Eating disorders (young people)

People had sometimes come across health professionals and services who wrongly thought that eating disorders were caused by a person’s desire to be thin, with weight loss as the only sign that they had the condition. Some people had not been able to get help from eating disorder services because the service based their entry criteria purely on weight. 
 

Even for those who said they had been driven by weight loss or appearance, the main motivation could often be a desire to change themselves. People had learnt to connect particular values to different weights. They described how they associated being overweight with 'laziness' or 'failure' and being thin with 'being happy', 'successful' or 'achieving things'.
 

The way people thought about their body image could change over the course of the illness. When people had been ill with an eating disorder for a while, weight loss could become an obsessive habit and about achieving a certain number rather than about the weight or the way they looked. An eating disorder was described as a “numbers game” where all that mattered was getting to the right number, but the goal posts could move and the target number would always get smaller.
 

Body and self-confidence

Body-image, or the way people think about their physical appearance, was closely linked to self-confidence and how people felt about themselves more generally. Some had felt “ugly” or “fat” and that they couldn’t look themselves in the mirror. A negative body-image was commonly tied up with an overall feeling of being “undeserving” or “a failure”.

 

People described how they viewed themselves and their bodies often in comparison to other people. They described comparing themselves to others, “not fitting in” and feeling “inferior to peers”. Laura was always very self-conscious and aware of how others viewed her. Often unintentional comments from others that people interpreted negatively could start a cycle of weight loss. Later on, positive comments about weight loss could encourage people to keep losing weight and make weight loss seem ‘desirable’. David could remember a jibe about his body that triggered him to lose weight. Later on, as people became more ill and lost more weight, comments from others turned to concern. At this point, people were often too ill to believe them. Emily felt that the media promotes the view that “skinny is better”. Ewan said he used to read a lot of men’s health magazines which promoted a narrow view of an acceptable body.
 

Body-confidence was especially important in intimate and physical relationships. If people felt negatively about their bodies, it could be difficult to feel comfortable being naked with a partner or even hug them. Laura felt “too self-conscious to even bother” with intimacy. Katherine said that while she was ill with anorexia nervosa she was never interested in boys but later on, compliments from them were reassuring.