Eating disorders are often treated very differently and I think that’s why there’s a misconception that anorexia is wildly different from bulimia, from binge eating disorder, from an EDNOS diagnosis and so on.

The truth is that people with eating disorders, regardless of how they are presenting, often think very similarly.

They are often plagued by very low self-esteem, have negative perceptions of themselves and what you see in terms of overall presentation of their eating disorder are really how their symptoms are manifesting. For example, somebody might have an overriding restrictive pattern with regards to their food; other people might have more of a binge-purge presentation. What I know to be true (particularly with those suffering from binge eating disorder) is that they also heavily restrict. Quite often people with binge eating disorder will restrict, restrict, restrict and then binge.

When you treat the eating disorder as just one illness that has many different forms, then we avoid being dragged into the symptoms.

I don’t think it’s helpful for sufferers to get dragged into their symptoms either, because people end up thinking “I am not anorexic because I ate more on this day; I am able to eat this; I don’t always restrict my food or I don’t really have a binge eating disorder – I am just greedy and I can’t help myself when it comes to food”. We end up trying to make sense of our symptoms because we don’t necessarily fit into any of these exact categories. People don’t – most people cross from one eating disorder ‘label’ to another.

What you find when people have treatment (and the treatment is very symptom focused) is one set of symptoms might go down and another might go up.

Symptom-focused treatment involves looking at trying to minimise all the symptoms of their illness and not necessarily dealing with the core issues, such as asking:

  • Where has this begun?
  • What are the origins of the illness?
  • Why is this person feeling like they need to rely on these destructive coping strategies to begin with?
  • When has this happened?

Somebody might be able to stop restricting but then they find that their binge pattern starts to increase. It’s just going from one thing to another and that’s why I think this question comes up about whether you can go from one eating disorder to another.

Yes, you can go from one eating disorder to another. Really, that’s because the core of the problem isn’t being dealt with and when that happens you will find the illness will manifest in different areas of somebody’s life.

It won’t just be around food. It will be around relationships, self-esteem, anxiety, depression etc. It is really important to tackle the core of the issue and try not to get too bogged down with “what label am I under?” and “what is my specific diagnosis?”.

If you know you are not well or if you know you have a disordered relationship with food, then that’s reason enough to get help and support.


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