Eating Disorders

Eating Disorders

9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime.

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What Is It?

Eating disorders are serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and food related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

The Science Behind It

Factors that may be involved in developing an eating disorder include:

  • Genetics. People with first degree relatives, siblings or parents, with an eating disorder appear to be more at risk of developing an eating disorder, too. This suggests a genetic link. Evidence that the brain chemical, serotonin, is involved also points to contributing genetic and biological factors.
  • Environment. Cultural pressures that idealize a particular body type place extreme pressure on people to achieve unrealistic standards. Popular culture and media images often tie thinness (for women) or muscularity (for men) to popularity, success, beauty and happiness.
  • Peer Pressure. With young people, this can be a very powerful force. Pressure can appear in the form of teasing, bullying or ridicule because of size or weight. A history of physical or sexual abuse can also contribute to some people developing an eating disorder.
  • Emotional Health. Perfectionism, impulsive behavior and difficult relationships can all contribute to lowering a person’s self-esteem and make them vulnerable to developing eating disorders.

Eating disorders affect all types of people. However there are certain risk factors that put some people at greater risk for developing an eating disorder.

  • Age. Eating disorders are much more common during teens and early 20s.
  • Gender. Women and girls are more likely to have a diagnosed eating disorder. However, it is important to recognize that men and boys may be under-diagnosed due to differences in seeking treatment.  
  • Family history. Having a parent or sibling with an eating disorder increases the risk.
  • Dieting. Dieting taken too far can become an eating disorder.
  • Changes. Times of change like going to college, starting a new job, or getting divorced may be a stressor towards developing an eating disorder.
  • Vocations and activities. Eating disorders are especially common among gymnasts, runners, wrestlers and dancers.

Warning Signs

Anorexia nervosa

People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight. Anorexia nervosa has the highest mortality rate of any mental disorder. While many people with this disorder die from complications associated with starvation, others die of suicide.

Symptoms include:

  • Extremely restricted eating
  • Extreme thinness (emaciation)
  • A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
  • Intense fear of gaining weight
  • Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight

Other symptoms may develop over time, including:

  • Thinning of the bones (osteopenia or osteoporosis)
  • Mild anemia and muscle wasting and weakness
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Severe constipation
  • Low blood pressure slowed breathing and pulse
  • Damage to the structure and function of the heart
  • Brain damage
  • Multiorgan failure
  • Drop in internal body temperature, causing a person to feel cold all the time
  • Lethargy, sluggishness, or feeling tired all the time
  • Infertility

Bulimia nervosa

People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or overweight.

Symptoms include:

  • Chronically inflamed and sore throat
  • Swollen salivary glands in the neck and jaw area
  • Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
  • Acid reflux disorder and other gastrointestinal problems
  • Intestinal distress and irritation from laxative abuse
  • Severe dehydration from purging of fluids
  • Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack

Binge-eating disorder

People with binge-eating disorder lose control over their eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.

Symptoms include:

  • Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
  • Eating even when you're full or not hungry
  • Eating fast during binge episodes
  • Eating until you're uncomfortably full
  • Eating alone or in secret to avoid embarrassment
  • Feeling distressed, ashamed, or guilty about your eating
  • Frequently dieting, possibly without weight loss

Common Misconceptions

Eating disorders are a choice. I just need to tell my loved one to snap out of it.

Eating disorders (EDs) are actually complex medical and psychiatric illnesses that patients don’t choose and parents don’t cause. Several decades of genetic research show that biological factors play a significant role in who develops an eating disorder. EDs commonly co-occur with other mental health conditions like major depression, anxiety, social phobia, and obsessive compulsive disorder.

Everyone has an eating disorder these days

Although our current culture is highly obsessed with food and weight, and disordered patterns of eating are very common, clinical eating disorders are less so. A 2007 study asked 9,282 English-speaking Americans about a variety of mental health conditions, including eating disorders. The results, published in Biological Psychiatry, found that 0.9% of women and 0.3% of men had anorexia during their life, 1.5% of women and 0.5% of men had bulimia during their life, and 3.5% of women and 2.0% of men had binge eating disorder during their life. The consequences of eating disorders can be life-threatening, and many individuals find that stigma against mental illness (and eating disorders in particular) can obstruct a timely diagnosis and adequate treatment.

Treatments

Treatment plans are tailored to individual needs and may include one or more of the following:

  • Individual, group, and/or family psychotherapy
  • Medical care and monitoring
  • Nutritional counseling
  • Medications

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Medical Disclaimer: Brain Health Bootcamp aims to promote education and awareness of mental health conditions among adolescents, families, and educators. We publish material that is researched, cited, and drawn from sources reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.