Eating Disorders
Introduction
It is very common and normal for teens and young adults to care about their appearance –watching their weight, occasional dieting and caring about what they eat is a healthy and normal behavior. There is a significant difference between this type of attention to food and what happens when a person has an eating disorder.
Eating disorders are characterized by strong emotions and distress, rigid attitudes, rules and behaviors surrounding food, distorted body image and intense fear of gaining weight. Someone who has an eating disorder engages in extreme behaviors that are harmful to their physical and mental health. The health consequences of serious eating disorders can include life threatening medical problems.
Eating disorders can be associated with other mental health issues such as depression, anxiety disorders, borderline personality disorder and substance use disorders. With proper treatment, many people with eating disorders respond well and can lead healthy, productive lives.
Prevalence
In the U.S., as many as 10 % of young women struggle with an eating disorder. Studies suggest that 1 in 20 people will be affected by an eating disorder at some point in their lives. 86% of individuals with eating disorders have an onset of symptoms by age 20. These disorders are much more common in women, though men can also experience eating disorders.
Signs and Symptoms
Eating disorders are characterized by mood changes, behavioral changes, obsessional thinking, and changes in physical appearance.
Behaviors
- Restricting food intake – eating significantly below normal daily requirement of calories/day, starvation
- Extremely controlling about food – meal time is usually a stressful and distressing experience; it is common for people with an eating disorder to want to eat in private
- Excessive exercise
- Purging, including self-induced vomiting or misuse of laxatives, diuretics or enemas – often spends long, unexplained amounts of time in bathroom; needs to run to bathroom right after each meal
- Rapidly consuming a large amount of food and being unable to stop
- Limited spontaneity – as though they can’t just “let go” and enjoy themselves
Change in Mood
- Anxiety, depressed mood or irritability
- Becomes defensive and/or irritable when approached about eating habits
- Restrained emotional expression – very controlling about letting people see their emotions
- Low self-esteem
- Feelings of guilt
Obsessional thinking
- Preoccupation with being thin – no matter how thin, a person with an eating disorder continues to believe they are fat
- Negative body image – no matter how they actually look, a person with an eating disorder tends to make frequent negative comments about their body
- People with certain eating disorders tend to always want perfection and set high goals for academic achievement or for how successful they can be at controlling weight
- Rigid rules and beliefs about what foods can be eaten, how they are to be eaten, etc.
Physical symptoms/appearance
- Excessive weight loss – significantly below what is the minimal normal for given height and age
- It is common to see a person with an eating disorder who is excessively thin wear bulky, baggy clothing to hide their body
- Constantly feeling cold
- Dry, yellowish skin
- Hair on body grows in long and fine
- Nails become brittle
- People who purge (make themselves vomit) frequently can have mouth lesions or chronic sore throat and “chipmunk cheeks” when the glands on the sides of the jaw enlarge from overstimulation
- An absence of menstruation for girls with very low weight (amenorrhea)
Types
Anorexia Nervosa
People with anorexia lose weight by voluntary starvation, purging, excessive exercise or other weight control measures. A classic symptom of anorexia is an obsessive fear of being overweight. It is believed that people with anorexia restrict food and deny themselves nutrition in order to gain a sense of control in other areas of their lives. They often have a negative or distorted body image and believe they’re overweight even when they are dangerously thin. A person with anorexia is at risk of serious, life-threatening complications related to starvation. In fact, it is estimated that 4% of people with anorexia will die from complications of the disorder. Anorexia is far less common in males than females. Suicide risk for people with anorexia is elevated as well.
Bulimia Nervosa
Bulimia is an eating disorder characterized by periods of binging (eating a massive amount of food in a very short period of time and feeling out of control during the eating episode) followed by some type of behavior to compensate for the binge (such as purging, using laxatives or diuretics, fasting or excessive exercise). When a person has bulimia, these behaviors (binging and compensating for the binge) occur at least once a week for three months.
