Eating disorders are serious mental illnesses affecting over 70 million people worldwide. In Australia, eating disorders are becoming increasingly prevalent, with increasing numbers of people diagnosed each year. Despite this, many Australians remain unaware of the true extent of the problem and the impact it has on individuals and their families.
Understanding the risk factors, signs, symptoms and treatment for eating disorders is essential if we are to remove the stigma and mystery surrounding eating disorders in Australia.
What Is an Eating Disorder?
Eating disorders are serious mental health conditions that involve persistent disturbances in eating habits, often accompanied by distress or worry about body weight, shape or size. The three most common eating disorders are bulimia nervosa, anorexia nervosa, and binge eating disorder.
Approximately one million Australians live with an eating disorder each year; that is 4% of the population. However, there are many more people who experience disordered eating behaviours that are similar to the symptoms of an eating disorder but don’t meet the clinical diagnostic criteria for an eating disorder. Approximately a third of Australian adolescents engage in this kind of behaviour each year. They may be a healthy weight, yet experience a strong desire to lose weight, even sometimes engaging in compensatory behaviours such as skipping meals to achieve their ideal body shape.
Anorexia Nervosa
Anorexia nervosa is characterised by an intense fear of gaining weight and a distorted body image. Individuals with this condition often have a significantly low body weight and restrict their food intake to avoid gaining weight. Anorexia nervosa is one of Australia’s most well-known and most common eating disorders.
Bulimia Nervosa
Bulimia nervosa involves a cycle of binge eating followed by purging. Individuals with bulimia often eat large amounts of food in a short period and then attempt to get rid of the calories through vomiting, laxatives, or excessive exercise. Similar to anorexia nervosa, individuals with bulimia have an unhealthy relationship with food and an intense fear of gaining weight.
Binge Eating Disorder (BED)
Binge eating disorder is characterised by recurrent episodes of binge eating, in which the individual feels a loss of control over their eating. Unlike bulimia, individuals with binge eating disorder do not engage in purging behaviours.
Other Eating Disorders
In addition to BED, anorexia and bulimia, there is a range of other eating disorders that affect the general population in Australia. This includes:
- Avoidant/restrictive food intake disorder (ARFID)
- Purging disorder
- Night eating syndrome
Statistics of Eating Disorders in Australia
According to recent studies, eating disorders are becoming increasingly prevalent in Australia. It is estimated that around 9% of the Australian population will experience an eating disorder at some point in their lives – that is over a million Australians – and this figure is on the rise.
Anorexia nervosa affects approximately 0.5% of the population in Australia. Bulimia nervosa is the second most common eating disorder, affecting approximately 1.5% of the population, while binge eating disorder is the most common, affecting approximately 2.5% of the population.
Statistics by Age
The prevalence of eating disorders is highest among Australian adolescents, with the National Eating Disorders Collaboration reporting that the highest incidence of eating disorders is among females aged 15 to 24 years. However, eating disorders can affect people of all ages, including children and older adults.
Economic and Social Impact
In addition to the impact on individuals and families, eating disorders have significant economic and social costs.
According to the Butterfly Foundation, an Australian organisation dedicated to supporting people with eating disorders, Australia’s estimated economic cost is $69.7 billion per year. This includes direct costs, such as medical treatment and hospitalisation, as well as indirect costs, such as lost productivity and reduced quality of life.
The social impact of eating disorders is also significant. Eating disorders can lead to social isolation, relationship difficulties, and poor academic or work performance. The stigma associated with eating disorders can also make it difficult for individuals to seek help, leading to delayed treatment and poorer outcomes. Many people still see eating disorders as a lifestyle choice and not a mental illness.
Treatment Statistics
Despite the prevalence of eating disorders in Australia, there are significant gaps in the availability and accessibility of treatment. The National Eating Disorders Collaboration reports that only one-third of people with eating disorders in Australia receive the right treatment. Even when treatment is available, there can be long waiting lists and limited resources.
There is also a need for increased awareness and understanding of eating disorders among the general public and healthcare professionals. Eating disorders are often misunderstood or misdiagnosed, and there is a need for greater education and training to improve diagnosis and treatment.
Risk Factors for Eating Disorders
Although the primary cause of eating disorders is unknown, medical professionals are aware that certain people are at increased risk of developing an eating disorder.
