Eating disorders are a group of serious conditions in which an individual is so preoccupied with food and weight that they most often are able to focus on little else. The three main types of eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.
Eating disorders can cause serious physical problems, and at their most severe can even be life-threatening. Most people with eating disorders are females, but males can also have eating disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females.
Treatments for eating disorders usually involve psychotherapy, nutrition education, family counselling, medications and hospitalization
The signs and symptoms of eating disorders vary with the particular type of eating disorder.
An individual suffering from anorexia nervosa is typically obsessed with food and being thin, sometimes to the extreme of deadly self-starvation.
Anorexia signs and symptoms may include:
Refusing to eat and denying hunger
An intense fear of gaining weight
Negative or distorted self-image
Flat mood or lack of emotion
Preoccupation with food
Dizziness or fainting
Soft, downy hair present on the body (lanugo)
Menstrual irregularities or loss of menstruation (amenorrhea)
Frequently being cold
Irregular heart rhythms
Low blood pressure
Individuals with bulimia, you have episodes of bingeing and purging. During a bulimic episode, the individual typically eats an excessively large amount of food in a short duration. They then attempt to rid themselves of the extra calories by vomiting or excessive exercise. Someone with bulimia may actually be at a normal weight or even a bit overweight.
Bulimia signs and symptoms may include:
Eating until the point of discomfort or pain, often with high-fat, high carbohydrate or sweet foods
Unhealthy focus on body shape and weight
Having a distorted, excessively negative body image
Going to the bathroom after eating or during meals
Feeling that you can't control your eating behavior
Abnormal bowel functioning
Damaged teeth and gums
Swollen salivary glands in the cheeks
Sores in the throat and mouth
Sores, scars or calluses on the knuckles or hands
Menstrual irregularities or loss of menstruation (amenorrhea)
Constant dieting or fasting
Binge-eating disorder, involves regularly eating excessive amounts of food which constitutes the binge. A person does not have to be hungry to trigger a binge and they continue eating even long after they’re uncomfortably full. Following a binge, the individual may try to diet or eat normal meals, however, this often triggers a new round of bingeing. They may be a normal weight, overweight or obese.
Symptoms of binge-eating disorder may include:
Eating to the point of discomfort or pain
Eating much more food during a binge episode than during a normal meal or snack
Eating faster during binge episodes
Feeling that your eating behaviour is out of control
Frequently eating alone
Feeling depressed, disgusted or upset over the amount eaten
When to seek medical assistance
Eating disorders are very complex to heal and can have a powerful pull on the individual making them difficult to manage or overcome without assistance. Eating disorders can virtually take over one’s life by causing them to think about food all the time, spend hours agonizing over what to eat, and exercise to exhaustion. Eating disorders are also often associated with feelings of shame, sadness, hopelessness and feeling drained, irritable and anxious. They can often cause a number of physical problems, such as irregular heartbeats, fatigue, bowel troubles and dizziness. If an individual is experiencing any of these problems, or if they think they may have an eating disorder, seek medical help.
Urging a loved one to seek treatment
Unfortunately, many people with eating disorders resist treatment. If there is a loved one that makes one worried, urge him or her to talk to a doctor. Even if the person’s loved one isn't ready to acknowledge having an issue with food, it may be helpful to open the door by expressing concern and a desire to listen. A parent may also want to consider contacting their child's doctor about their concerns. A physician may be able to provide a referral to qualified mental health providers for treatment.
Parents or guardians need to be careful not to mistake occasional dieting with an eating disorder. On the other hand, be alert for eating patterns and beliefs that may signal unhealthy behaviour that may trigger eating disorders.
Red flags that family and friends may notice include:
Making excuses for not eating
Eating only a few certain "safe" foods, usually those low in fat and calories
Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
Cooking elaborate meals for others, but refusing to eat them themselves
Withdrawing from normal social activities
Persistent worry or complaining about being fat
A distorted body image, such as complaining about being fat despite being underweight
Not wanting to eat in public
Frequent checking in the mirror for perceived flaws
Wearing baggy or layered clothing
Repeatedly eating large amounts of sweet or high-fat foods
Use of dietary supplements or herbal products for weight loss
The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes. Possible causes of eating disorders include:
There may be genes that make certain people more vulnerable to developing eating disorders. People with first-degree relatives — siblings or parents — with an eating disorder may be more likely to develop an eating disorder too, suggesting a possible genetic link. In addition, there's some evidence that serotonin or norepinephrin, naturally occurring brain chemicals, may influence eating behaviours.