People with bulimia often binge/purge in secrecy, feeling ashamed when they binge, yet relieved once they purge. A person with bulimia is often fearful that they are gaining weight, are preoccupied with wanting to lose weight, and are unhappy with their body size and shape. Unlike anorexia, people with bulimia may fall in the normal weight or overweight range for their height/age – for this reason, it may not be easy for friends and family to notice that their loved one is struggling. Repeated vomiting or use of laxatives or medications to reduce weight can cause several serious, life-threatening medical complications.
The prevalence of bulimia peaks in older adolescents and young adults and it is far less common in males than females (DSM 5, Diagnostic and Statistical Manual of Mental Disorders, 2013, APA – Bulimia nervosa).
Binge-Eating Disorder
People with a binge-eating disorder have recurrent episodes of binging (eating a large amount of food in a very short period of time and feeling out of control during the eating episode) – unlike bulimia, they do not compensate for binging with purging behaviors (excessive exercise, laxatives/diuretics, vomiting or fasting). People who are diagnosed with a binge-eating disorder binge at least once a week for three months. Though they can be normal weight, people with binge-eating disorder are commonly overweight or obese. People who struggle with this type of eating disorder often feel ashamed of their eating problems and try to eat in secrecy or with as much privacy as possible. After a binge, they can feel shame, disgust, frustration, guilty or depressed. Binge-eating disorder can lead to obesity and health problems related to obesity such as high blood pressure and cardiovascular disease.
Causes and Risk Factors
The causes of eating disorders are not clear. However, eating disorders tend to run in families. Additionally, there are a number of psychological and social factors that may contribute to the development of an eating disorder, including cultural pressures to be thin, perfectionism, a history of trauma, feelings of inadequacy or lack of control, anxiety and depression.
Treatment
There are a variety of treatments and interventions for eating disorders. The most effective treatment combines therapy and medication (when indicated) along with careful attention to medical and nutritional management. Coordinating care between members of the treatment team (including therapist, nutritionist and physician) and the family (for younger people) is the most effective way to address an eating disorder. A comprehensive mental health and medical evaluation is very important to determine the best course of treatment for an eating disorder. In rare cases, hospitalization for severe malnutrition and the consequences of starvation or purging may be necessary before outpatient treatment is possible.
Read on to learn more about different treatment options.
Therapy
An important component of treatment for eating disorders includes working with a therapist – cognitive behavioral therapy has been shown to be useful for the treatment of eating disorders. An effective treatment would address distorted thoughts and problematic behaviors and the underlying factors that contribute to the disorder. Therapy for eating disorders would focus on triggers for eating disordered behavior and ways to avoid unhealthy coping strategies.
Medication
Some antidepressant medications (SSRIs) can be helpful in treating bulimia and binge eating disorder. No specific medication has been identified as an effective treatment for anorexia. However, medication management may be helpful for all eating disorders to alleviate anxiety, depressive symptoms and struggles with obsessive-compulsive behaviors.
Nutrition therapy
Working with a nutritionist is part of the comprehensive approach to eating disorder treatment. The primary role of nutrition therapy is to help a person develop healthier and safer eating patterns. This includes eating adequately to meet their body’s daily nutritional needs, developing a more stable relationship with food that can be sustained over time and learning to eat when they are hungry and stop eating when they are full. Although distorted thoughts and emotional factors remain at the core of eating disorders, a person’s nutrition, eating patterns, and feelings about food can play an important role in promoting the recovery process.
Family therapy
Family therapy can be an essential part of treatment and recovery for families of adolescents coping with an eating disorder. Family therapy (such as the Maudsley approach) is designed to enlist the entire family to participate in and support recovery. This may include supporting healthy eating patterns, establishing positive family dynamics, and increasing effectiveness of family interactions to reinforce recovery and relapse prevention.
