Eating disorders are illnesses in which people experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become pre-occupied with food and their body weight.
Eating disorders affect several million people at any given time, most often women between the ages of 12 and 35. There are three main types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder.
People with anorexia nervosa and bulimia nervosa tend to be perfectionists with low self-esteem and are extremely critical of themselves and their bodies. They usually “feel fat” and see themselves as overweight, sometimes even despite life-threatening semi-starvation (or malnutrition). Intense fear of gaining weight and of being fat may become all-pervasive. In the early stages of these disorders, patients often deny that they have a problem.
In many cases, eating disorders occur together with other psychiatric disorders like anxiety, panic, obsessive-compulsive disorder, and alcohol and drug abuse problems. New evidence suggests that heredity may play a part in why certain people develop eating disorders, but these disorders also afflict many people who have no prior family history. Without treatment of both the emotional and physical symptoms of these disorders, malnutrition, heart problems and other potentially fatal conditions can result. However, with proper medical care, those with eating disorders can resume suitable eating habits, and return to better emotional and psychological health.
Summary Eating disorders may be caused by several factors. These include genetics, brain biology, personality traits, and cultural ideals.
Anorexia Nervosa
Anorexia nervosa is diagnosed when patients weigh at least 15 percent less than the normal healthy weight expected for their height. Hallmarks of anorexia include:
- Limited food intake
- Fear of being “fat”
- Problems with body image or denial of low body weight
People with anorexia nervosa don’t maintain a normal weight because they refuse to eat enough, often exercise obsessively, and sometimes force themselves to vomit or use laxatives to lose weight. Over time, the following symptoms may develop as the body goes into starvation:
- Menstrual periods cease
- Osteopenia or osteoporosis (thinning of the bones) through the loss of calcium.
- Hair/nails become brittle
- Skin dries and can take on a yellowish cast
- Mild anemia; and muscles, including the heart muscle, waste away
- Severe constipation
- Drop-in blood pressure slowed breathing and pulse rates
- Internal body temperature falls, causing a person to feel cold all the time
- Depression and lethargy
Bulimia Nervosa
Bulimia nervosa is another well-known eating disorder.
Like anorexia, bulimia tends to develop during adolescence and early adulthood and appears to be less common among men than women .
People with bulimia frequently eat unusually large amounts of food in a specific period of time.
Each binge eating episode usually continues until the person becomes painfully full. During a binge, the person usually feels that they cannot stop eating or control how much they are eating.
Binges can happen with any type of food but most commonly occur with foods the individual would normally avoid.
Individuals with bulimia then attempt to purge to compensate for the calories consumed and relieve gut discomfort.
Common purging behaviors include forced vomiting, fasting, laxatives, diuretics, enemas, and excessive exercise.
Symptoms may appear very similar to those of the binge eating or purging subtypes of anorexia nervosa. However, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight.
Common symptoms of bulimia nervosa include :
- recurrent episodes of binge eating with a feeling of lack of control
- recurrent episodes of inappropriate purging behaviors to prevent weight gain
- self-esteem overly influenced by body shape and weight
- a fear of gaining weight, despite having a normal weight
Side effects of bulimia may include an inflamed and sore throat, swollen salivary glands, worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration, and hormonal disturbances .
In severe cases, bulimia can also create an imbalance in levels of electrolytes, such as sodium, potassium, and calcium. This can cause a stroke or heart attack.
Summary People with bulimia nervosa eat large amounts of food in short periods of time, then purge. They fear gaining weight despite being at a normal weight.
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Binge Eating Disorder
Binge eating disorder is believed to be one of the most common eating disorders, especially in the United States
It typically begins during adolescence and early adulthood, although it can develop later on.
Individuals with this disorder have symptoms similar to those of bulimia or the binge eating subtype of anorexia.
For instance, they typically eat unusually large amounts of food in relatively short periods of time and feel a lack of control during binges.
