Video Transcription

Eating disorder questions, answered by a doctor

I’m Dr. Aaron Gordon. I nearly said Jordan, that was pretty funny. I’m Dr. Aaron Gordon, I do know who I am. That’s great. I’m Dr. Erin, and have you ever had a question that you’re too embarrassed to ask? I’m here to answer your questions. An estimated nine percent of Australians have been affected by an eating disorder at some point in their life. It’s such a taboo subject, and none of us are really talking that much about it. What, why, and what are we doing about them?

An eating disorder is not a lifestyle choice, and it’s not a diet gone wrong. An eating disorder is a mental illness where someone’s body weight, body image, the amount they eat, and the amount they exercise become an unhealthy preoccupation. The big three: bulimia, anorexia, and binge eating disorder, they don’t discriminate and can affect people of all body shapes and sizes, gender, and age.

Am I sick enough to deserve help? I think the most important thing from this is that everyone deserves help, and there’s no such thing as being sick enough to get the help that you need. The fact that you’re asking that question does make me feel that you do need to reach out, and that’s the most important thing to do right now. [Music]

A focus on body image and a preoccupation with meeting social norms, particularly around body weight, are both risk factors for developing an eating disorder. But they’re not the only ones. Some of the other risk factors include previous trauma, low self-esteem, depression, stress, and a high-achieving personality type. Social factors also play a big role, and these can include the way the media portrays body image and ideal body type, and perceived pressure coming from family, friends, and other people in your life, such as sports coaches.

My name’s Mel, and I’m a youth mental health advocate with lived experience of anorexia nervosa. What advice would you give to someone who is looking for help, especially for the first time?

So, what happens when someone visits me and tells me they’re worried about having an eating disorder? Well, what I usually do is take a thorough history, perform a physical examination, including height, weight, and blood pressure, and then we’ll have a chat about some investigations we might need to do to make sure that all your nutrients are not deficient and that you’re not at risk of developing any organ problems.

There’s been this huge game changer that’s come into play in Australia in the past 12 months called an Eating Disorders Management Plan, and that’s something put in place by Medicare to enable GPs to work with their patients with eating disorders. What this does is give you access as a patient to a dietitian and a psychologist for you.

How do I talk to a friend I’m worried about? Plenty of people with eating disorders actually don’t have much insight into the fact that they are being affected. I think the most important thing as a friend of somebody who may be suffering from an eating disorder is to just be upfront and ask them, “Are they okay? Is it something they want to talk about?” and be a good listener.

Binge eating disorder is definitely a thing. In fact, binge eating disorder is the most common eating disorder here in Australia. Unlike a person with bulimia, someone suffering from binge eating disorder won’t vomit after ingesting a large amount of food but instead will restrict their caloric intake, leading to a binge-restrict kind of pattern. And so, you get this incredibly awful cycle of ingesting a lot of food or bingeing and then restricting again. Feelings such as guilt and shame will often follow an episode of binge eating.

Eating disorders can be incredibly dangerous because of the impact they have on people’s physical and psychological health. The preoccupation with food and calories and exercise and weight can really exhaust somebody, but also the mental impact of trying to hide this from loved ones is incredible. I find that it’s really common that people totally disregard the physical effects that having an eating disorder has on them, and this includes short-term effects and long-term effects. Short-term, we talk about dizziness, nausea, fatigue, and poor concentration. Then, more long-term, we start looking at things like effects on heart muscle, kidneys, high cholesterol, high blood pressure, which then leads on to diabetes, stroke, and heart disease. The mortality rate from eating disorders is whopping, around six times higher than a person who doesn’t have an eating disorder.

Osteoporosis is when someone’s bone density reduces so much it gets to a certain level that puts us at increased risk of bone breaks or fractures. Eating disorders have a huge impact on our bone health. This is through rapid weight loss, restricting our diet, so limiting calcium and vitamin D, and period suppression. Can osteoporosis be reversed? Well, in truth, no, but there is so much that we can do to help out, focusing treatment on improving the eating disorder and restoring body weight and the hormones back to normal, and improving our dietary intake. Well, that minimizes the risk of developing osteoporosis.

Hi there, Maddie here. I would love to ask Dr. Erin Gordon whether eating disorders are genetic. Do they get passed down in families?

Well, there is some evidence showing that we can inherit an eating disorder from a biological parent, but this is still not fully understood.

Yes, yes, you can. There are a few things that can help with this. Getting help early is really important. Surrounding yourself with a support team of not only health professionals but also family and friends can really help. It’s important to remember that recovery is so much more than regaining the weight that you’ve lost or eating a better diet. It’s about targeting why you wanted to restrict your eating or excessively exercise, to look at your mood and to look at ways to cope. Recovery from an eating disorder can be a lifelong commitment, but it can be done. I love answering these questions, but I can only give general advice. If you’re worried about yourself, go and see your GP. The first step to recovery is talking about the issue.