For help and more information
Worried that you or someone you know might be struggling with eating? Look here for more information and help:
For more information:
Introduction
It is very common and normal for teens and young adults to care about their appearance –watching their weight, occasional dieting and caring about what they eat is a healthy and normal behavior. There is a significant difference between this type of attention to food and what happens when a person has an eating disorder.
Eating disorders are characterized by strong emotions and distress, rigid attitudes, rules and behaviors surrounding food, distorted body image and intense fear of gaining weight. Someone who has an eating disorder engages in extreme behaviors that are harmful to their physical and mental health. The health consequences of serious eating disorders can include life threatening medical problems.
Eating disorders can be associated with other mental health issues such as depression, anxiety disorders, borderline personality disorder and substance use disorders. With proper treatment, many people with eating disorders respond well and can lead healthy, productive lives.
Prevalence
In the U.S., as many as 10 % of young women struggle with an eating disorder. Studies suggest that 1 in 20 people will be affected by an eating disorder at some point in their lives. 86% of individuals with eating disorders have an onset of symptoms by age 20. These disorders are much more common in women, though men can also experience eating disorders.
Signs and Symptoms
Eating disorders are characterized by mood changes, behavioral changes, obsessional thinking, and changes in physical appearance.
Behaviors
- Restricting food intake – eating significantly below normal daily requirement of calories/day, starvation
- Extremely controlling about food – meal time is usually a stressful and distressing experience; it is common for people with an eating disorder to want to eat in private
- Excessive exercise
- Purging, including self-induced vomiting or misuse of laxatives, diuretics or enemas – often spends long, unexplained amounts of time in bathroom; needs to run to bathroom right after each meal
- Rapidly consuming a large amount of food and being unable to stop
- Limited spontaneity – as though they can’t just “let go” and enjoy themselves
Change in Mood
- Anxiety, depressed mood or irritability
- Becomes defensive and/or irritable when approached about eating habits
- Restrained emotional expression – very controlling about letting people see their emotions
- Low self-esteem
- Feelings of guilt
Obsessional thinking
- Preoccupation with being thin – no matter how thin, a person with an eating disorder continues to believe they are fat
- Negative body image – no matter how they actually look, a person with an eating disorder tends to make frequent negative comments about their body
- People with certain eating disorders tend to always want perfection and set high goals for academic achievement or for how successful they can be at controlling weight
- Rigid rules and beliefs about what foods can be eaten, how they are to be eaten, etc.
Physical symptoms/appearance
- Excessive weight loss – significantly below what is the minimal normal for given height and age
- It is common to see a person with an eating disorder who is excessively thin wear bulky, baggy clothing to hide their body
- Constantly feeling cold
- Dry, yellowish skin
- Hair on body grows in long and fine
- Nails become brittle
- People who purge (make themselves vomit) frequently can have mouth lesions or chronic sore throat and “chipmunk cheeks” when the glands on the sides of the jaw enlarge from overstimulation
- An absence of menstruation for girls with very low weight (amenorrhea)
Types
Anorexia Nervosa
People with anorexia lose weight by voluntary starvation, purging, excessive exercise or other weight control measures. A classic symptom of anorexia is an obsessive fear of being overweight. It is believed that people with anorexia restrict food and deny themselves nutrition in order to gain a sense of control in other areas of their lives. They often have a negative or distorted body image and believe they’re overweight even when they are dangerously thin. A person with anorexia is at risk of serious, life-threatening complications related to starvation. In fact, it is estimated that 4% of people with anorexia will die from complications of the disorder. Anorexia is far less common in males than females. Suicide risk for people with anorexia is elevated as well.
Bulimia Nervosa
Bulimia is an eating disorder characterized by periods of binging (eating a massive amount of food in a very short period of time and feeling out of control during the eating episode) followed by some type of behavior to compensate for the binge (such as purging, using laxatives or diuretics, fasting or excessive exercise). When a person has bulimia, these behaviors (binging and compensating for the binge) occur at least once a week for three months.
