What is an eating disorder?

  • Eating disorders are disturbances in eating habits which result in a significant impairment in physical health or psychosocial functioning.
  • Individuals suffering from eating disorders consider their self-worth largely dependent on their body shape and weight, which they over-evaluate.
  • Eating disorders can develop at all ages; however, they often develop during the teen and young adult years.

There are three main types of eating disorders:
  • Anorexia Nervosa
    • This disorder is characterized by weight loss that is due to extreme dieting and exercise. People suffering from anorexia nervosa continue to see themselves as fat, and can never be thin enough.
  • Bulimia Nervosa
    • The main feature of this disorder is over eating. Individuals often feel a sense of loss of control and eat excessive quantities of food. This overeating is then followed by purging the food by various methods such as self-induced vomiting or misusing laxatives.
  • Binge-eating disorder
    • Individuals with this disorder experience regular episodes of extreme overeating. However, unlike bulimia nervosa, individuals do not follow episodes of overeating, with purging.

How common are eating disorders?

  • Eating disorders are more often seen in girls and women rather than boys and men, especially anorexia nervosa and bulimia nervosa. However, both disorders can still affect men.
  • Binge-eating disorder can affect both sexes, with a slightly higher prevalence in women.

What Causes eating disorders?

The exact causes of eating disorders are unknown; however, many factors can contribute to its development, including:
  • Heritability:
    • Having certain genes may increase a person’s risk of developing an eating disorder.
  • Personality traits:
    • Certain traits are associated with different disorders such as being a perfectionist is related to anorexia, while bulimic people tend to be more impulsive. Other factors such as low self-esteem can also increase the risk of having an eating disorder.
  • Environmental factors:
    • Factors such as societal pressures and situational events may also lead to the development of eating disorders. In western societies, eating disorders are more common than in other parts of the world.

What are the risk factors for an eating disorder?

Certain risk factors may increase the chances of developing an eating disorder. These factors include:
  • Being female
  • Being a teenager or young adult
  • Having a family member who has had the disorder
  • Being on a diet and receiving positive remarks
  • Suffering from mental health disorders such depression or anxiety
  • Environmental situations that can bring stress
  • Working in certain areas such as modeling or sports

How is the diagnosis of an eating disorder made?

  • Your doctor will base his/her diagnosis based on signs, symptoms and eating habits.
  • If your doctor suspects that you have an eating disorder, physical and psychological exams will be administered.
  • The physical tests will help rule out other likely medical causes that may show similar symptoms. Also they will determine whether the patient is in immediate danger or not.
  • Your physician will also ask for your family history, eating habits and weight loss methods.

What are the signs and symptoms of an eating disorder?

The symptoms of eating disorders vary from one disorder to the other.

Anorexia Nervosa
  • Individuals with anorexia control their weight by using extreme methods. These methods include restricting food intake through dieting, fasting or excessive exercising.
  • An individual may also resort to self-induced vomiting or misusing laxatives or diuretics in order to achieve weight loss.
  • These efforts to reduce one’s weight may cause severe health issues.

Anorexia nervosa disorder is characterized by:
  • Significantly low body weight
  • An intense fear of gaining weight or becoming fat
  • Over-evaluating one’s weight or shape

Symptoms of anorexia include:
  • Dramatic weight loss
  • Constipation or stomach pain
  • Menstruating cycle changes (stops menstruating)
  • Thinning hair, brittle nails, and dry skin
  • Low blood pressure
  • Shrunken breasts
  • Having a lower than normal body temperature, therefore, feeling cold

Behaviors related to anorexia include:
  • Wearing loose clothing
  • Preoccupation with dieting
  • Avoiding eating in front of others
  • Excessive exercise
  • Denying that the extreme thinness is a problem
  • Commenting that their body is fat
  • Preparing food for others but refusing to eat

Bulimia Nervosa
  • Individuals with bulimia experience episodes of excessive eating, called binging. Binging is then followed by purging the food by self-inducing vomiting or using laxatives.
  • Binging can also be followed by fasting or excessive exercising.
  • Individuals suffering from bulimia often are within the normal weight range. Similar to anorexia, they also have an intense fear of weight gain and a distorted body image.
  • Individuals with bulimia nervosa see themselves as fat and want to lose weight and often hide their behaviors because they are ashamed of their actions.

