Recognizing an Eating Disorder
There is a common misconception that eating disorders are a choice, but that is not the case. Eating disorders are a behavioral condition characterized by an unhealthy relationship with food. These disorders can severely impact a person's physical, psychological and social function.
In the United States, 28.8 million Americans will suffer from an eating disorder at some point in their lives, according to the National Eating Disorders Association (NEDA).
For the purpose of awareness, we describe four common eating disorders: Anorexia, bulimia, binge-eating and avoidant restrictive food intake disorder.
Eating Disorders and Their Symptoms
Anorexia nervosa
People with anorexia avoid or severely restrict food, or eat very small portions of only a certain type of food.
Physical and behavioral symptoms include:
- Dramatic weight loss
- Dressing in layers to hide weight loss or stay warm
- Fixation with weight, food, calories, fat grams, and dieting
- Making frequent comments about feeling "fat" or overweight
- Resisting or being unable to maintain a body weight appropriate for age, height, and build
- Maintaining an excessive, rigid exercise regime – despite weather, fatigue, illness, or injury
People with this condition are at a higher risk of dying due to medical conditions associated with starvation. Suicide is the second leading cause of death among individuals with this condition.
Learn more about anorexia nervosa.
Bulimia nervosa
Bulimia is a serious and potentially life-threatening eating disorder developed from compensatory behaviors after eating, such as self-induced vomiting.
Physical and behavioral symptoms include:
- Any new practice with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
- Skipping meals or taking small portions of food at regular meals
- Evidence of purging behaviors, such as numerous trips to the bathroom after meals
- Signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
- Using excessive amounts of mouthwash, mints, and gum
The health risks associated with recurrent binge-and-purge cycles of bulimia can affect the entire digestive system and can lead to imbalances in the body that affect the heart and other major organ functions.
Learn more about bulimia nervosa.
Binge-eating
Binge-eating disorder (BED) is a severe and treatable disorder that involves recurrent episodes of eating large amounts of food.
Physical and behavioral symptoms include:
- Fluctuations in weight
- Evidence of large amounts of food eaten, such as empty wrappers and containers
- Feelings of disgust, depression, or guilt after overeating
- Feeling out of control over ability to stop eating
- Stomach cramps and other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
Health risks associated with BED include those associated with obesity and weight stigma.
Learn more about BED.
Avoidant restrictive food intake disorder
Avoidant restrictive food intake disorder (ARFID), previously referred to as "selective eating disorder," is similar to anorexia in restricting the amount or types of food consumed, however, those with ARFID do not experience any concerns about body shape or size.
Physical and behavioral symptoms include:
- Dramatic weight loss
- Reports of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
- Reports of consistent gastrointestinal issues such as an upset stomach or feeling full around mealtimes with no known cause
- Dramatic restriction in types or amount of food eaten
- Will only eat certain textures of food
- Fears of choking or vomiting
- Lack of appetite or interest in food
While it may seem like "picky eating," those with ARFID are at risk for health conditions because the body is not getting the proper nutrients it needs to function.
Learn more about ARFID.
Risk Factors and Prevention
Similar to other health conditions, eating disorders can develop for a variety of different reasons, including biological, psychological and social conditions. These conditions include anxiety, history of dieting, type 1 diabetes, family history of eating disorders, weight stigma and body image concerns, low self-esteem, being teased or bullied about their body, acculturation and trauma.
Because the risk factors for an eating disorder vary from person to person, it's difficult to determine a single prevention tactic, however, there are efforts to lower these risk factors by reducing negative responses such as low self-esteem and anxiety. Additionally, it's important that people surround themselves with others who have a positive impact on them and make them feel good about themselves.
Treatment
If you or someone you love is experiencing dramatic weight fluctuations, showing extreme concern with body weight and shape or experiencing other symptoms of an eating disorder, it may be time to seek professional help.
Diagnosing an eating disorder is the first step to treating it, but the real treatment typically involves a combination of psychological and nutritional counseling along with medical and psychiatric monitoring. While your primary care physician may not be your primary treatment provider, you are in a safe space to discuss your concerns with them and they will work with you to find a treatment option that is best for you.
NEDA has a plethora of helpful resources, including questions to bring to your treatment provider; toolkits for parents, coaches and educators; and free and low cost support.
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