June 15, 2023

Understanding Eating Disorders

Having an eating disorder is like being trapped in a never-ending nightmare, where every thought and action revolves around food and body image. It's a constant battle between the desire to eat and the fear of gaining weight. Food becomes the enemy–something to be feared and avoided at all costs. Every meal is a battle and every bite is a negotiation. You count and track every calorie, every carb, every gram of fat, until you've become an expert in the science of starvation.

But the truth is, you are not in control. Your eating disorder has taken over, dictating every aspect of your life. Social events become terrifying, as you struggle to find safe foods or excuses to avoid eating altogether. The physical toll of an eating disorder is just as devastating. Constantly restricting food intake leads to malnourishment, fatigue, and weakness. 

But perhaps the most heartbreaking aspect of having an eating disorder is the isolation and loneliness that comes with it. You feel like no one understands the battle you're fighting, and you're too ashamed to ask for help. So you suffer in silence.

The good news is that there is always hope for recovery from an eating disorder. With the right treatment, support, and commitment to healing, it is possible to overcome this debilitating illness and live a fulfilling, healthy life.

What Are Eating Disorders?

Eating disorders are serious, biologically influenced medical illnesses marked by severe disturbances to one’s eating behaviors. Although many people may be concerned about their health, weight, or appearance from time to time, some people become fixated or obsessed with weight loss, body weight or shape, and controlling their food intake. These may be signs of an eating disorder. In some cases, they can be life-threatening. With treatment, however, people can recover completely from eating disorders.

How Common Are Eating Disorders?

Eating disorders affect several million people at any given time, most often women between the ages of 12 and 35, and approximately 20 million girls and women and 10 million boys and men in America have an eating disorder. The most common are anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID) and other specified feeding and eating disorder (OSFED).1

Who Is At Risk For Eating Disorders?

People who may be at risk for developing an eating disorder include:

Adolescents and young adults: Eating disorders often develop during adolescence or young adulthood, although they can occur at any age.

Women: Eating disorders are more common in women than in men, although they can affect people of any gender.

Individuals with a history of dieting: Repeated attempts at dieting or restrictive eating patterns can increase the risk of developing an eating disorder.

Those with a history of mental health issues: People with anxiety, depression, obsessive-compulsive disorder (OCD), or other mental health conditions may be more susceptible to developing an eating disorder.

Those with a history of trauma: Trauma, such as physical, emotional, or sexual abuse, can increase the risk of developing an eating disorder.

People in certain professions or activities: Certain professions or activities that place a high emphasis on body weight or shape, such as modeling, dance, or sports that emphasize weight classes, can increase the risk of developing an eating disorder.

Other factors include:

  • Diabetes (up to one-fourth of women with Type 1 diabetes develop an eating disorder).
  • Involvement in activities that focus on a slender appearance, such as modeling, gymnastics, swimming, wrestling and running.
  • Major life changes, such as starting a new school or job, a divorce or a move.
  • Perfectionistic tendencies.

How Are Eating Disorders Diagnosed?

It is important to note that diagnosing an eating disorder can be complex and should only be done by a qualified healthcare professional. An eating disorder can be diagnosed by a healthcare professional, such as a primary care physician, psychiatrist, psychologist, or a licensed therapist with expertise in the diagnosis and treatment of eating disorders.

Types Of Eating Disorders

  1. Anorexia nervosa. 

Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight, leading to severe calorie restriction, often accompanied by excessive exercise. 

People with anorexia nervosa typically have a distorted body image and see themselves as overweight even when they are underweight. 

Symptoms may include:

  • Dramatic weight loss
  • Obsession with food, calories, and weight
  • Refusal to eat certain foods or entire food groups
  • Avoidance of social situations involving food
  • Preoccupation with body shape and size
  • Low body weight
  • Absence of menstrual periods (in females)

  1. Bulimia Nervosa.

Bulimia nervosa is an eating disorder characterized by a cycle of binge eating followed by purging behaviors such as vomiting, laxative use, or excessive exercise. People with bulimia nervosa often feel out of control during their binge episodes and then experience feelings of shame and guilt, leading them to engage in purging behaviors to get rid of the calories. 

Symptoms may include:

  • Recurrent episodes of binge eating
  • Preoccupation with food, calories, and weight
  • Purging behaviors such as vomiting or laxative use
  • Excessive exercise
  • Swollen salivary glands
  • Tooth decay and erosion
  • Electrolyte imbalances

  1. Avoidant/Restrictive Food Intake Disorder (ARFID).

ARFID is a disorder characterized by avoidance or restriction of food intake, leading to weight loss, malnutrition, and impaired functioning. People with ARFID may avoid certain foods based on their texture, color, or smell, or have a lack of interest in eating altogether. 

