Eating disorder

The first serious studies into the symptoms and motivations around eating disorders appeared in the late ‘70s. At that time, health professionals viewed disorders like anorexia nervosa as afflictions restricted to affluent white women who wanted to keep up with the latest fashions. This view was obviously very limited, and medical and psychological researchers now have a much better understanding of the complexity of physical and emotional factors that contribute to someone developing an eating disorder. Recent Australian research supports the theory that eating disorders are on the increase across a range of demographic groups, with middle aged men in fact showing the greatest increase in extreme dieting, binge eating and purging.

Study design
A team of Australian researchers felt the old world view of what type of person is most likely to acquire an eating disorder was still impacting policies and treatment options in the present day, with many of the prevention programs still targeted mainly at young women. Their study was designed to explore the prevalence of eating disorders across a wider range of population groups by charting demographic information (sex, age, income and residency) against disordered eating behaviours. The study also looked at the impact of eating disorders on mental and physical health-related quality of life.
Researchers drew data from the Health Omnibus Survey, an annual health census conducted by the South Australian Health Commission that includes face-to-face interviews with selected participants. By comparing data from the 1998 survey to the 2008 results, researchers noted significant changes in the demographic profile of eating disorder behaviours over the decade.

The study revealed a general increase in disordered eating behaviours across the population, however rates of increase varied for specific groups. For example:
– Binge eating behaviour increased between 1998 and 2008 across all demographic groups, but was significantly higher for men and women in lower socioeconomic groups.
– Binge eating resulted in similar levels of physical health impairment across all demographic groups, but men in regional areas reported the greatest mental health impact.
– Extreme dieting increased significantly between 1998 and 2008 in men and women across all income brackets, but only in two age groups: 25-44 years and 45+. The greatest rate of increase was seen in males from lower socioeconomic groups, who also reported the greatest decrease in physical quality of life.
– Purging (via the use of laxatives or vomiting) increased markedly for the 45+ age group, with men from lower socioeconomic backgrounds again showing the most significant increase.

Middle aged men show the greatest increase in disordered eating
Overall, the findings from this study suggest that disordered eating patterns have increased most rapidly in demographic sectors that were never traditionally associated with eating disorders. Eating disorder behaviours increased across all sectors of the surveyed population between 1998 and 2008, and younger women were still in the majority. But men in lower socioeconomic areas and older survey participants were catching up fast. Most worryingly, purging behaviours increased at the fastest rate in participants from the oldest age group (45+), a behaviour that was almost non-existent in reporting from this age group in 1998. All of this suggests that treatment and prevention programs need to be developed with the wider population in mind; it is no longer sufficient to concentrate advocacy efforts on young women.
As a weight loss professional, your job is to encourage balanced, nutritional eating, but providing emotional support is always a major part of your role. This study suggests that it’s worth keeping an eye out for signs of extreme dieting or other disordered eating behaviours amongst clients from all kinds of backgrounds – and always encourage them to seek professional help if required.

Deborah Mitchison, Phillippa Hay, et al. (2014). The changing demographic profile of eating disorder behaviours in the community. BMC Public Health 14:943