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Friday, August 20, 1999 Published at 16:40 GMT 17:40 UK


The complex world of eating disorders

BBC Doctor Colin Thomas: "Eating disorders are not just about food"

Imagine being scared by a piece of broccoli! No, I'm not straying into the world of genetically modified food again, but that is exactly what someone told me recently about their struggle with anorexia.

Exceptions prove the rule, and whilst this week we have heard that men too can suffer eating disorders, there is no doubt that the vast majority of sufferers are women.

Why women more than men? For women a slim body image these days is considered "good", but this was not always the case, think of all those Boticelli and Ruebens paintings.

In the past, and in some cultures today, skinny frames were considered a sign of malnutrition, and the truest beauties were those with an excess of adipose tissues even in the "wrong" places.

But for men of course the reverse is true. Charles Atlas types rather than Mr Bean tend to be the physical role models, so if anything the pressure is on looking "hunky" rather than slim, and manipulation of body image is not such an important issue.

For people who would class themselves as normal eaters, the concept of anorexia is very difficult for them to grasp.

Well meaning individuals will advise sufferers to "just get some food inside you", but if only just eating a bit more was the real answer then the solution would be easy.

Psychological illness

Anorexia is a psychological illness where food and eating are the symptoms rather than the cause.

If you control the essentials of life you have power. No oxygen and you would be dead in minutes. No water and perhaps a few days, but deprivation of food may take months to cause death, and therefore is a far superior way of manipulating your body, and ultimately yourself.

Anorexia becomes the "normal" state for sufferers. It becomes a safe refuge where food is the enemy, and the reward is the sense of control and the feeling of protection the illness gives.

Sufferers perceive slimness as a way of gaining admiration and approval, but eventually sufferers get so attached to their illness that they can't give it up and things begin to get out of hand.

In fact in many cases they will convince themselves that they have the situation under control, but nothing could be further from the truth.

Their whole attitude to food is different. It becomes the enemy. Those with eating disorders create strategies to fool themselves and others that everything is well.

Bulimics for example may eat a normal meal with friends and colleagues, but in private throw the whole lot up.

Well meaning family and friends concentrate on the food aspect but I'm afraid this amateur psychology will have little impact. Anorexia is a very serious condition.

Sufferers need support from families and friends, but specialised professional help is essential.

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