Eating Disorders-An Overview
Eating disorders are so much more than about food. They are complex mental health conditions that almost always require treatment by a physician and psychologists to improve symptoms. These disorders are described in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In the United States alone, it is estimated that 20 million women and 10 million men suffer from or have had an eating disorder.
You may not know this, but there is more than one type of eating disorder. I am going to address some of the most common versions of eating disorders and their symptoms. Then, at the end of the post, I am going to share some resources to turn to for help and support.
Overview
Let's first talk about what eating disorders are. They are a range of psychological conditions that result in unhealthy eating habits. They might be triggered by an obsession with food, body weight or body shape. In severe cases, eating disorders can cause serious health consequences and if left untreated can even cause death. Eating disorders can have a variety of symptoms but most include an extreme restriction of food, food binges or purging behaviors like vomiting or over-exercising. I'll have more specifics on symptoms later.
Eating disorders can affect anyone but they are most commonly reported in adolescents and young women.
Causes
Experts believe that eating disorders are caused by a lot of different factors. One is genetics. While genetics don't determine that someone will have an eating disorder, they do contribute to the onset of a disorder. Studies show that those who have a family member with an eating disorder are two-times more likely to develop one themselves. Personality traits are another large factor. In particular, neuroticism, perfectionism and lack of impulse control. People with these traits have a greater risk of developing an eating disorder. Other factors include pressures to be thin, cultural preferences for thinness and exposure to media that promotes such ideals. It is interesting to note that eating disorders are mostly non-existent in culture that haven't been exposed to Western ideals of thinness.
Recently, experts have proposed that differences in brain structure and biology could also play a role in the development of eating disorders. Specifically, the levels of brain messengers like serotonin and dopamine. But this theory is in it's early stages and more studies need to be completed.
Types of Eating Disorders
Anorexia Nervosa
This disorder usually develops during adolescence or young adulthood and effects more women than men.
Those with anorexia nervosa view themselves as overweight, even if they are dangerously underweight. They constantly monitor their weight, avoid eating certain foods and restrict their calorie intake to extremes.
Symptoms Include
- being underweight compared to people of similar age and height
- very restricted eating habits
- an extreme fear of gaining weight or persistent behaviors to avoid gaining weight, even though they are very underweight
- relentless pursuit of thinness
- heavy influence of body weight or perceived body shape on self-esteem
- a distorted body image, including denial of being seriously underweight
Obsessive compulsive symptoms are also often present with anorexia nervosa. For example, some with anorexia are often so preoccupied with food that they constantly think about food and some may obsessively collect recipes or hoard food. Difficulty eating in public is another common problem for those with anorexia. They might exhibit a strong desire to control their environment which limits their ability to be spontaneous.
Anorexia is divided into two sub-types: the restricting type and the binge eating and purging type.
Individuals with the restricting type lose weight only through dieting, fasting or excessive exercise.
Those with the binge eating and purging type typically binge on large amounts of food or eat very little. In both cases, after they eat, they purge using activities like vomiting, taking laxatives or exercising excessively.
Overall, anorexia is very damaging to the body. Over time, those living with the disorder can experience thinning of the bones, infertility, brittle hair and nails and the growth of a fine hair all over the body. In severe cases, heart, brain or multi-organ failure can occur, and possibly even death.
Bulimia Nervosa
Like anorexia, bulimia tends to develop during adolescence or young adulthood, and is more common in women than it is in men.
People with bulimia usually consume a large amount of food in a specific period of time. Each binge eating episode is usually carried on until the person starts to feel ill. They feel like they cannot stop eating or cannot control the amount that they are eating.
After the binge eating episode, they use purging methods to compensate for the calories that they have consumed and to relieve stomach discomfort. Common purging techniques are forced vomiting, fasting, laxatives, diuretics, enemas and excessive exercise.
Individuals with bulimia can usually maintain a normal weight rather than becoming underweight.
Common Symptoms Include
Bulimia Nervosa
Like anorexia, bulimia tends to develop during adolescence or young adulthood, and is more common in women than it is in men.
People with bulimia usually consume a large amount of food in a specific period of time. Each binge eating episode is usually carried on until the person starts to feel ill. They feel like they cannot stop eating or cannot control the amount that they are eating.
After the binge eating episode, they use purging methods to compensate for the calories that they have consumed and to relieve stomach discomfort. Common purging techniques are forced vomiting, fasting, laxatives, diuretics, enemas and excessive exercise.
Individuals with bulimia can usually maintain a normal weight rather than becoming underweight.