People with bulimia often binge/purge in secrecy, feeling ashamed when they binge, yet relieved once they purge. A person with bulimia is often fearful that they are gaining weight, are preoccupied with wanting to lose weight, and are unhappy with their body size and shape. Unlike anorexia, people with bulimia may fall in the normal weight or overweight range for their height/age – for this reason, it may not be easy for friends and family to notice that their loved one is struggling. Repeated vomiting or use of laxatives or medications to reduce weight can cause several serious, life-threatening medical complications.
The prevalence of bulimia peaks in older adolescents and young adults and it is far less common in males than females (DSM 5, Diagnostic and Statistical Manual of Mental Disorders, 2013, APA – Bulimia nervosa).
Binge-Eating Disorder
People with a binge-eating disorder have recurrent episodes of binging (eating a large amount of food in a very short period of time and feeling out of control during the eating episode) – unlike bulimia, they do not compensate for binging with purging behaviors (excessive exercise, laxatives/diuretics, vomiting or fasting). People who are diagnosed with a binge-eating disorder binge at least once a week for three months. Though they can be normal weight, people with binge-eating disorder are commonly overweight or obese. People who struggle with this type of eating disorder often feel ashamed of their eating problems and try to eat in secrecy or with as much privacy as possible. After a binge, they can feel shame, disgust, frustration, guilty or depressed. Binge-eating disorder can lead to obesity and health problems related to obesity such as high blood pressure and cardiovascular disease.
Causes and Risk Factors
The causes of eating disorders are not clear. However, eating disorders tend to run in families. Additionally, there are a number of psychological and social factors that may contribute to the development of an eating disorder, including cultural pressures to be thin, perfectionism, a history of trauma, feelings of inadequacy or lack of control, anxiety and depression.
Treatment
There are a variety of treatments and interventions for eating disorders. The most effective treatment combines therapy and medication (when indicated) along with careful attention to medical and nutritional management. Coordinating care between members of the treatment team (including therapist, nutritionist and physician) and the family (for younger people) is the most effective way to address an eating disorder. A comprehensive mental health and medical evaluation is very important to determine the best course of treatment for an eating disorder. In rare cases, hospitalization for severe malnutrition and the consequences of starvation or purging may be necessary before outpatient treatment is possible.
Read on to learn more about different treatment options.
Therapy
An important component of treatment for eating disorders includes working with a therapist – cognitive behavioral therapy has been shown to be useful for the treatment of eating disorders. An effective treatment would address distorted thoughts and problematic behaviors and the underlying factors that contribute to the disorder. Therapy for eating disorders would focus on triggers for eating disordered behavior and ways to avoid unhealthy coping strategies.
Medication
Some antidepressant medications (SSRIs) can be helpful in treating bulimia and binge eating disorder. No specific medication has been identified as an effective treatment for anorexia. However, medication management may be helpful for all eating disorders to alleviate anxiety, depressive symptoms and struggles with obsessive-compulsive behaviors.
Nutrition therapy
Working with a nutritionist is part of the comprehensive approach to eating disorder treatment. The primary role of nutrition therapy is to help a person develop healthier and safer eating patterns. This includes eating adequately to meet their body’s daily nutritional needs, developing a more stable relationship with food that can be sustained over time and learning to eat when they are hungry and stop eating when they are full. Although distorted thoughts and emotional factors remain at the core of eating disorders, a person’s nutrition, eating patterns, and feelings about food can play an important role in promoting the recovery process.
Family therapy
Family therapy can be an essential part of treatment and recovery for families of adolescents coping with an eating disorder. Family therapy (such as the Maudsley approach) is designed to enlist the entire family to participate in and support recovery. This may include supporting healthy eating patterns, establishing positive family dynamics, and increasing effectiveness of family interactions to reinforce recovery and relapse prevention.
For help and more information
Worried that you or someone you know might be struggling with eating? Look here for more information and help:
For more information: