Conditions Eating disorders: when food becomes a problem

Eating disorders are serious conditions that require medical treatment. They primarily disrupt the way people eat and their relationship with their own body. This can result in them becoming underweight or overweight to an extent that is harmful to their health.

There are different types of eating disorders: the most significant are anorexia (Anorexia nervosa), bulimia, and binge-eating disorder.

People suffering from anorexia are terrified of gaining weight and take various measures to lose as much weight as possible – even if they are of normal weight or already underweight.

Binge-eating disorder is also known as bulimia. This results in regular binge-eating episodes, during which those affected feel like they’re losing control. They then try to get rid of the excess calories, for example, by vomiting. Although the weight is often normal as a result, those affected suffer greatly from shame and feelings of guilt. Frequent vomiting also impairs physical health. 

Regular binge-eating episodes with loss of control are also signs of binge-eating disorder. However, unlike bulimia, there are no regular countermeasures such as vomiting, exercise or fasting. Those affected are often overweight and also suffer from shame and feelings of guilt.

Besides classic forms of eating disorders, mixed forms also occur frequently. Each of these conditions can and should be treated. The sooner they are identified, the greater the chances of successful treatment and a return to healthy eating behavior.

Eating disorders have diverse causes. Usually, many different factors work together and affect each other. Personal, familial, biological and societal factors can all contribute to disordered eating behavior.

Young people in particular are strongly influenced by the beauty standards promoted in advertising, TV, and social media. The pressure to be thin or particularly muscular yourself is increased, for example, by images posted by popular influencers. The changing body during puberty, lack of exercise in everyday life, or the overabundance of unhealthy foods also present a particular challenge. This path often automatically leads to sports and nutrition tips on platforms such as YouTube or on other social media. The services offered by these platforms are not necessarily harmful. Rather, it is important that children and young people use these media under parental guidance and learn how to critically engage with the content. For example, content from social networks in which eating disorders are trivialized or glorified can be dangerous. In so-called “challenges”, users motivate each other to achieve extreme weight loss.

Further information and tips on handling online content that glorifies eating disorders can be found on the Klicksafe website.

However, societal factors like beauty standards alone do not automatically lead to an eating disorder. For instance, individual characteristics such as perfectionism, strong ambition, or the ability to control impulses, but also biological factors can also play a role. Traumatic experiences or the family environment can also contribute to the development of eating disorders.

Girls and young women are particularly at risk of developing an eating disorder. However, boys and young men can also be affected.

Eating disorders often develop gradually. If they constantly compare themselves to others, this can compound the situation. Unrealistic standards can contribute to a distorted self-image developing – the person affected thinks they’re too fat, even if they are actually of normal weight. Self-esteem is excessively dependent on weight and one’s figure. Depending on the type of eating disorder, many of those affected increasingly lose control over their eating behavior – or they increasingly limit their food intake, as with anorexia. People with anorexia often engage in excessive exercise to compensate for even small amounts of calories consumed. The subjects of food and body weight take on an increasingly significant role in eating disorders. Little room remains for anything else. 

Eating habits are therefore increasingly becoming a starting point for health problems: being extremely underweight can lead to muscle loss and osteoporosis. Typically, girls and women stop having monthly periods, and fertility reduces. Being overweight and obesity (adiposity) increase the risk of conditions like heart and cardiovascular diseases or joint and back problems. However, they can also cause mental disorders such as anxiety or depression – which can conversely also lead to an eating disorder.

People with eating disorders often find it hard to recognize the illness as such and get help. Appropriate medical and psychotherapeutic treatment is therefore all the more important but should not be enforced.

People with eating disorders who are looking for help and their relatives can consult their general practitioner, for example.

Professional advice centers such as the anonymous telephone helpline provided by the Federal Institute for Public Health (BIÖG) can also help people with eating disorders find a suitable treatment option. 
Contact the telephone hotline

Depending on the type and severity of the eating disorder, treatment can be provided in an outpatient capacity or in a hospital. The aim is to restore healthy eating habits. Psychotherapeutic treatment is an important and central part of this.

How relatives can help:

• Listen and show understanding – this can already relieve some strain off the person affected.
• Take action without pressure: do not reprimand, apportion blame, make threats or set mandatory rules. Start with little steps.
• Gently address worries and concerns without focusing on the person’s body weight and eating habits.
• Break the taboo and talk openly and clearly about the topic.
• Try to overcome fear and obstacles together by offering support and guidance and helping the person improve their self-confidence.

Further information and advice on eating disorders can be found on the website of the Federal Institute for Public Health (BIÖG) (in German).

A list of contact points and advice services for those affected by eating disorders and their relatives is also provided by Deutsche Gesellschaft für Essstörungen e.V. (The German Society of Eating Disorders) on their website. You can also check whether you have an increased risk of having an eating disorder with a simple online test.