by Donna O’Connor-Hunnisett

INEDA is a community-based organization run by ex-sufferers of anorexia
 nervosa, bulimia nervosa, compulsive overeating, their families, carers and 
health-care professionals. We have six facilitated, support group meetings 
per month for sufferers and their families and carers, at two locations in 
Dublin and one in Clonmel, Co Tip. We plan to have two more located in
 Galway and Cork in the Autumn. We also plan to begin a men’s group in
 the Dublin area shortly. We currently have two help and information lines, 
a hospital visiting and support group and organize public information and 
awareness lectures. During the past year, we visited twelve secondary 
schools to give talks to students, teachers and parents on prevention, early
 detection and intervention. We usually take two girls who are doing well
 in their recovery from eating disorders to these venues to give teenagers 
and young women a positive role model of recovery. Our approach to the
 area of eating disorders is based on a choice theory model, which 
incorporates the concepts of unconditional love and acceptance to
 sufferers from group members and facilitators.

Although we accept new members exactly where they are in their food 
behaviour, we encourage them to express themselves openly in a safe, 
confidential environment and encourage them to learn new, more effective 
ways of dealing with their negative feelings and traumas. This takes place 
in the meeting-room environment through interaction and dialogue with
 others who are further in their recovery process. Trained facilitators are 
also present, should someone need to talk over an issue of a sensitive or 
personal nature on a one-to-one basis.

Anorexia and bulimia nervosa, contrary to popular belief, are not about
 food or weight, but rather about negative feelings about one s self and life 
situations and “traumatic” experiences. People who develop eating
 disorders are usually those with a genetic pre-disposition, sensitive nature,
 people pleasers, high achievers and perfectionistic and yet they have a 
seriously flawed self-perception. They usually hate their body shape and
 size, and try to distort and minimize it. They have no regard for their 
personalities, opinions and decisions. They will therefore readily abdicate
 most of their responsibilities to others, whom they will then perceive as
 controlling. After a period of time, they begin to control the one aspect of
 their lives they feel they can, which is the intake of food. Thus develops a 
potentially debilitating and sometimes fatal eating disorder.

In anorexia nervosa, the person becomes obsessed with starvation and
 food avoidance in an attempt to exercise control and obliterate feelings such as rejection, insecurity, self-loathing, loneliness, anger and inadequacy:
 They gradually become totally centred in self, in the mastery of sell denial
 and body-reconstruction, ie, “The less space I occupy, the less of me there 
will be to hate…” As this situation progresses, the sufferer loses touch with 
reality and their self-evaluation process becomes flawed. Even at five or six 
stone, they still feel the need to continue the minimizing and 
reconstruction of their body. At this point it may be necessary to seek
 medical intervention for blood tests and physical assessment. While in-
hospital treatment serves an essential function, if the sufferer’s condition
 has become life-threatening, there is controversy and doubt as to the long
 term effect on recovery that the present therapeutic approaches to 
changing the patient’s eating behaviour may have.

People suffering from bulimia, although they have similar feelings and 
issues around self-hatred, perceived ineffectiveness and failure, have
 different patterns of behaviour in that they are more aggressive and are 
often seen by those around them as “disgusting and bordering on
 madness.” This leads the sufferer of bulimia nervosa to engage in elaborate 
scenarios of secretive planning, timing and cover-up behaviours to 
camouflage their illness. They often go unnoticed for this reason, and also
 due to the fact that they are usually of normal or excessive body size.

Bulimia manifests itself in the progressive use of laxatives, diuretics, 
appetite suppressants, prescription medication, relaxants and alcohol
 binges, as well as the predominating binges on high-caloric carbohydrate
 foods, followed by vomiting in an attempt to control weight gain. It is not
 rare for such a sufferer to ingest well over 5,000 calories in a binge or to 
take as many as thirty laxatives on a daily basis. (We are petitioning the
 Health Boards to consider limiting such over-the-counter medication to
 prescription only, as the addictive use of such medication can lead to 
serious side-effects.) We have a very effective “Coming off laxatives” 
programme that we use with the monitoring and support of the medical 
profession, involved in the sufferer’s recovery programme.

Both anorexia and bulimia sufferers have mood swings and bouts of
 depression. However, these would usually be more pronounced in the area
 of bulimia, where the level of anger directed at oneself and those around
 one is more intense and can lead, in some chronic cases, to self-cutting and 
mutilation, which requires specific intervention on a one-to-one basis with 
a trained therapist.

Recovery from an eating disorder is a slow process and requires patience
 and encouragement from those closest to the person. It also involves
 focusing on the issues and perceptions underlying the symptomatic food 
behaviour, the learning of more effective choices of behaviour to deal with
 these issues. This procedure best takes place in the safe, supportive environment of meetings on a facilitated, self-help basis. At these meetings 
the sufferers learn to talk openly about their feelings, the attempts they
 have made to anaesthetize those feelings with food, starvation, etc., and
 step by step, they learn from those who have been there and are still
 recovering, how to get well.

At these meetings we also introduce exercises and programmes on building
 the self-esteem, self-awareness, self-acceptance, self-love and self-belief 
which are essential for full recovery and a positive, happy life-style.

Donna O’Connor-Hunnisett is the Director of the Irish National Eating 
Disorders Association. Their address is 47 Harrington Street, Dublin 8,
 and their phone number is Dublin 497 5667