When someone develops a feeding or eating disorder, the reasons why may go beyond comparisons to the skewed modern standards of beauty. Potential triggers include stress, bullying, genetic tendencies, and changes in brain chemicals.1 Eating disorders can also occur with anxiety, depression, substance use disorder and other conditions.
Though teenage girls and young women have been prone to develop eating disorders, the National Eating Disorders Association (NEDA) reports that about one in three people struggling with an eating disorder are male.2 Disordered eating habits tend to form from the teens through earrly 20s, but they can occur at any age, including childhood.
Eating disorders go beyond a lifestyle choice or a change in diet. The American Psychiatric Association (APA) defines them as “Abnormal eating habits that can threaten your health or even your life.” Their Diagnostic and Statistical Manual of Mental Disorders (DSM-5) covers a range of eating disorders, some of which we’ll explore below.
Types of eating disorders
Besides the typical symptoms, eating disorders can involve laxative use, excessive exercise, and obsession with “fad” diets.
Anorexia Nervosa – When people don’t eat enough food or restrict their eating habits so they won’t gain weight, they may suffer from anorexia. People with anorexia can have a distorted view of their bodies, believing they weigh more than they do and obsessing over weight gain. In its extreme form, people with anorexia may look gaunt, however, not everyone with anorexia is underweight.
Among the physical signs of anorexia are insomnia, missing or irregular periods, and dry skin and nails. Emotional and behavioral symptoms include dressing in layers to hide weight loss, denying feeling hungry, and having a strong need for control.
Bulimia Nervosa – Bulimia involves regular consumption of lots of food at once — often in secret — which the person disposes of through self-induced vomiting, laxatives, or other means. People diagnosed with bulimia often feel a lack of control over their eating habits and will binge and purge, on average, at least once a week for three months.3 They may feel guilty for overeating and then purge to compensate for the behavior and prevent weight gain. It’s important to note that an individual with bulimia will not always appear to have lost weight.
A few common signs of bulimia to look out for include: dental issues caused by stomach acids, calloused fingers from induced vomiting, unusual absences surrounding meals and the appearance of empty diuretic and/or laxative bottles.
Binge Eating Disorder (BED) – Like people with bulimia, those with BED eat lots of food quickly, often to the point of discomfort. They can also feel a loss of control during their binges. Sufferers can feel shame and guilt over not purging the food afterward and from leaving empty food wrappers or containers behind. They may eat when they don’t feel hungry, and complain of stomach cramps or other discomfort. Their weight can also fluctuate. The NEDA reports that BED is the most common eating disorder in the U.S. It can be diagnosed in people of any weight.
Avoidant Restrictive Food Intake Disorder (ARFID) – Once known as “Selective Eating Disorder,” people with ARFID limit the amount and/or types of food they eat. The most mild example being, people who are referred to as, “picky eaters.” As a result, people with ARFID may experience major weight loss and nutritional deficiencies. Experts suggest ARFID doesn’t involve weight or body image issues. It’s linked to mental health conditions, including obsessive-compulsive disorder (OCD), depression, anxiety and intellectual and developmental disabilities. Sufferers often avoid certain foods due to fear of vomiting, allergic reactions or extreme dislike of certain flavors or textures.
Pica – People with pica tend to eat items such as hair, dirt or paper. Among the more rare eating disorders, it’s tied to intellectual and developmental disabilities and mental health conditions like schizophrenia and hair-pulling disorder (trichotillomania). Similar symptoms can also occur during pregnancy or as signs of an iron or other nutritional deficiency. The NEDA recommends not testing children under two for pica, as children this age tend to put small objects in their mouths as a part of their natural development.
Other Specified Feeding or Eating Disorders (OSFED) – The DSM-5 used to classify this as “Eating Disorder Not Otherwise Specified (EDNOS).” And, as the name implies, it’s a “catch-all” term for severe conditions that fall outside the strict diagnostic criteria of known eating disorders.3
The hidden effects of disordered eating
Lab tests for nutrient imbalances, electrolyte imbalances and other deficiencies may not always detect the signs of an eating disorder. As the NEDA puts it, “The body is generally resilient at coping with the stress” of eating disorders, and test results “can generally appear perfect even as someone is at high risk of death.” However, when someone doesn’t get proper nutrients, the body can and will reduce its processes to save energy, which can lead to serious health problems such as heart attack, kidney failure and osteoporosis.
When is it a problem?
The National Association of Anorexia Nervosa and Associated Disorders (ANAD) suggests you ask yourself, “How much time do I spend thinking about food, weight, and body image?” Doing so can help you determine how much these thoughts influence your life and well-being. If your eating habits interfere with your ability to function, you may have a problem. Before something serious happens, know that recovery is an option and help is available.
Standard treatment typically uses a combination of psychological and nutritional counseling with medical and psychiatric monitoring to address the causes and symptoms of eating disorders.
If you or someone you know may have an eating disorder, contact us today.