Symptoms of bulimia include:
  • Recurrent episodes of eating a large amount of food, whether hungry or not
  • Feelings of loss of control over eating
  • The binge eating and the compensatory behaviors that follow occur at least once a week for 3 months
  • Eating quicker than usual
  • Eating until feeling uncomfortably full
  • Eating alone because of embarrassment over the quantity of food being eaten
  • Feelings of disgust, depression and guilt after overeating
  • Weight fluctuations
  • Low self-esteem
  • Loss of sexual desire

Constant dieting signs that a person has bulimia include:
  • Evidence that a large amount of food has disappeared in a short amount of time
  • Proof of purging such as disappearing after meals to the bathroom, sounds or smells of vomit, or finding laxatives or diuretics
  • Skipping meals or eating extremely small amounts
  • Avoiding eating in front of others
  • Excessive exercise
  • Wearing loose clothing
  • Dieting constantly
  • Having scarred knuckles from constantly inducing vomiting
  • Using product that refreshes the mouth such as mints
  • Describing one’s self as fat

Binge Eating
  • Binge eating is similar to bulimia in that both disorders involve overeating in a short amount of time.
  • Unlike bulimia, binge eating does not involve purging food after eating.
  • Two out of three individuals who are suffering from this condition are obese.
  • Many people that have this condition also suffer from depression.

Symptoms of binge eating include:
  • Binge eating at least once a week for 3 months
  • Feeling of loss of control over how much you eat
  • Eating faster than normal
  • Binge eating even when you’re not feeling hungry
  • Eating alone due to feelings of embarrassment
  • Feeling upset, depressed, or guilty after binge eating episodes
  • Eating until becoming uncomfortably full
  • Distorted body image
  • Low self-esteem

Are there treatments for eating disorders?

A team of specialists will be involved when treating eating disorders. This team usually includes a medical provider (family doctor or general physician), a psychiatrist, a mental health provider (psychologist), and a nutritionist. Treatment varies from one eating disorder to the other but generally includes psychotherapy, nutrition education, and medication.
  • Psychotherapy
    • Cognitive behavioral therapy (CBT) is a commonly used treatment for eating disorders such as bulimia and binge-eating. CBT helps you monitor your mood and eating. Also it will help you develop problem-solving skills and teaches you to explore healthy ways to cope when experiencing a stressful situation.
    • Family-based therapy (FBT) is a treatment for children and teenagers who have eating disorders. It is a an evidence-based treatment where the individual’s family is involved in ensuring that the person is following a healthy eating pattern and is maintaining a healthy weight.
    • Dialectical-behavioral therapy (DBT) is used to help individuals adapt healthier ways when dealing with painful emotions. This therapy is often used to treat borderline personality disorders, in which eating disorders occur at an increased rate. DBT teaches adaptive skills that enhance a patients’ emotion regulation capabilities. Through this treatment, patients are taught how to increase self-awareness, how to regulate self-defeating thoughts, and better stress and conflict management.
  • Nutrition Education
    • If an individual is underweight due to an eating disorder, the first thing to be done is to get that person to a healthy weight.
    • Dietitians can provide individuals who have an eating disorder with information about healthy diets and can provide a diet plan that can help establish healthy eating habits.
  • Medication
    • Medication does not cure eating disorders; however, some medications can help control preoccupation with food and dieting, and it can control urges to binge eat or purge after overeating.
    • Antidepressants and anti-anxiety medications can be prescribed to help with the symptoms of depression and anxiety which may be associated with the eating disorder.

What happens if an eating disorder is left untreated?

  • Eating disorders, if left untreated, can have serious consequences.
  • Eating disorders can lead to many serious health issues. Research has also shown that people suffering from anorexia have a mortality rate that is 18 times higher than those who do not suffer from an eating disorder.
  • Suicide risk is also elevated in individuals suffering from anorexia and bulimia. Assessing suicidal ideation and behaviors, as well as history of suicide attempts should be evaluated.

Some of the negative physical problems for anorexia include:
  • Anemia
  • Constipation
  • Osteoporosis
  • Damage to the heart and brain

Negative physical problems associated with bulimia include:
  • Sore throat
  • Worn-away tooth enamel
  • Acid reflux
  • Heart attacks
  • May develop diabetes, high blood pressure and other problems

Can eating disorders be prevented?

  • There are no methods that can surely prevent eating disorders from occurring. However, there are certain methods people can follow to ensure healthy eating behaviors for them and their children.
  • Some of these methods include encouraging healthy eating habits, avoiding diets around children and reinforcing healthy body image.

Useful Links

Middle East Eating Disorders Association
Academy for Eating Disorders
National Institute of Mental Health
Eating Disorder Hope
National Eating Disorders Association