Eating Disorder Symptoms, Types and Treatment Methods
What are Eating Disorders?
An eating disorder is defined as a continual disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food, significantly impairing physical health or psychological and social functioning.
Eating disorders are often long-term problems, which can cause immeasurable suffering for victims and their families.
There are generally two recognized types of eating disorders:
1. Anorexia Nervosa (AN)
This disorder's name means "loss of appetite." In reality, the person has not actually lost their appetite, but chooses to deny the hunger because of an unreasonable fear of becoming fat. If left untreated, anorexia nervosa can be fatal, with an estimated fatality rate of 6% in serious cases.
Restrictive Type: Individuals with this specific type of anorexia nervosa limit the amount of food they eat, typically eliminating foods that contain fat. These individuals also tend to exercise excessively to assist in weight loss.
Binge Eating/Purging Type: These individuals are first diagnosed with the restrictive type of anorexia nervosa and then begin to regularly engage in the binge eating and purging behaviors that are more commonly linked with bulimia nervosa.
Individuals with anorexia nervosa can be further categorized based on their eating behaviors.
2. Bulimia Nervosa (BN)
This eating disorder is described by repeated episodes of binge eating, during which large amounts of food are consumed in a short period of time (sometimes as many as 20,000 calories). To be diagnosed with bulimia nervosa, binge eating needs to occur at least twice every week for a 3-month period. As a result of the repeated binge eating, the person often feels depressed and guilty.
Purging Type: Individuals with this specific type of bulimia nervosa will have an episode of binge eating followed by self-induced vomiting, abuse of laxatives and/or diuretics (water-pills) to avoid gaining weight from the binge.
Non-Purging Type: Individuals with this specific type of bulimia nervosa will have an episode of binge eating and then use other behaviors to offset the behavior, such as fasting or excessive exercise. Individuals with this type of bulimia nervosa do not regularly engage in self-induced vomiting or the misuse of laxatives and/or diuretics.
Individuals with bulimia nervosa can be further categorized based on their purging behaviors.
Many times it is difficult to differentiate between anorexia nervosa and bulimia nervosa. Every individual who resorts to binge eating and purging may not be classified as bulimic because of the subgroup of patients diagnosed with anorexia nervosa who may also display these behaviors. Furthermore, a large percentage of individuals may have both eating disorders at the same time. It has been estimated that 50% of anorexics will develop bulimia nervosa and that 30% to 40% of bulimics will develop anorexia nervosa.
3. Binge Eating Disorder (BED)
This eating disorder is characterized by recurrent consumption of large amounts of food without purging, fasting, or excessive exercise. The difference between binge eating disorder and non-purging type bulimia nervosa is the behavior that takes place after binge eating. In non-purging type bulimia nervosa after binge eating the individual will try to offset their calorie consumption by fasting or excessive exercise. In binge eating disorder the individual does nothing to offset the calorie consumption.
What is EDNOS?
EDNOS, Eating disorder not otherwise specified, is described as a category disorders of eating that do not meet the criteria for any specific eating disorder. People diagnosed with EDNOS may frequently switch between different eating patterns, or may with time fit all diagnostic criteria for anorexia or bulimia. People who eat a normal amount of food, but become exceedingly obsessed with healthy eating, or strictly categorize normal foods or entire food groups as "safe" and "off-limits", may be referred to as having orthorexia. However, this diagnosis is not formally accepted by the psychiatric community.
What causes Eating Disorders?
The exact cause of eating disorders is unknown; however, physical, psychological, personal, and social issues have been associated with triggering eating disorders.
The social pressure to be thin affects everyone to some extent. Society is flooded with messages on TV, in the movies, in magazines, on billboards, and on the Internet that thinness brings beauty, success, and happiness. These messages can also come from an individual's family structure, culture, and way of life. Social and cultural pressures along with a low self-esteem are thought to be the major causes for the development of anorexia nervosa and bulimia nervosa. Compare your technique with the methods recommended in our Using Medicine section.
