Eating Disorders

What Are Eating Disorders?

Eating disorders are psychological conditions with both emotional and physical symptoms. The disorders include anorexia nervosa (voluntary starvation), bulimia nervosa (binge-eating followed by purging), binge-eating disorder (binge-eating without purging), and unspecified eating disorders (disordered eating that does not fit into anther category). Eating disorders occur frequently—but not exclusively—in affluent cultures. A disproportionate number of those diagnosed are young women in their teens and 20s, but anyone, including young men and older adults, can develop an eating disorder at any age. Among the most baffling of conditions, eating disorders take on a life of their own so that eating, or not eating, becomes the focus of everyday existence.

Biological factors, social pressure, and family history and dynamics are some of the factors associated with eating disorders. Culturally mediated body-image concerns and personality traits like perfectionism and obsessiveness also play a large role in eating disorders, which are often accompanied by depression and/or anxiety.

Treatment is never simple for these conditions,. They often create multiple medical problems and can even be acutely life-threatening, requiring hospitalization and forced nourishment. It can take a multidisciplinary team of of health professionals, including a psychotherapist, a medical doctor, and a specialized dietitian or nutritionist to bring about full recovery in someone with an eating disorder.

Find a Treatment Center here.

Symptoms of Eating Disorders

A disturbed relationship to food marks all eating disorders, as does emotional fragility. Since eating is a normal part of life, these are conditions marked by extremes. Eating disorders typically start out unnoticed––a person eats a little more or a little less food than usual. The urge to eat more or to eat less becomes increasingly compelling, until it can become the focus of a person's existence.

In anorexia, sufferers dramatically restrict what they eat and are markedly underweight. Symptoms include:

  • refusal to maintain a minimally normal body weight for age and height
  • intense fear of gaining weight or becoming fat
  • extreme influence of body weight or shape on self-evaluation
  • infrequent or absent menstrual periods in those who have reached puberty
  • use of either food restriction or excessive exercising to limit body weight
  • feeling cold or lethargic, due to drop in body temperature as weight loss progresses
  • growth of hair all over the body
  • dry yellowish skin
  • brittle hair and nails
  • severe constipation

In bulimia, periods of food restriction are punctuated by bouts of binge-eating and some compensatory behavior, usually purging. As a result, sufferers may appear to be normal weight. Symptoms of bulimia include:

  • recurrent episodes of binge-eating, characterized by consuming in a short amount of time an amount of food larger than most people would eat
  • during binge-eating bouts, a feeling of not being able to stop eating or control how much is consumed
  • some compensatory behavior to prevent weight gain; purging is most common, but laxative use and excessive exercising are also widely used
  • extreme influence of body weight or shape on self-evaluation
  • chronically inflamed sore throat
  • swollen glands in the neck or jaw
  • erosion of tooth enamel and frank decay as a result of exposure to stomach acids
  • dehydration due to purging of fluids
  • kidney problems from diuretic abuse

By contrast, binge-eating disorder is marked by recurrent episodes of extreme overeating not accompanied by compensatory behavior; as a result, those with the disorder are usually overweight to obese. Symptoms include:

  • eating much more rapidly than normal
  • eating until feeling uncomfortably full
  • eating large amounts of food even when not hungry
  • eating alone because of shame or embarrassment over eating behavior
  • binge-eating at least two days a week for six months or more

Causes of Eating Disorders

There is no single cause of any of the eating disorders, but they exist largely in affluent cultures where there is an abundance of food. No one knows why voluntary behaviors, such as eating smaller or larger than usual amounts of food, turn into an eating disorder for some people.

Biology plays a role: Appetite control and the regulation of food intake is highly complex, with many hormones in the brain and the body signaling hunger and satiety.

Culture is thought to also play a significant role, as women, especially, are pressured to fit an ideal of beauty that is increasingly defined by the sole criterion of body weight. Families contribute, too; parents who emphasize looks and/or dieting or who criticize their children's bodies are more likely to raise a child who develops an eating disorder.

Other circumstances figure in, too; the conditions can be triggered by stress, social difficulty, loneliness, depression, other unpleasant emotions, or by dieting itself.

Treating Eating Disorders

Medical care, including hospitalization to treat malnutrition or create weight gain, is sometimes necessary in anorexia, but psychotherapy is an essential part of any treatment plan for eating disorders. Individual, group, and family therapy, and combinations thereof, all address different aspects of these complex conditions. Antidepressants, both to improve mood and reduce obsessiveness, are often prescribed for those with eating disorders, but the jury is still out on their effectiveness.

Find a Treatment Center here.

More on Anorexia

Anorexia nervosa is an eating disorder marked by an extreme obsession with weight loss or exercise. It is especially prevalent among young to middle-aged women and, increasingly, among young men, but it can affect anyone at any age.

Characterized by a distorted sense of body image and extreme voluntary starvation or overexercising, and closely associated with perfectionism and depression, it is the most deadly psychiatric disorder. The most common behavioral signs of anorexia include extreme dieting, obsessive food rituals, and secretive and antisocial behavior.

Anorexia is highly resistant to treatment and is often accompanied by anxiety and depression. Treatment may include cognitive behavioral therapy, medication, nutrition education and management, and family-based therapies, all of which may take place at specialized eating-disorder centers. If the condition becomes life-threatening, the only recourse may be hospitalization with forced feeding, which may create ethical and legal dilemmas for all caregivers involved. 

More on Bulimia

The eating disorder known as bulimia nervosa is marked by frequent cycles of binge-eating excessive amounts of food in one sitting and then purging the food, usually by self-induced vomiting but sometimes by the use of laxatives or diuretics or nonpurging compensatory behaviors, such as fasting or overexercising. The disorder typically begins during adolescence and it can be difficult to identify because those with bulimia are often secretive about their eating and purging habits. 

Although many people with bulimia are overweight, they generally have an intense fear of weight gain and often suffer anxiety, depression, and poor self-esteem. Some signs of bulimia include unusual eating behaviors, constant weight fluctuation, frequent use of the bathroom, and avoidance of social events. Treatment usually includes cognitive-behavioral or other forms of psychotherapy, antidepressant medication, and nutrition counseling.

In Their Own Words

Eating disorders tear families apart and affect every aspect of sufferers' lives: Cognitive faculties suffer due to nutritional deficits, mood is erratic or severely depressed, and relationships are strained to the breaking point.

Case studies of anorexia and bulimia can be heartbreaking, but often they are highly instructive. Here are three women's stories.

More on Eating Disorders

Eating disorders encompass a number of other conditions. Avoidant/Restrictive Food Intake disorder is characterized by the avoidance or restriction of food intake. People with the condition may be uninterested in food, trying to avoid a negative experience they had in the past, or unsettled by particular sensory characteristics of food, such as its smell or texture. Rumination disorder is characterized by repeated regurgitation of food after eating, bringing previously swallowed food up into the mouth without displaying nausea, involuntary retching, or disgust. The food is typically then re-chewed and spit out or swallowed again. Pica is a condition characterized by the eating of one or more nonnutritive, nonfood substances on a regular basis, such as paper, soap, or hair. Those with the disorder typically do not have an aversion to food in general.


Bulimia Nervosa, Anorexia Nervosa

Recent Posts