Eating Disorders
Today, 29 million Americans are impacted by eating disorders, such as anorexia, bulimia, and binge eating disorder.
Eating Disorders
Consuming foods and fluids for nourishment is essential for survival. Food provides nutrients that help the body grow, develop, and repair properly. It gives the body the energy it needs to function.
Eating disorders disrupt healthy eating patterns and interfere with physical and psychological well-being. Ranging from mild to severe, eating disorders rarely have anything to do with food. Instead, they are associated with unregulated thoughts and emotions.
An eating disorder can happen to males and females of all ages, races, cultures, and socioeconomic statuses. Anyone with an eating disorder is at risk for adverse or life-threatening consequences, however, with proper treatment and support, a person can recover from an eating disorder.
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Types Of Eating Disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lists eight types of eating disorders. Below is a description of the various types of eating disorders and their specific characteristics.
Anorexia Nervosa
Studies estimate that 4% of females and 0.3% of males have anorexia nervosa. According to the DSM-5, to determine whether a person has anorexia nervosa, they must experience the following conditions for three or more months:
- Low body weight due to restrictive food intake
- High anxiety over gaining weight and unhealthy actions that prevent weight gain
- Low self-worth due to distorted perception of body weight or shape or lack of understanding of the seriousness of low body weight
Bulimia Nervosa
Up to 3% of females and 1% of males have bulimia nervosa, an eating disorder characterized by binging large amounts of food and then purging to avoid weight gain.
According to the DSM-5, for a diagnosis of bulimia nervosa, the following behaviors must occur at least once a week for three consecutive months:
- Consuming large amounts of food within two hours
- Feeling unable to control what or how much is consumed
- Purging or elimination of the food consumed
- Equating self-worth with body weight, shape, and image
Binge Eating Disorder (BED)
Binge eating disorder is the most common type of eating disorder in the United States among people of all ages. Data shows that out of all people with an eating disorder, BED accounts for 2.6%, with a third of those being male. BED happens when large amounts of food are consumed but, unlike bulimia, a person does not purge. They do experience the negative emotions that follow a binge, however.
The DSM-5 criteria for BED are:
- Repeated episodes of binge eating larger portions than what is considered healthy
- Feeling out of control regarding eating habits
During a binge eating episode, the person does at least three of the following:
- Eats rapidly
- Feels uncomfortably full after binging
- Eats when they’re not feeling hungry
- Eats in private to avoid embarrassment
- Feels guilty, depressed, or disgusted after binging food
Avoidant Or Restrictive Food Intake Disorder (ARFID)
ARFID is diagnosed when a person does not eat enough food to provide the body with enough nutrients to be healthy, which can result in weight loss, nutritional deficiencies, and changes in psychosocial functioning.
ARFID often develops in childhood with children who experience severe picky eating behaviors, autism spectrum conditions, and attention deficit disorders at a higher risk. The prevalence of avoidant or restrictive food intake disorder is between 5% and 14% for children and adolescents. That means for every 100,000 children, two have the disorder.
Someone with ARFID may limit their food consumption to avoid gaining weight, though ARFID is not related to anorexia nervosa behaviors, according to the DSM-5. Under the criteria for diagnosis, a person with ARFID may:
- Depend on nutritional supplements to make up for nutrient deficiencies
- Avoid food intake for reasons unrelated to food access and medical conditions
- Only consume food with certain textures, regardless of how limiting that may be
- Experience gastrointestinal problems
- Experience sleeping problems
- Have dry, brittle nails and hair
- Have a weak immune system
Pica
With pica, a person craves non-food substances that do not provide nutrients. Examples include chalk, dirt, coffee grounds, eggshells, ice, paper, or soap. Research shows pica is found more often in children, people with intellectual disabilities, and pregnant women.
According to the DSM-5 criteria for diagnosis, a person with pica:
- Experiences symptoms for at least one month
- Exhibits behaviors that are not related to cultural norms or developmental age
- Is age two or older
Other Specified Feeding And Eating Disorders
In addition to the eating disorders already listed, there are other specified feeding and eating disorders. These include purging disorder, rumination disorder, night eating syndrome, atypical anorexia nervosa, sub-threshold bulimia nervosa and binge eating disorder, and orthorexia.
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How Eating Disorders Affect The Body
Eating disorders can harm the body in many ways because they deprive it of necessary nutrients needed to perform most bodily functions.
Physical Effects
Someone with an eating disorder may experience varied and widespread physical effects, including:
- Cardiovascular problems
- Increased weakness and lethargy
- Dehydration
- Weakened immune system
- Kidney damage
- Digestive issues
Cognitive Effects
A person with an eating disorder may also notice changes in their cognitive function, including:
- Lack of concentration
- Impaired memory
- Impaired brain processes
Effects on the body also depend on the type of eating disorder a person has. Below are some examples:
- Anorexia nervosa can cause loss of bone mass and hair and can disturb sleep. Chronic cases can lead to pituitary and adrenal failure.
- Bulimia nervosa can cause dental deterioration and damage to the salivary glands due to vomiting behaviors.
- BED can lead to obesity and other health conditions, including diabetes, high blood pressure, sleep apnea, and heart disease.
- ARFID worsens mental health symptoms like depression and can lead to electrolyte imbalances.
- Pica, depending on the substance a person eats, can lead to bacterial infections, choking, and poisoning.
Eating disorders often co-occur with mental and physical health disorders, including depression, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, and substance use disorders. If left untreated, symptoms typically worsen and can be life-threatening.
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Risk Factors For Eating Disorders
There’s no single reason why some people develop an eating disorder while others don’t. However, those with an eating disorder tend to have higher risk factors that contribute to the condition. Among the most significant risk factors is genetics. If someone in your family has an eating disorder, you likely carry the same genes. This risk factor, combined with others, increases your chances. Examples of risk factors for eating disorders include:
- Having a mental health disorder
- Being abused as a child
- Childhood obesity
- Self-esteem and body image insecurities
- Social media use and peer influence
- Lack of higher education
- Participating in elite sports with strict weight and body rules
- Gender, with females generally more affected than males
Treatment For Eating Disorders
Treatment for eating disorders often encompasses both psychotherapy and medical intervention. Psychotherapy can help improve and treat the mental health conditions that are often at the root of an eating disorder. A focus on social, coping, and problem-solving skills, often through individual and family therapy, is often implemented.
For those in more advanced stages of eating disorders who are suffering from dangerous physical side-effects, medical interventions, like inpatient treatment, are essential to help treat any life-threatening, physical side-effects.
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Find Help For Eating Disorders
If you are suffering from an eating disorder and are ready to get help, online therapy can provide support to get you started on your journey of recovery.
For those who are in the later stages of an eating disorder and suffer from the dangerous physical and phycological side effects, the 24-hour support provided by inpatient treatment can be necessary. Contact a treatment provider today to explore rehab options available to you.
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Ashish Bhatt, MD, MRO
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