Symptoms may include:

  • Significant weight loss or failure to gain weight
  • Nutritional deficiencies
  • Dependence on nutritional supplements or tube feeding
  • Avoidance of certain foods based on their texture, color, or smell
  • Lack of interest in eating
  • Anxiety or fear related to eating or food

  1. Binge Eating Disorder.

Binge eating disorder is a disorder characterized by recurrent episodes of binge eating, without purging behaviors. People with binge eating disorder often feel out of control during their binge episodes and experience feelings of shame and guilt afterward. 

Symptoms may include:

  • Recurrent episodes of binge eating
  • Preoccupation with food, calories, and weight
  • Eating rapidly and until uncomfortably full

  1. Other Specified Feeding or Eating Disorders (OSFED).

OSFED is a category of eating disorders that do not meet the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder, but still involve significant disturbances in eating and/or body image. 

Examples of OSFED include 

  • Atypical anorexia nervosa: All the symptoms of anorexia nervosa, but with a normal body weight.
  • Pica: A disorder characterized by the persistent eating of non-food items, such as dirt, hair, or paper.
  • Rumination Disorder: A disorder characterized by the repeated regurgitation and re-chewing of food, without apparent nausea or retching.

What Are the Complications of Eating Disorders?

Eating disorders are the second most lethal psychiatric disorder, followed only by opioid use disorder.

Greatly restricting calories, throwing up or extreme exercise can take a toll on your overall health. An untreated eating disorder places you at risk for serious problems, such as:

  • Arrhythmia, heart failure and other heart problems.
  • Acid reflux (gastroesophageal reflux disease or GERD).
  • Gastrointestinal problems.
  • Low blood pressure (hypotension).
  • Organ failure and brain damage.
  • Osteoporosis and tooth damage.
  • Severe dehydration and constipation.
  • Stopped menstrual cycles (amenorrhea) and infertility.
  • Stroke.

How Are Eating Disorders Treated?

Treatments for eating disorders vary depending on the type and your specific needs. Even if you don’t have a diagnosed eating disorder, an expert can help you address and manage food-related issues. 

Treatments include:

Psychotherapy: A mental health professional can determine the best psychotherapy for your situation. Many people with eating disorders improve with cognitive behavioral therapy (CBT). This form of therapy helps you understand and change distorted thinking patterns that drive behaviors and emotions.

Maudsley approach: This form of family therapy helps parents of teenagers with anorexia. Parents actively guide a child’s eating while they learn healthier habits.

Medications: Some people with eating disorders have other conditions, like anxiety or depression. Taking antidepressants or other medications can improve these conditions. As a result, your thoughts about yourself and food improve.

Nutrition counseling: A registered dietitian with training in eating disorders can help improve eating habits and develop nutritious meal plans. This specialist can also offer tips for grocery shopping, meal planning, and preparation.

The best treatment approach is often a combination of all of these professionals working together to obtain a comprehensive treatment to address the physical, mental, and behavioral aspects.

When Should I See a Doctor?

If you're unsure about whether you have an eating disorder, your healthcare provider is a good place to start. Your healthcare provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating eating disorders.

You should call your healthcare provider if you have an eating disorder and you:

  • Find that your relationship with food is causing you distress.
  • Find that your relationship with food is getting in the way of your everyday activities.
  • Have chest pain, shortness of breath, or heart palpitations.
  • Have dizziness or fainting.
  • Have a severe sore throat or acid reflux.
  • Have slurred speech or blurred vision.

You Are Not Alone

If you're reading this and you're struggling with an eating disorder, please know that you're not alone. Recovery is possible, and there are people who can help you. With proper medical care and mental health counseling, you can get better. Years of living with an untreated eating disorder can harm your physical health and may lead to life-threatening problems. You don't have to keep living in this prison of your own making. You deserve to be happy, healthy, and free.

And if you know someone who is struggling with an eating disorder, please don't underestimate the power of your support and empathy.

Want To Learn More About Eating Disorders?

Eating Disorders: About More Than Food. National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/eating-disorders

Families Empowered And Supporting Treatment For Eating Disorders. https://www.feast-ed.org/

National Eating Disorders Association. https://www.nationaleatingdisorders.org/

Screen for disordered eating from the National Eating Disorders Information Institute (NEDIC). https://nedic.ca/media/uploaded/Screen_for_Disordered_Eating_-_fillable.pdf

Source Of Information

1 What Are Eating Disorders? American Psychiatric Association. https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

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