Eating disorders have long been misunderstood, and now, even with extensive research and study, many people still hold false assumptions about these illnesses. Having an eating disorder is not simply a choice or a matter of will power. Eating disorders are real behavioral disorders and can be diagnosed and treated as psychiatric conditions.
There are several types of eating disorders, and it is crucial to seek treatment or to help a loved one get treatment for any of them. Left untreated these conditions can spiral out of control and cause serious health problems, including death. Good nutrition is so important for both physical and mental health. When eating becomes disordered nutrition suffers and along with it so does mental, emotional, and physical well-being.
What Are Eating Disorders?
Eating disorders are psychological, psychiatric, mental, or behavioral disorders that are characterized by disordered and abnormal eating habits as well as extreme attitudes about eating and emotions about food or weight. Most eating disorders cause obsessions with weight, appearance, body image, food, and sometimes exercise. These are not conditions to be taken lightly. Eating disorders have huge impacts on a person’s life and both mental and physical well-being and can even be life-threatening.
Who Gets Eating Disorders?
Young women are most often associated with eating disorders, but these conditions do not discriminate. The pressures placed on women to be thin may trigger some of the obsessive thoughts about weight and eating that are characteristic of eating disorders, but these conditions go much deeper than that and anyone can develop the behaviors of an eating disorder.
According to the National Institute of Mental Health, about three percent of adults will have an eating disorder at some point in their lives. For women only the rate is 3.5 percent, while for men it is two percent. Among children, under the age of 18, the prevalence of a lifetime eating disorder is 2.7 percent of the population. This includes four percent of girls and only 1.5 percent of boys.
Anorexia nervosa, often called just anorexia, is what most people think of when they hear the term eating disorder. It is a condition that causes a person to believe that she is overweight and to obsess over weight and take extreme measures to lose weight. Although young women are most often affected, men can develop anorexia too. The most common characteristics of anorexia are obsession with weight and restricted eating.
Mortality rates are higher for anorexia than for any other mental health disorder. This illness can be fatal because the body is essentially starved. The condition can be so severe that a person does not consume enough calories or enough nutrients until it becomes fatal. Anorexia may cause osteoporosis, anemia, muscle wasting, low blood pressure, constipation, slowed breathing, brain damage, organ failure, and infertility. Suicide is also more likely in a person with anorexia than with any other mental health condition. Symptoms and signs of anorexia include:
- Extreme food restriction
- Extreme weight loss and thinness
- Inability to maintain a healthy weight
- Extreme fear of weight gain
- Distorted body image – perception of being overweight even while extremely thin
Someone with bulimia is also obsessed with weight and food, but the resulting behaviors differ from anorexia. Bulimia is characterized by a cycle of binging on food and then purging it. The purging method can vary, but is often vomiting after binging. A person with bulimia may also purge by using laxatives, by exercising excessively, by fasting, or with a combination of strategies. The person feels out of control when binging, then guilty, ashamed, and embarrassed after, which leads to purging.
Unlike with anorexia, someone with bulimia is likely to maintain a normal weight. This can make it more difficult to recognize in a loved one. A person with bulimia is likely to be secretive about both binging and purging, often doing one or both in private. Some of the symptoms of bulimia include an inflamed and sore throat, acid reflux, and worn down tooth enamel from excessive vomiting. It may cause gastrointestinal distress from laxative use or dehydration.
Binge Eating Disorder
Binge eating disorder (BED) is similar to bulimia, but there is no purging or limited purging. This condition is characterized by loss of control when eating. People with BED tend to be overweight. This is the most common eating disorder. Not everyone who is overweight or obese has a binge eating condition, though. As with bulimia, it can be difficult to realize that a loved one is binging because it is often done in secret. Some symptoms and signs of BED include:
- Eating excessive amounts of food in a short amount of time
- Eating quickly during a binge and without thinking
- Eating even when not hungry
- Eating to the point of being uncomfortable
- Eating to excess in secret
- Feeling guilty or ashamed after eating
- Dieting often, but without losing weight
Other Eating Disorders
Anorexia, Bulimia, and BED are the three main types of eating disorders, but not every example of disordered eating falls neatly into the diagnostic parameters of one of these. If the symptoms are similar but not enough to meet the criteria for anorexia, bulimia, or BED, a person may be diagnosed with EDNOS, eating disorder not otherwise specified.
Some of the behaviors that may fall into the EDNOS category include purging, but without binging first as with bulimia. Infrequent binge eating may be categorized as EDNOS, as can night eating, when a person tends to binge at night only. Anorexic behaviors that are not yet extreme may also be diagnosed in this category. It is important to take a diagnosis of EDNOS seriously because although the person has not yet matched the diagnostic criteria for anorexia, bulimia, or BED, things can change quickly and become much more serious and harmful without monitoring or treatment.
Nutrition and Mental Health
There is a complicated relationship between food and nutrition and mental health. The issues associated with eating disorders may seem, on the surface, to be related to image, but they are often much more complicated. For instance, many people with anorexia report feeling a need to have control over something in their lives, and that restricting food intake gives them that sense of control in an otherwise chaotic existence.
Physical and mental health are also intertwined, so that good nutrition and bad nutrition alike can have a major impact on mental well-being. It is well known that good nutrition impacts all aspects of physical health and that nutritional deficits can cause illnesses and physical symptoms, but what is becoming better understood through research is that the same can be said for mental health and symptoms.
Some examples include omega-3 fatty acids and vitamin D. The fatty acids have been found to improve the symptoms of psychosis. Vitamin D has been found to improve depression and bipolar disorder. Another example is the neurotransmitter naturally made in the body called serotonin. It plays a role in regulating mood and has been found to be impacted by bacteria in the gut. In studies researchers have found that people who take probiotic supplements —supplements that add so-called healthy bacteria to the gut—see improvements in stress, depression, and anxiety.
When people struggle with eating disorders, they do not eat a healthy diet. Their eating has become disordered and that in itself is a problem, but it can also have ripple effects. Poor nutrition, whether that means not eating enough or binging on junk food can have negative impacts on mental health that only exacerbate the underlying eating disorder.
Treating Eating Disorders
It is so important to get treatment for eating disorders. The effects on mental and physical well-being can be extreme and these illnesses can even lead directly to death. Treatment for eating disorders involves both treating the physical problems, such as a low weight or a nutritional deficiency, and the underlying mental health issues. In extreme cases, especially with anorexia, a patient may be hospitalized.
Treatment involves therapy, counseling for nutrition and diet, medications like antidepressants or anti-anxiety drugs, and medical care. Therapy is one of the most important aspects of eating disorder treatment. A medication cannot cure this illness and can cause serious complications as well. Therapy may be individual, in a group, or with family support. The goal of therapy is to help a patient change her negative thought patterns and her behaviors. Eating disorders are considered chronic illnesses, and treatment should be ongoing and regular.
If you feel you may have some of the symptoms of eating disorders or you are worried that you are seeing them in a loved one, don’t hesitate to reach out. Many people struggle with an eating disorder, so you are not alone, and getting treatment is the only way to overcome this illness.