsive behaviours, which at their worst can be life threatening. Both males and females can become excessively concerned with body image, size, weight, fitness, shape and perceived defects, and as a result of this preoccupation, change their behaviour in unhealthy ways.
Types of eating and body image disorders
Anorexia Nervosa is characterised by the restriction of energy intake (reluctance or refusal to eat) leading to significantly low body weight, intense fears and thoughts about body size (worry about becoming fat), and distorted perceptions of body weight (denial that weight is too low).
Bulimia Nervosa is characterised by recurrent episodes of binge eating (overeating with a sense of no control) followed by compensatory behaviour, like self-induced vomiting (purging), misuse of laxatives, fasting or excessive exercise.
Binge Eating Disorder
Binge Eating Disorder is characterised by recurrent and rapid episodes of binge eating (overeating when not physically hungry combined with a sense of no control over what or how much is eaten). The type of food eaten can vary, but often eating occurs alone and is followed by feelings of shame, depression and guilt. The young person usually eats food quickly until they become uncomfortably full, and then will become emotionally distressed, embarrassed and fatigued.
Other Specified Feeding or Eating Disorder
An Other Specified Feeding and Eating Disorder is characterised by many of the symptoms of another eating disorder – such as Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder – but the full criteria for diagnosis of one of those disorders isn’t quite met. This category includes Atypical Anorexia Nervosa, where weight is within or above the normal range, and Purging Disorder, which is engaging in a recurrent behaviour to influence weight or shape in the absence of binge eating.
Body Dysmorphic Disorder
Body Dysmorphic Disorder is characterised by a preoccupation (obsession) with a perceived defect in a person’s appearance. This causes significant distress or disruption in social, school or occupational life. If a slight defect is present, which others hardly notice, then the concern is regarded as markedly excessive. These obsessions are hard to resist or control and make it difficult to focus on anything but the imperfections. This can lead to low self-esteem, avoidance of social situations, and problems at work or school. Often some type of compulsive or repetitive behaviour is performed to try to hide or improve the flaws, although these behaviours usually give only temporary relief.
Young people with an eating or body image disorder may also experience other mental health difficulties, including depression, anxiety or substance use. A young person with an eating or body image disorder may go to great lengths to hide, disguise or deny their behaviour, or do not recognise that there is anything wrong. This can result in a delay in getting treatment, which means that long-term health, mental health and relationship problems are more likely. Getting the right support for what’s going on now can assist with recovery and planning for getting on with education, work and relationships.
Medical teams should be involved in the treatment of eating and body image disorders because all these disorders can lead to serious physical health issues, psychological distress and emotional and relationship problems. Starvation, repeated cycles of binge-eating and purging or fasting can lead to major metabolic and other chemical changes in the body as well as damage to vital organs. If a young person has extreme weight loss, as is the case with Anorexia Nervosa, they may need to be kept safe while they restore their weight.
It’s in these cases that assessment and treatment should use a medical or a specialised team approach.
A young person with an eating or body image disorder may go to great lengths to hide, disguise or deny their behaviour, or do not recognise that there is anything wrong
Advice and referral
Talk about your concerns and difficulties. You might choose to talk with someone you trust, such as a school counsellor, family friend, a parent, teacher or other support. Your GP can help to sort out what is and isn’t an eating or body image disorder and help with a plan for getting better.
If someone you know has an eating or body image disorder, let them know you’re there to support them and, if needed, encourage them to get professional support.
There are effective treatments to help young people who experience eating and body image disorders. The type of treatment will depend on the type of disorder. One of the most commonly used treatments is cognitive behaviour therapy (CBT). CBT explores thinking patterns and how they affect our behaviour and emotions. There are other psychological treatments for eating and body image disorders, including family approaches for when adolescents or young people are experiencing an eating disorder. In certain instances medication may also be helpful. If a young person does need medical treatment, there are health professionals and treatment programs that specialise in eating disorders.
If someone you know has an eating or body image disorder, let them know you’re there to support them
Ask family and friends to support you to eat in a healthy and balanced way
If you or someone you know experience symptoms of an eating or body image disorder, you can use these tips to start seeking help.
- Talking to someone you trust helps. Tell family or friends about what you’re feeling and thinking so they can support you.
- Ask family and friends to support you to eat in a healthy and balanced way.
- Try to find ways to relax by doing things you enjoy (e.g. listening to music or reading or other hobbies).
- Try to avoid alcohol and drugs as they often make the situation worse over time, and can lead to other problems (e.g. dependency).
- Do some research to understand your treatment and recovery options. It may be useful to seek professional help from a counsellor, psychologist, psychiatrist or doctor.
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Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.