No one factor causes an eating disorder, but a few or a combination of factors may increase the risk.
Here are some common psychological factors that may contribute to developing eating disorders:
For anorexia:
- fear of growing up
- inability to separate from the family
- need to please or be liked
- perfectionism
- need to control
- need for attention
- lack of self esteem
- high family expectations
- parental dieting
- family discord
- temperament - often described as the "perfect child"
- teasing about weight and body shape
For bulimia:
- difficulty regulating mood
- more impulsive - sometimes with shoplifting, substance abuse, etc.
- sexual abuse
family dysfunction - If individuals are at risk of developing an eating disorder, sometimes all it takes to put the ball in motion is a trigger event that the individual does not know how to handle. A trigger could be something as seemingly harmless as teasing or as devastating as rape.
Who has Eating Disorders?
Currently, it is estimated that 7 million women and 1 million men suffer from an eating disorder. Eating disorders have reached epidemic levels in America in all segments of society; however, eating disorders are most common in individuals who have a higher social or economic background. This may be due to the fact that these individuals are continually striving to achieve the social standards of thinness in order to be accepted into their chosen career or lifestyle.
Almost all (86%) anorexics and bulimics begin their eating disorder related behaviors by the age of 20; however, reports that eating disorders are occurring in children 8 to 11 years of age are on the rise. Also, adults are not immune to eating disorders. A significant number of newly diagnosed anorexics and bulimics are in their upper 20s, 30s, and 40s.
It is estimated that about 6% of persons with serious cases of eating disorders die and only 50% report being cured. Therefore, it is a debilitating disease that has consequences if it is not realized (by the individual or people around them) and treated correctly.
What are the risk factors of Eating Disorders?
Risk factors are characteristics that can make you more likely to develop a condition. The risks associated with developing an eating disorder are related to the following:
- Family history of anorexia nervosa or bulimia nervosa
- Less than 20 years of age
- Female gender
- Participating in activities that focus on weight, appearance, and lean body mass (for example, ballet, modeling, gymnastics, acting, figure skating, running, diving)
- Existing psychiatric illness such as obsessive-compulsive disorder (a type of anxiety distinguished by patterns of repetitive thoughts and behaviors) or depression.
- Presence of personality traits such as being a perfectionist (having the best or expecting the best at all times) and low self-esteem.
Symptoms of Eating Disorders
- The main symptom of anorexia nervosa is self-induced starvation.
- The main symptom of bulimia nervosa is binge eating with purging.
- The main symptom of binge eating is out of control eating without purging.
These disorders may become a compulsive addiction such as alcoholism. Most patients with anorexia nervosa, bulimia nervosa, and binge eating disorder report psychological impairments (mainly depression), shame, guilt, and withdrawal from social events.
Because many people are concerned about their weight, most people diet at least once in a while; however, it may be difficult to distinguish between normal dieting behaviors and abnormal dieting behaviors that could develop into a serious eating disorder. Not every individual will show all of the characteristics listed below for anorexia nervosa and bulimia nervosa, but people with eating disorders may clearly show several of them.
Signs of anorexia nervosa may include the following:
- Intentional self-starvation associated with weight loss
- Intense, persistent fear of gaining weight
- Refusal to eat, except tiny portions
- Pretending to eat and trying to hide that you are not eating from others
- Continuous dieting
- Excessive facial/body hair due to inadequate protein in diet (malnutrition)
- Abnormal, rapid weight loss
- Hair loss - mainly on the head
- Dry, cracked, or discolored skin
- Sensitivity to cold temperatures
- Absent or irregular menstruation.
Signs of bulimia nervosa may include the following:
- Constantly thinking about food
- Binge eating, usually in secret
- Vomiting after binging
- Abuse of laxatives, diuretics, diet pills
- Denial of hunger
- Denial of induced vomiting
- Swollen salivary glands
Anorexia nervosa and bulimia nervosa are closely related and several characteristics of the two eating disorders often overlap.
