While nearly two out of three adults in the United States struggle with issues related to being overweight, a smaller, but significant, portion of the population has eating disorders that result in being normal weight or underweight.
Anorexia nervosa is an eating disorder characterized by the maintenance of a body weight well below average through starvation and/or excessive exercise. Individuals suffering from anorexia nervosa often have a distorted body image. A distorted body image is referred to as body dysmorphia in the research literature and it means that people with anorexia nervosa view themselves as overweight even though they are not. Anorexia nervosa is associated with a number of significant negative health outcomes including bone loss, heart failure, kidney failure, amenorrhea (cessation of the menstrual period), reduced function of the gonads, and in extreme cases, death. Furthermore, there is an increased risk for a number of psychological problems, which include anxiety disorders, mood disorders, and substance abuse (Mayo Clinic, 2012a).
Estimates of the prevalence of anorexia nervosa vary from across different studies but generally range from less than 1% to just over 4% in women. Generally, prevalence rates are considerably lower for men (Smink et al., 2012).
People with bulimia nervosa engage in binge eating behavior (consuming large amounts of food) that is followed by an attempt to compensate for the large amount of food consumed. Purging the food by inducing vomiting or through the use of laxatives are two common compensatory behaviors. Some affected individuals engage in excessive amounts of exercise to compensate for their binges. Bulimia is associated with many adverse health consequences that can include kidney failure, heart failure, and tooth decay. In addition, these individuals often suffer from anxiety and depression, and they are at an increased risk for substance abuse (Mayo Clinic, 2012b). The lifetime prevalence rate for bulimia nervosa is estimated at around 1% for women and less than 0.5% for men (Smink, van Hoeken, & Hoek, 2012).
Eating Disorders and Cross-Cultural Considerations
While both anorexia and bulimia nervosa occur in men and women of many different cultures, Caucasian females from Western societies tend to be the most at-risk population. Recent research indicates that females between the ages of 15 and 19 are most at risk, and it has long been suspected that these eating disorders are culturally-bound phenomena that are related to messages of a thin ideal often portrayed in popular media and the fashion world (Smink et al., 2012). While social factors play an important role in the development of eating disorders, there is also evidence that genetic factors may predispose people to these disorders (Collier & Treasure, 2004)..