What are eating disorders
Usually perceived as a lifestyle choice or a diet gone “too far,” eating disorders (EDs) are serious mental illnesses characterized by irregular eating habits that can lead to other complications as well. While the disorder can exist on its own, in many cases eating disorders occur along with other psychiatric disorders like anxiety and depressive disorders as well as personality and substance abuse disorders.
As per the latest eating disorders statistics, the illness affects at least 30 million people in the United States irrespective of their age, gender, ethnicity and socio-economic status. It is a serious and potentially life-threatening problem, but eating disorder treatment at certified rehab centers combines medication management and psychotherapy to help one find healthier ways to cope with negative feelings/behavior and overcome one’s eating disorder.
Warning signs and symptoms of eating disorders
Given the complexity of the illness, there are various physical and psychological symptoms to signal the presence or onset of an eating disorder. Individuals suffering from eating disorders may either show only one symptom or a combination of various symptoms. In many cases, they may not show any symptom at all. While people with eating disorders may behave in various ways or even may make efforts to conceal their behaviors, being aware of its warning signs increases the chance of an early detection of the illness, thereby, increasing one’s chance of recovery.
Following are some of the most common warning signs and symptoms of eating disorders.
Physical signs of eating disorders
- Sleep problems
- Dizziness and fainting spells
- Dry skin, brittle nails and hair
- Impaired immune functioning
- Muscle weakness and poor wound healing
- Dental problems, such as cavities, tooth sensitivity
- Visible variations in weight; weight gain or weight loss
- Gastrointestinal complaints like acid reflux, constipation, etc.
Emotional and psychological signs of eating disorders
- Extreme mood swings.
- Fear of eating in public or with others.
- Maintaining excessive and rigid exercise regimen.
- Withdrawal from usual friends and social activities.
- Skipping meals or eating small portions of food at regular intervals.
- Constant preoccupation with food, calories consumed, weight and dieting.
- Development of life schedules or rituals to make time for binge and purge eating sessions.
- Evidence of binge eating behavior like disappearance of large amounts of food in short periods of time or purging behavior like frequent trips to the bathroom after meals.
Though the disorder is marked by some common physical, psychological and behavioral signs, one needs to remember that it is common for eating disorder symptoms to change over time.
What are the different types of eating disorders?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), eating disorders can be classified into following categories:
Anorexia Nervosa (AN):
Anorexia nervosa is a problem characterized by weight loss, difficulty in maintaining appropriate body weight and a distorted body image. Individuals suffering from anorexia have an intense fear of gaining weight and a strong desire to be thin that leads to food restrictions. Anorexia can be divided into two subtypes: restrictive and binge-purge.
Symptoms of anorexia nervosa include:
- Intense fear of gaining weight.
- Restricted eating or intensive exercise.
- Distorted body image.
- Extreme thinness.
Bulimia Nervosa (BN):
A serious psychiatric illness, bulimia nervosa or bulimia involves recurrent binge-eating episodes associated with a sense of a loss of control and are immediately followed by feelings of guilt and shame, leading the sufferer to indulge in compensatory behavior, such as forced vomiting, fasting, excessive exercise or a combination of these behaviors to compensate the overeating.
Symptoms of bulimia nervosa include:
- Gastrointestinal problems.
- Intestinal distress due to laxative abuse.
- Severe dehydration from purging.
- Electrolyte imbalance.
Binge Eating Disorder (BED):
Commonly known as compulsive overeating, binge eating disorder is characterized by regular episodes of binge eating; however, unlike BN, it does not involve compensatory behavior of over-exercising or self-induced vomiting. A binge eating episode involves eating larger than normal amounts of food in a short period of time and is accompanied by guilt, shame and psychological distress.
Symptoms of binge eating disorder include:
- Eating even when full or not physically hungry.
- Feeling of guilt or repulsion with oneself.
- Eating alone due to feelings of shame and embarrassment.
- Eating much more rapidly than normal way.
Other Specified Feeding and Eating Disorders (OSFED):
A feeding or eating disorder, OSFED causes significant distress or impairment to the sufferer but does not meet the criteria for another feeding or eating disorder. A clinical category of disordered eating, OSFED describes individuals suffering from irrational thoughts and behaviors related to food, eating and body image. There are five categories of OSFED.