Psychological and emotional health. People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behaviour, anger management difficulties, family conflicts and troubled relationships.
The modern Western cultural environment often cultivates and reinforces a desire for thinness. Success and worth are often equated with being thin in popular culture. Peer pressure and what people see in the media may fuel this desire to be thin, particularly among young girls.
Certain situations and events might increase the risk of developing an eating disorder. These risk factors may include:
Teenage girls and young women are more likely than teenage boys and young men to have eating disorders.
Although eating disorders can occur across a broad age range — from pre-adolescents to older adults — they are much more common during the teens and early 20s.
Eating disorders are significantly more likely to occur in people who have parents or siblings who've had an eating disorder.
People who feel less secure in their families, whose parents and siblings may be overly critical, or whose families tease them about their appearance are at higher risk of eating disorders.
People with depression, anxiety disorders and obsessive-compulsive disorder are more likely to have an eating disorder.
People who lose weight are often reinforced by positive comments from others and by their changing appearance. This may cause some people to take dieting too far, leading to an eating disorder.
Whether it's heading off to college, moving, landing a new job or a relationship breakup, change can bring emotional distress, which may increase your susceptibility to an eating disorder.
Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications. Complications may include:
Suicidal thoughts or behaviour
Absence of menstruation (amenorrhea)
Severe tooth decay
High or low blood pressure
Type 2 diabetes
Eating disorder treatment depends on an individual’s specific type of eating disorder. But in general, it typically includes psychotherapy, nutrition education and medication. If a person’s life is at risk, they may need immediate hospitalization to stabilize their health.
Individual psychotherapy can help and individual learn how to exchange unhealthy habits for healthy ones. They learn how to monitor their eating and moods, develop problem-solving skills, and explore healthy ways to cope with stressful situations. Psychotherapy can also help improve relationships. A type of psychotherapy called cognitive behavioural therapy is commonly used in eating disorder treatment, especially for bulimia nervosa and binge-eating disorder. Group therapy also may be helpful for some people.
Weight restoration and nutrition education
If an individual is underweight due to an eating disorder, the first goal of treatment will be to start getting them back to a healthy weight. No matter what their weight, health care providers can give them information about a healthy diet and help design an eating plan that can help them achieve a healthy weight and instill normal-eating habits. If a person has binge-eating disorder, they may benefit from medically supervised weight-loss programs.
If an individual has serious health problems or if they have anorexia and refuse to eat or gain weight, their doctor may recommend hospitalization. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.
Medication can't cure an eating disorder. However, medications may help an individual control urges to binge or purge or to manage excessive preoccupations with food and diet. Medications such as antidepressants and anti-anxiety medications may also help with symptoms of depression or anxiety, which are frequently associated with eating disorders.
Lifestyle and home remedies
Coping and support:
In addition to getting professional treatment for an eating disorder, there are coping skills which can be helpful:
Boost your self-esteem. Get involved in activities that interest you and that are personally rewarding. These may include learning a new skill, developing a hobby or participating in a social group in your church or community.
Be realistic. Don't accept what some of the media portray about what's a normal weight and what's an ideal body image.
Resist the urge to diet or skip meals.
Dieting actually triggers unhealthy eating and makes it difficult to cope with stress.
Remind yourself what a healthy weight is for your body, especially at times when you see images that may trigger your desire to binge and purge.
Don't visit Web sites that advocate or glorify eating disorders. These sites can encourage you to maintain dangerous habits and can trigger relapses.
Identify troublesome situations that are likely to trigger thoughts or behaviour that may contribute to your eating disorder so that you can develop a plan to deal with them.
Look for positive role models, even if they're not easy to find. Remind yourself that the ultra thin models or actresses showcased in popular magazines often don't represent healthy bodies.
Acknowledge that you may not be the best judge of whether your eating habits and weight are healthy.
Consider journaling about your feelings and behaviours. Journaling can make you more aware of your feelings and actions, and how they're connected.