Eating Disorders

Eating disorders involve consistent unhealthy behaviors in which an individual under or over-consumes food to the detriment of their physical and mental health. Eating disorders are more frequently seen in girls and women, but many boys and men are vulnerable to them as well. While most eating disorders develop during adolescence, they can also arise during early childhood or later in life.

Types of Eating Disorders

Anorexia Nervosa

A person suffering from Anorexia Nervosa severely restricts his/her food intake, resulting in a body weight that is less than minimally normal or minimally expected for that individual.

Signs and symptoms

Intense fear of gaining weight or of becoming fat
Perfectionism
Excessive concerns about weight and body shape
Distorted body image
Skipping meals, taking tiny portions, and/or avoiding eating with others
Exercising excessively or compulsively
Irregular or absent menstrual cycles in women
Purging via self-induced vomiting, laxatives, or other means
Significant weight loss
Wearing baggy clothes or layers of clothes to hide one’s body
Mood changes, including depression, guilt, and/or irritability

Bulimia Nervosa

A person suffering from Bulimia Nervosa engages in recurrent episodes of binge eating, often followed by inappropriate compensatory behaviors to prevent weight gain. Because their body weight may be close to normal, individuals with Bulimia Nervosa may be more difficult to recognize.

Signs and symptoms

Eating excessive amounts of food in discrete periods of time
Feeling out of control during binge eating episodes
Impulsivity
Use of self-induced vomiting, laxatives, diuretics or other medications, enemas, or other means purging food
Use of fasting or excessive exercise as a means of compensating for binges
Feelings of relief and contentment following purges
Secrecy around food
Feelings of disgust and shame directed toward self

Binge Eating Disorder

A person with a Binge Eating Disorder engages in recurrent binge eating. Because such behavior is not associated with inappropriate compensatory strategies, they may be overweight or obese.

Signs and symptoms

Eating excessive amounts of food in discrete periods of time
Feeling out of control during binge eating episodes
Eating much more rapidly than normal
Eating to the point of uncomfortable fullness
Overeating despite lack of physical hunger
Feelings of embarrassment, disgust, or guilt about one’s food intake
Frequently consuming food alone
Dressing to hide one’s body and weight gain

Other Specified or Unspecified Eating Disorder

More common than the eating disorders described above are those that cause significant distress or impairment but do not meet the full criteria for a specific disorder. Many of the same harmful behaviors and distressing emotions are involved, and the impact on an individual’s physical and mental health can be similarly severe.

Factors that may influence susceptibility to eating disorders

There is no single cause of eating disorders. Some evidence suggests that genetic, biological, and hormonal factors may contribute to one’s susceptibility. Situational stressors, both positive and negative, can trigger the onset of an eating disorder. A variety of factors most often converge in the development of eating disorders. Some of the most common precipitants include:

Family Factors

Family history of eating disorder or obesity
Parental criticism or ridicule
Family history of addiction, emotional or psychological disorders
Unhealthy food rules in the family

Cultural Factors

Social judgment about weight and body size
Conflicting media promotions of ultra-thin bodies and super-sized foods
Unhealthy standards of attractiveness within different cultural groups

Psychological Factors

Emotional insecurity and/or helplessness
High-stress levels
Extreme self-criticism, particularly regarding one’s body and appearance
Perfectionism
Traumatic events such as sexual abuse, assault, or rape
Fears of sexual development

Treatment

Recovery from eating disorders is possible, although treatment is difficult and long term. Because changing such deeply ingrained habits and beliefs is so challenging, early detection is an important part of successful treatment. Individuals working toward recovery from eating disorders can expect relapses as part of the process. They must remain hopeful and engaged, and they can certainly emerge successful.

Treatment approaches for eating disorders may take place in either inpatient or outpatient settings, depending upon the severity of the disorder. Treatment can include:

Psychotherapies: Various approaches, particularly cognitive-behavioral therapy, can be effective in treating eating disorders.
Medications: Treating co-existing psychiatric conditions can be important in the comprehensive care of an individual with an eating disorder.
Nutritional counseling: Psychoeducation, food planning, and/or meal monitoring help individuals learn and re-shape their relationships with food.
Therapeutic activities: Art therapy, equine-assisted therapy, and movement-oriented activities can assist in the recovery process.
Family therapy: The support of family members, including parents, siblings, and/or spouses, can be key in helping an individual remain in recovery.

How can you be supportive of a person with an eating disorder?

Educate yourself. Recognize the significant emotional, psychological and physiological struggles involved with eating disorders.
Avoid making negative comments about anyone’s eating habits, weight, or body shape.
Show interest in aspects of life not related to food or body image. Focus on health and emotional well-being.
Remain non-judgmental and compassionate. Strive to understand.
Convey your concern for the person’s health and happiness.
Have boundaries in your attention to the issue. Address your concerns directly and offer resources for support, but do not attempt to shame or force the person into treatment.