Categories of OSFED include:
- Atypical anorexia nervosa: It involves meeting all of the symptoms of anorexia, except that despite significant weight loss, the weight of the sufferer is within or above the normal range.
- Binge eating disorder: It involves meeting all the criteria for BED, except that it is less frequent or does not occur as long as needed for a full diagnosis.
- Bulimia nervosa: It involves meeting all the criteria for BN, except that it is less frequent or does not occur as long as needed for a full diagnosis.
- Purging disorder: It involves recurrent purging behavior in the absence of binge eating.
- Night eating syndrome: It involves recurrent episodes of night eating and involves eating excessively after the evening meal or eating after sleep.
Avoidant/Restrictive Food Intake Disorder (ARFID):
A disorder characterized by highly selective eating habits and/or disturbed feeding patterns, ARFID often results in significant nutrition and energy deficiencies. Most common in infants and children, the disorder involves eating and feeding challenges, such as eating at an abnormally slow pace, difficulty in digesting food or having a general lack of appetite.
Symptoms of ARFID include:
- extreme pickiness in selecting food.
- significant weight loss (adults) or the inability to gain weight (children).
- adverse reactions to foods causing gastrointestinal upsets.
- anxiety when presented with “fear” foods.
- dependence on oral nutritional supplements or enteral tube feeding.
Unspecified Feeding or Eating Disorder (UFED):
Unspecified feeding or eating disorder is diagnosed when an individual’s symptoms do not meet the criteria of any other eating disorder but still cause clinically significant distress or impairment in social, occupational or other areas of functioning. While the disordered behaviors vary greatly, some of the common behaviors include bingeing, purging and/or restriction. The category is used in situations that contain insufficient information to make a more specific diagnosis.
An eating disorder, rumination disorder involves a sufferer to repeatedly and involuntarily spit out partially or undigested food from the stomach, re-chew it and then either swallow it or spit it out. A mental health disorder, rumination disorder is characterized by repeated ejection of food for at least one month. The illness is not associated with nausea or abdominal pain and as the food has not been digested, the spit out food does not taste sour or bitter.
Symptoms of rumination disorder include:
- Repeated spitting out of food.
- Weight loss, bad breath and tooth decay.
- Repeated stomach ache and indigestion.
- Repeated re-chewing of food.
An eating disorder, pica involves eating non-food items such as soil, soap, hair and paint chips that do not contain substantial nutritional value. The disorder involves eating non-food items with no nutritional value over a period of at least one month and often occurs with other mental health disorders that are associated with impaired functioning.
Symptoms of pica include:
- Eating non-food items for at least one month.
- Substances indigested tend to vary with age and availability.
- Behavior is considered inappropriate for a child’s age or developmental stage.
- Indigestion of substances is not part of one’s cultural, ethnic or religious practice.
Helping someone with eating disorder: Dos and Don’ts
According to the National Alliance on Mental Illness (NAMI), eating disorders are a group of related conditions that cause serious emotional and physical problems. Each condition involves extreme food and weight issues; however, each has unique symptoms that separate it from the others. Here are the dos and don’ts of helping someone who has an eating disorder.
Treating eating disorders
Although it can be scary and awkward to seek help for an eating disorder, admitting the problem is the first step toward recovery. As all EDs involve physical, psychological, behavioral and emotional aspects, an effective ED treatment should address all the issues in some way.
Frequently misunderstood as lifestyle choices, misconceptions surrounding the disease are quite prevalent than one may think. Given the seriousness of the disorder, addressing the prevalent eating disorders myths and realities is the first step toward making people speak about their illness and seek professional help. It is often recommended for individuals to seek residential treatment programs that offer round-the-clock care, monitoring and support. Eating disorder treatment at a residential rehab may include medical monitoring, psychotherapy sessions, nutritional counseling and self-help strategies basis a patient’s medical and nutritional needs.
Considered to be serious behavioral complications, eating disorders are related to persistent eating behaviors that have a negative impact on an individual’s health, emotions and the ability to function in important areas of life.
For those struggling with an eating disorder, the best course of action is to seek professional help at a certified rehab center. While recovery from eating disorders may seem out of reach to many, professional eating disorder treatment combined with effective self-help strategies can help one find healthier ways to cope with negative feelings, overcome one’s illness and gain back self-confidence.