Common Symptoms Include
- recurrent episodes of binge eating while feeling out of control
- recurrent episodes of extreme purging to prevent weight gain
- a self-esteem that is largely influenced by body shape and weight
- a fear of gaining weight despite maintaining a normal weight
The side effects of bulimia can include inflamed and sore throat, swollen saliva glands, worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration and hormonal disturbances. In extreme cases, bulimia can also cause an imbalance in levels of electrolytes which can cause a stroke or heart attack.
Binge Eating Disorder
This is believed to be the most common of all eating disorders, especially in the United States. Typically, it starts in early adulthood, but it can also develop later on.
Individuals with binge eating disorder have symptoms that are similar to bulimia, or the binge eating sub-category of anorexia. They typically eat a large amount of food in a short period of time, during which they feel an incredible lack of control. However, they do not restrict calories or use purging behaviors to compensate for their binges.
Common Symptoms Include
- rapidly eating large amounts of food until uncomfortably full, despite not being hungry
- feeling out of control during episodes of binge eating
- feelings of distress, like shame, guilt or disgust when thinking about their binge eating behavior
- does no use purging behaviors to compensate for binging
People with binge eating disorder are often overweight or obese. This could increase their risk of medical issues like heart disease, stroke and type 2 diabetes.
Pica
Pica is a disorder that involves eating things that are not considered food. Individuals with this disorder experience overwhelming cravings for non-food substances like ice, dirt, chalk, soap, paper, hair, wool, pebbles or laundry detergent.
To be considered pica, the eating of non-food substances must not be a part of someones culture or religion, and it must be considered socially unacceptable by peers.
Common Symptoms Include*
- extreme cravings for non-food items
- upset stomach
- bloody stool
- bowel problems
*The symptoms of Pica vary based on what non-food item the person has ingested.
Those with pica may be at an increased risk of poisoning, infections, gut injuries and nutritional deficiencies. Depending on what was ingested, pica can be fatal.
Rumination Disorder
This describes a disorder in which a person regurgitates their food that they have previously chewed and swallowed, re-chews it and then either re-swallows it or spits it out. The rumination usually occurs within 10 minutes of eating.
This disorder can occur during infancy, childhood or adulthood. In infants, it usually develops between 3-12 months of age and usually goes away on it's own. Children and adults typically require therapy to overcome the disorder.
Common Symptoms Include
- effortless regurgitation usually within 10 minutes of eating
- abdominal pain or pressure relieved by regurgitation
- a feeling of fullness
- bad breath
- nausea
- unintentional weight loss
When rumination disorder isn't resolved in infants, it can cause malnutrition that could be fatal. Adults with this disorder may restrict the amount of food that they eat, especially in public. This may lead them to lose weight and become underweight.
Avoidant/Restrictive Food Intake Disorder (ARFID)
This term replaces what used to be known as "feeding disorder of infancy and early childhood." This diagnosis was previously given only to children under 7 years of age. Even though ARFID usually develops during infancy or early childhood, it can continue on into adulthood.
Those with ARFID experience disrupted eating either due to lack of interest in eating or distaste for certain smells, tastes, colors, textures or temperatures.
Common Symptoms Include
- avoiding or restricting food intake that prevents the person from eating sufficient calories or nutrients
- eating habits that interfere with social functions
- weight loss or poor development for age and height
- nutrient deficiencies or dependence on supplements or tube feeding
It's worth noting that ARFID goes beyond picky eating. Also, it does not include the avoidance or restriction of food due to lack of availability or religious or cultural practices.
Other Eating Disorders
- purging disorder-these individuals often use purging behaviors to control their weight or shape but they do not binge
- night eating syndrome-this disorder describes those who frequently eat excessively, often after awakening from sleep
- other specified feeding or eating disorder-this disorder is not found in the DSM-5 but includes any other conditions that have symptoms similar to those of an eating disorder but do not fit into any of the above categories.
One disorder that may not fall under "other eating disorders" is orthorexia. This disorder is being talked about more frequently in the media and in the science community. However, orthorexia has not been recognized as a separate eating disorder by the current DSM.
Individuals who suffer from orthorexia have an obsessive focus on healthy eating, to an extent that it disrupts their daily lives. For example, they may eliminate entire food groups out of fear that they are unhealthy. That behavior can lead to malnutrition, severe weight loss, emotional distress and difficulty eating outside of the home.
Those with orthorexia rarely focus on losing weight. Instead, their self-worth, identity, or satisfaction in life depends on how well they can comply to their self-imposed diet rules.
Resources
If you or someone you know has an eating disorder, your first step should be to seek out professional help from a practitioner who specializes in eating disorders.
With that said, here is a great list of resources for those who have an eating disorder. The list is on a website called eatingdisorderhope.com, and has so many wonderful resources that I decided to just share the link.
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