In addition to treatment and support, there is a need for prevention programmes to address the risk factors for disordered eating behaviours that may develop into an eating disorder. The National Eating Disorders Collaboration identifies risk factors for eating disorders, including a negative body image, perfectionism, mental health conditions, social anxiety, and diet culture, including the advertisement of diet pills.
Eating Disorder Statistics by Gender
Eating disorders generally affect women at higher rates than they affect men. This is thought to be a result of a range of factors, but particularly the impact of media expecting women’s bodies to look a certain way. Social media has added to this, although it has existed throughout history.
Australian women are more than twice as likely to have experienced binge eating in their lifetime than men.
The lifetime prevalence of binge eating disorder for females is between 2.5%-4.5%, and for men ranges from 1%-3%.
As well as being more common in women, eating disorders are also more prevalent in those from other genders, as well as sexual minorities. Sexually and gender-diverse (LGBTQI +) individuals were six times more likely to have an eating disorder compared to the general male population.
Eating Disorders and Mental Health: Co-occurring Conditions
In addition to the physical complications associated with an eating disorder, such as malnutrition and organ damage, there are a number of co-occurring mental health conditions that can arise as a result of an eating disorder or contribute to the onset of disordered eating. Understanding these co-occurring conditions is essential for effective treatment and recovery.
Depression
One of the most common co-occurring conditions associated with eating disorders is depression.
Depression is a mood disorder that causes intense feelings of hopelessness, sadness, and a loss of interest in activities a person once enjoyed.
Depression and eating disorders are closely linked. The relationship between depression and eating disorders is complex, with each condition potentially exacerbating the other.
Anxiety Disorders
Anxiety disorders are another common co-occurring condition associated with eating disorders. Anxiety disorders cause excessive worry and fear and can lead to physical symptoms such as sweating and rapid heartbeat. Eating disorders and anxiety are often linked, with anxiety commonly triggering or exacerbating eating disorder behaviours.
Trauma
Post-traumatic stress disorder (PTSD) is another co-occurring condition that can arise in individuals with eating disorders. PTSD is a mental health condition that can appear after a traumatic event and can cause flashbacks and nightmares, and impact daily life, often making people feel like they are not in control of their minds and bodies.
Suicidality
Suicidality varies across eating disorders, although those with an eating disorder are more likely to commit suicide than the rest of the population. In Australia, one-quarter to one-third of people with anorexia nervosa, bulimia nervosa, and binge eating disorder have contemplated suicide and up to one-third of people with anorexia and bulimia have attempted suicide.
Tragically, suicide remains the second leading cause of death for people with anorexia nervosa.
Other comorbidities include autism spectrum disorder, substance use disorders, personality disorders, and other mental disorders.
Diagnosis of Eating Disorders
An eating disorder is generally diagnosed using the diagnostic and statistical manual (DSM-5).
The statistical criteria for each eating disorder are different. Criteria for anorexia includes:
- Restriction of energy, or calorie, intake in an attempt to lose weight.
- Low body weight for age, sex, or developmental trajectory.
- Intense fear of weight gain or becoming fat, even though underweight.
- Obsession with body shape and food.
Criteria for bulimia nervosa includes:
- Recurrent episodes of binge eating, meaning eating – often at a discrete time – an amount of food that is greater than would normally be consumed in that period.
- A feeling of lack of control over eating during these episodes.
- Recurrent compensatory behaviour that aims to prevent weight gain, such as self-induced vomiting, fasting, misuse of diuretics, laxatives, or other medications, or excessive exercise.
Even if all the DSM-5 criteria for anorexia are not met, a serious eating disorder can still be present.
Treatment for Eating Disorders
Effective treatment for an eating disorder should address all aspects of a person’s disordered eating behaviours. Treatment will likely include therapy in order to get to the root cause of a person’s unhealthy relationship with food and eating.
When eating disorders are present in young people, there is particular concern for the health impacts of restrictive eating and low body weight. People with eating disorders who are severely underweight are at risk of diabetes, irritable bowel syndrome, weak or fragile bones, menstrual problems, and joint issues. Inpatient treatment will often include a nutritional programme to help counteract the negative physical effects of an eating disorder.
Treatment at The Wave Clinic
At The Wave Clinic, we are experts in eating disorder treatment. Offering individualised treatment programmes for a wide range of eating disorders, from anorexia nervosa to ARFID, we ensure every young person has the tools they need to make a full recovery and find the right treatment approaches for their unique needs. We offer nutritional programmes to help young people develop a healthy relationship with food and prepare them for life after their time with us to ensure long-term recovery.