Signs associated with both anorexia nervosa and bulimia nervosa may include the following:
- Poor body image (constant thoughts of thinness)
- Malnutrition
- Anxiety
- Lethargy (sluggish, inactive, or slow moving)
- Decreased concentration
- Abdominal pain
- Constipation/diarrhea
- Bloating
- Compulsive exercise (a person feels compelled to exercise and struggles with guilt and anxiety if she or he doesn't exercise)
If continued, the starving, binge eating, and purging can lead to irreversible physical damage and even death. Eating disorders can affect every cell, tissue, and organ in the body. The following is a list of some of the physical and medical dangers associated with anorexia nervosa and bulimia nervosa.
- Malnutrition (can lead to loss of muscle and bone density [osteoporosis] resulting in dry, brittle bones)
- Severe dehydration, which can result in kidney failure and chemical imbalances (can lead to seizures, irregular heartbeats and possibly heart failure and death)
- Tearing of the esophagus from excessive vomiting
- Chronic irregular bowel movements and constipation as a result of laxative abuse
- Potential for a ruptured stomach during periods of binge eating
- Tooth decay and gum erosion from stomach acids released during frequent vomiting
- Irregular menses or absence of menstruation
- Abnormally low blood pressure.
How are Eating Disorders Treated?
There are many factors that contribute to the development of an eating disorder, and because each individual's situation is different, the "best treatment" must be tailored for that individual. The process begins with an evaluation by a physician or psychiatrist. From there, a variety of approaches are used to treat individuals with anorexia nervosa and bulimia nervosa.
Nutritional Therapy
A professional nutritionist or dietician can help patients learn how to manage their weight effectively. Individualized guidance and a meal plan that provides a framework for meals and food choices (but not a rigid diet) are helpful for most individuals. Nutritionists can also help individuals better understand how their eating disorders can create serious medical problems.
Drug Therapy
Drug therapy in the treatment of anorexia nervosa and bulimia nervosa should be used in combination with psychotherapy and nutritional therapy.
For anorexia nervosa, medications are used most frequently after weight and normal eating behaviors have been restored. Medications including certain antidepressants, antipsychotics, and gastrointestinal stimulants are used to treat psychiatric and gastrointestinal symptoms that may coincide with eating disorders. Also calcium plus vitamin D supplementation is recommended for people with low bone mineral density (BMD) because of their high risk of developing bone loss and/or osteoporosis.
Eating Disorder Articles
| Pub. Date | Topic | Author |
|---|---|---|
| 2012-02-07 | Orthorexia Nervosa - Fact or Fictionional Eating Disorder | Wendy Taormina-Weiss |
| 2012-01-04 | Calculating Weight in Children with Eating Disorders - Experts Urge BMI Method | University of Chicago Medical Center |
| 2011-02-22 | Online Secret Society | University of Cincinnati |
| 2011-02-21 | Hollywood Celebs Eating Kleenex to Stay Thin | Timberline Knolls Residential Treatment Center |
| 2011-02-07 | Users of Facebook Prone to Eating Disorders | University of Haifa |
| 2010-10-28 | Patients Can't Hide Eating Disorders From Dentists | Academy of General Dentistry |
| 2010-06-19 | Anorexia Treatment and Recovery Book | Timberline Knolls Residential Treatment Center |
| 2010-06-17 | Body-image Distortion Predicts Onset of Unsafe Weight-loss Behaviors | University of Illinois at Urbana-Champaign |
| 2010-05-12 | Binge Eating Disorder Linked to Childhood Sexual or Emotional Abuse | Jewish General Hospital |
| 2009-01-26 | Do you Have an Eating Disorder | Disabled World |
- Eating Disorder - An eating disorder is an illness that causes serious disturbances to your everyday diet, such as eating extremely small amounts of food or severely overeating. A person with an eating disorder may have started out just eating smaller or larger amounts of food, but at some point, the urge to eat less or more spiraled out of control. Severe distress or concern about body weight or shape may also characterize an eating disorder. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. Eating disorders such as anorexia, bulimia, and binge eating disorder include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.