People with binge eating disorder do not restrict calories or use purging behaviors, such as vomiting or excessive exercise, to compensate for their binges.
Common symptoms of binge eating disorder include :
- eating large amounts of foods rapidly, in secret, and until uncomfortably full, despite not feeling hungry
- feeling a lack of control during episodes of binge eating
- feelings of distress, such as shame, disgust, or guilt, when thinking about the binge eating behavior
- no use of purging behaviors, such as calorie restriction, vomiting, excessive exercise, or laxative or diuretic use, to compensate for the binging
People with binge eating disorder often have overweight or obesity. This may increase their risk of medical complications linked to excess weight, such as heart disease, stroke, and type 2 diabetes.
Summary People with binge eating disorder regularly and uncontrollably consume large amounts of food in short periods of time. Unlike people with other eating disorders, they do not purge.
Pica
Pica is another eating disorder that involves eating things that are not considered food.
Individuals with pica crave non-food substances, such as ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent.
Pica can occur in adults, as well as children and adolescents. That said, this disorder is most frequently observed in children, pregnant women, and individuals with mental disabilities
Individuals with pica may be at an increased risk of poisoning, infections, gut injuries, and nutritional deficiencies. Depending on the substances ingested, pica may be fatal.
However, to be considered pica, the eating of non-food substances must not be a normal part of someone’s culture or religion. Besides, it must not be considered a socially acceptable practice by a person’s peers.
Summary Individuals with pica tend to crave and eat non-food substances. This disorder may particularly affect children, pregnant women, and individuals with mental disabilities.
Rumination Disorder
Rumination disorder is another newly recognized eating disorder.
It describes a condition in which a person regurgitates food they have previously chewed and swallowed, re-chews it, and then either re-swallows it or spits it out.
This rumination typically occurs within the first 30 minutes after a meal. Unlike medical conditions like reflux, it’s voluntary .
This disorder can develop during infancy, childhood, or adulthood. In infants, it tends to develop between 3–12 months of age and often disappears on its own. Children and adults with the condition usually require therapy to resolve it.
If not resolved in infants, rumination disorder can result in weight loss and severe malnutrition that can be fatal.
Adults with this disorder may restrict the amount of food they eat, especially in public. This may lead them to lose weight and become underweight .
Summary Rumination disorder can affect people at all stages of life. People with the condition generally regurgitate the food they’ve recently swallowed. Then, they chew it again and either swallow it or spit it out.
Avoidant/Restrictive Food Intake Disorder
Avoidant/restrictive food intake disorder (ARFID) is a new name for an old disorder.
The term replaces what was known as a “feeding disorder of infancy and early childhood,” a diagnosis previously reserved for children under 7 years old.
Although ARFID generally develops during infancy or early childhood, it can persist into adulthood. What’s more, it’s equally common among men and women.
Individuals with this disorder experience disturbed eating either due to a lack of interest in eating or distaste for certain smells, tastes, colors, textures, or temperatures.
Treatment
Eating disorders clearly illustrate the close links between emotional and physical health. The first step in treating anorexia nervosa is to assist patients with regaining weight to a healthy level; for patients with bulimia nervosa interrupting the binge-purge cycle is key. For patients with binge eating disorder, it is important to help them interrupt and stop binges.
However, restoring a person to normal weight or temporarily ending the binge-purge cycle does not address the underlying emotional problems that cause or are made worse by the abnormal eating behavior. Psychotherapy helps individuals with eating disorders to understand the thoughts, emotions, and behaviors that trigger these disorders. Besides, some medications have also proven to be effective in the treatment process.
Because of the serious physical problems caused by these illnesses, any treatment plan for a person with anorexia nervosa, bulimia nervosa, or binge eating disorder must include general medical care, nutritional management, and nutritional counseling. These measures begin to rebuild physical well-being and healthy eating practice.
Resources : psychiatry.org
healthline
ncbi.nlm.nih.gov
dsm.psychiatryonline.org
