“Eating disorders are serious but treatable mental and physical illnesses that can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives” (National Eating Disorders Association, 2018). Numerous factors can contribute to disordered eating. One big factor is body image, which is defined as a person’s perception, feelings about, and critique of their body’s appearance and functioning (Thompson, 2020). Body image greatly impacts eating behaviors and exercise habits, leading directly to the development of eating disorders. Other factors that can contribute to disordered eating include genetics, personality, and the environment (Thompson, 2020). Genetics comes into play and has shown through multiple studies that those with familial ties to eating disorders are more likely to develop themselves than those with no family history. An individual’s personality plays a role as well. When people are already perfectionists or impulsive, this can become amplified through basic needs to control their lives. This includes eating, body image, and exercise. The most influential on an individual’s risk could very well be their environment. Someone’s environment includes family, friends, media, sociocultural factors, and countless others. Everything around people affects them in one way or another, whether it be positive or negative.
What eating disorders do these risk factors lead to? There are actually more types of eating disorders than one may think. These include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Orthorexia, Other Specified Feeding or Eating Disorder (OSFED), Avoidant Restrictive Food Intake Disorder (ARFID), Pica, Rumination Disorder, Unspecified Feeding or Eating Disorder, Laxative Abuse, and Compulsive Exercise (National Eating Disorders Association, 2018). Eating disorders have the highest mortality rate of any mental illness. It is imperative to recognize them to prevent, identify, and treat them effectively (National Eating Disorders Association, 2018). It is beneficial for all individuals to understand these mental illnesses, focusing specifically on the most common eating disorders. These include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
What is Anorexia Nervosa?
Anorexia Nervosa is commonly defined as an eating disorder that negatively affects an individual through abnormally low body weight and an intense fear of gaining weight. Many people coping with this mental illness may even have a warped view of their own weight, believing that they are larger than they really are, indicating body dysmorphia (Staff, 2018).
Anywhere “between 0.9% and 2.0% of females and 0.1% to 0.3% of males will develop anorexia”(National Eating Disorders, 2018) in their lifetime and, it is considered one of the deadliest psychiatric disorders. People who suffer from anorexia can suffer from various long-term health complications such as amenorrhea, infertility, bone density loss, and at its most severe, sudden death from ventricular arrhythmias.
Individuals who are living with this disorder can exhibit symptoms, such as:
- Extreme or unhealthy weight loss
- Dizziness and fainting from lack of energy and nutrients
- Thinning hair or hair loss
- Chills or intolerance to cold
- Irregular menstruation flow
If left untreated, it can develop to more permanent consequences, such as:
- Heart issues (mitral valve prolapse, ventricular arrhythmias)
- Gastrointestinal problems
- Electrolyte Imbalance
However, eating disorders are not exclusive to physical well-being but are psychological as well. Traumatic experiences from friends, family, and even society can impact a person’s behavior and relationship to their bodies and food.
There are numerous ways for a person to recover from Anorexia Nervosa. For each person, that experience may be unique. Since it is a psychological disorder with detrimental physical effects, many people can help guide the individual looking for a happier and healthier lifestyle.
A way to start the journey would be to speak to a psychologist to learn more about the nature of the behaviors and feelings that an individual may be experiencing. They can help identify the underlying issues and develop a treatment plan, working through destructive thoughts with more positive ones. By focusing on overall health and well-being, rather than weight, an individual can conquer Anorexia Nervosa without fear of relapse (APA 2020).
Another way for people to gain motivation and support in their journey is by finding groups that support body positivity and realistic healthy standards. It is essential to find groups that aren’t focused on subjective concepts on the perfect body. Through Facebook, Blogs, YouTube, Instagram, and many other social media platforms, people cannot only find motivation from other strong individuals who want to help others struggling. They can also find support from admirers and use their platform to raise awareness of a balanced, happy, healthy lifestyle.
What is Bulimia Nervosa?
Bulimia Nervosa is an eating disorder and severe illness that is life-threatening like all other eating disorders.
Bulimia is characterized by the cyclical rotation of the behaviors bingeing and purging. Bingeing is the act of eating large amounts of food during a discrete period of time while feeling a lack of control of your actions and self. This bingeing moment is usually followed by intense feelings of regret, disgust in oneself, and the need to get rid of it. Thus, it is followed by the act of purging. Purging is recurrent inappropriate compensatory behavior, usually to prevent weight gain. The most common form of purging is self-induced vomiting. Other purging forms include abuse of laxatives, other diuretics, periods of fasting, and excessive exercise. These are the criteria they use to diagnose bulimia nervosa with the DSM-IV. Diagnosis also involves the behaviors occurring on average once a week for at least three months (National Eating Disorders Association, 2018).
A few warning signs and symptoms to look out for yourself or loved ones include but are not limited to (National Eating Disorders Association, 2018)
- In general, behaviors and attitudes indicate that weight loss, dieting, and food control are becoming primary concerns.
- Evidence of binge eating, including the disappearance of large amounts of food in short periods or lots of empty wrappers and containers indicating consumption of large amounts of food
- Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
- Disappears after eating, often to the bathroom
- Fear of eating in public or with others
- Has calluses on the back of the hands and knuckles from self-induced vomiting
- Withdraws from usual friends and activities
- Bodyweight is typically within the normal weight range; may be overweight.
- Dental problems, such as enamel erosion, cavities, and tooth sensitivity
- Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
- Difficulties concentrating
There are various treatment settings and care provided for recovery from bulimia nervosa and other eating disorders. Treatment depends on the severity of illness and personal needs. There is intensive outpatient care for those who don’t need daily monitoring and can continue to function effectively in everyday life while still focusing on recovery. Another way to obtain treatment is through partial hospitalization programs. The person would still reside at home but would go to treatment every day due to impaired ability to function and the need for daily monitoring of behaviors. The next step in treatment settings would be residential. The patient would no longer be residing at home, is considered medically stable but is too mentally impaired to respond to other less intensive treatment programs. The final level of treatment setting is inpatient programs. In these cases, the person is deemed medically and psychiatrically unstable and lives in a facility with constant monitoring and care (National Eating Disorders Association, 2018). On top of getting treatment in a certain setting, many people get help through different psychotherapy forms. Psychotherapy can help form acceptance, modify behaviors, alter belief systems, and find support from within and from others to recover from an eating disorder, specifically bulimia (National Eating Disorders Association, 2018).
What is Binge Eating Disorder?
Binge eating disorder is a severe, life-threatening, and treatable eating disorder. It is one of the newest eating disorders to be recognized in the DSM-5. Further, it is the most common eating disorder in the United States, affecting 3.5% of women and 2.0% of men over the course of their lifetime (National Eating Disorders Association, 2018).
First and foremost, binge-eating disorder consists of recurrent episodes of binge eating. Binge eating is the consumption of a large amount of food in a short period of time, usually accompanied by a feeling of loss of self-control. (Thompson, 2020) Further, the binge eating episode is associated with at least three patterns (National Eating Disorders Association, 2018):
- Eating more rapidly than normal.
- Eating until uncomfortably full.
- Eating large amounts when not feeling hungry.
- Eating alone due to embarrassment about the amount consumed.
- Feeling disgusted with oneself, depressed, or guilty after the binge.
Also, to obtain a medical diagnosis, the binge eating must have occurred at least two days a week for six months. (Norris, 2019)
When binge eating occurs, the individual will experience extreme distress. The majority of people with BED tend to be overweight due to the positive calorie intake. This can, in turn, lead to low self-esteem, avoidance of social situations, depression, and negative thoughts related to the self. (Thompson, 2020) It is not associated with the compensations present in bulimia, such as forcing oneself to vomit or using laxatives to promote voiding (National Eating Disorders Association, 2018).
The primary goal of treating people with binge-eating disorders is to establish a regular, healthy eating pattern. (Norris, 2019) Overall, BED has a greater rate of remission than other eating disorders. People struggling with this disorder respond more positively to cognitive behavioral therapy. In seeking help, it is important to remember that BED is not a choice. It has a neurological and biological basis, and that past trauma may have a role in developing the eating pattern. (Pryor, 2018)
Appropriate treatment for this disorder is not about weight loss. In fact, when interventions are aimed at weight loss, the patient shows a lower rate of overall weight loss, more rapid weight regain, and higher resistance to future treatment. (Pryor, 2018) Instead, the focus of treatment should be as follows (Pryor, 2018):
- Development of skills to interrupt binge eating
- Understand how weight stigma contributes to the development of a binge eating disorder
- Understanding how weight stigma leads to unhealthy efforts to change one’s body to make one feel worthy
- Establishment of a healthy and enjoyable relationship with food and eating through nutritional rehabilitation
In terms of nutrition, the successful treatment of binge eating disorder comes from making sustainable lifestyle changes. Of the individuals who have successfully made it to remission, long-term, positive results were found in individuals who (Norris, 2019):
- Made meal plans
- Maintained a balanced diet of three regular meals
- Avoided high sugar and other binge foods
- Wrote a food intake log
- Avoided alcohol and drugs
- Began regular exercise regimens
In designing a meal plan to treat a binge eating disorder, it may be wise to enlist a physician’s aid. It is inadvisable to reduce caloric intake by an extreme amount (500-1000 calories) without being monitored by a doctor. Also, the meal plan must contain all the components of a healthful diet. (Thompson, 2020) A healthful diet provides the proper combination of energy and nutrients and is adequate, moderate, nutrient-dense, balanced, and varied. This eating pattern can aid in weight loss in concert with exercise, leading to better overall health for the individual in terms of risk for hypertension, type 2 diabetes, and cardiovascular disease. (Thompson, 2020)
Importance of Healthful Eating
All eating disorders are harmful to the body and mind. A large portion of eating disorders is regarding mental health, but focusing on how it affects the body is important. There are specific health risks for those suffering from Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Anorexia Nervosa sends the body into starvation, which leads to deficiencies in energy and nutrients required for the body to function properly. The body tries to use stored fat and tissues to preserve brain and vital body functions and eventually leads to heart failure and death due to electrolyte imbalances (Thompson, 2020). Bulimia Nervosa may also lead to heart failure and death due to electrolyte imbalances due to excessive vomiting. It also creates gastrointestinal problems like esophageal ruptures and constipation due to chronic bingeing and purging (Thompson, 2020). Binge Eating Disorder directly leads to weight gain and likely obesity. Obesity is positively correlated with health consequences such as CVD, type 2 diabetes, and cancer (Thompson, 2020). Overall, it is vital to prevent, identify, and treat eating disorders effectively to maintain good mental health and healthful eating habits to prevent disease and keep our bodies and minds functioning properly.
Links for Local and Online Resources
WD Recovery and Wellness Center, 7330 N 16th St, Suite B101, Phoenix: https://wdrecoverycenters.com/
The Mandel Center, 8120 E. Cactus Rd. Suite 310, Scottsdale: http://www.mandelcenter.com/
Doorways, 4747 N. 7th Street, Suite 450, Phoenix: https://www.doorwaysarizona.com/
Healthy Futures, 8065 N. 85th Way, Scottsdale: https://healthyfuturesaz.com/
NEDA Student Life Resources: https://www.nationaleatingdisorders.org/blog-tags/student-life
NEDA Helpline Information: https://www.nationaleatingdisorders.org/help-support/contact-helpline
Female Coaching Network. (2018, January 10). Disordered Eating Continuum. Retrieved November 17, 2020, from https://pbs.twimg.com/media/DTNNzMnW4AE2FNF?format=jpg&name=large
Risk Factors of Eating Disorders. (2020, October 5). In 1063059257 810004124 C. Renzoni (Ed.). Retrieved November 17, 2020, from https://www.therecoveryvillage.com/wp-content/uploads/2019/02/risk-factors-for-eating-disorders.png
National Eating Disorders Association. (, 2018). NEDA. https://www.nationaleatingdisorders.org/
Norris, T. L. (2019). Porth’s pathophysiology: Concepts of altered health states. Philadelphia: Wolters Kluwer.
Pryor, T. (2018, August 03). Binge Eating Disorder Recovery-It’s Not About Weight Loss. Retrieved November 14, 2020, from https://www.nationaleatingdisorders.org/blog/binge-eating-disorder-recovery%E2%80%94it%E2%80%99s-not-about-weight-loss
Thompson, J. (2020). The Science of Nutrition (5th ed.). Pearson.