Eating disorders are serious mental illnesses that can emerge in people of any gender, age, race, ethnicity, nationality, and socioeconomic status.
They are potentially life-threatening and involve an array of emotional, cognitive, and physical complications. While eating disorders are centered around extreme behaviors around eating and attitudes about weight and/or shape, they are not just about food-- they typically represent a way for people to avoid or manage difficult emotions, low self-image, protection, or an expression of the person's inner experiences. They are complex, challenging, and worthy of recognition. It is important to remember that even if a person does not meet full diagnostic criteria for a specific eating disorder, their eating concerns may still be serious and warrant treatment.
Types of Eating Disorders
Anorexia Nervosa
Symptoms
- Restricting food intake leading to a significantly low body weight given the context of age, sex, developmental trajectory, and physical health
- Intense fear of gaining weight or becoming fat, even though underweight
- Disturbance in the way in which one's body weight or shape is experiences, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
Warning Signs
- Significant weight loss
- Distorted, negative body image
- Frequent comments about being fat or fearing being fat
- Preoccupation with weight, calories, or food
- Hiding body in baggy clothing
- Feelings of guilt after eating
- Low self-esteem
- Withdrawal from friends and family
- Excuses for not eating, such as denying hunger or avoiding mealtimes
- Strict food rules or rituals around eating, such as only eating foods in a certain order, arranging foods in a certain way, or refusing to alter a planned meal
- Categorizing entire categories of food as off-limits, such as no fats, no carbs, etc.
- Extreme mood swings in response to food
- Pale appearance or yellowish skin-tone
- Dull, dry, or brittle skin, hair, and nails
- Easily cold
- Fatigue
- Fainting/dizziness
- Excessive or compulsive exercise
Health Consequences
- Amenorrhea (loss of menstrual cycle)
- Irregular or abnormally slow heart beat
- Low blood pressure
- Dizziness or fainting upon standing
- Anemia
- Poor circulation in hands and feet
- Memory loss, disorientation
- Bone density loss or osteoporosis
- Hair loss
- Growth of excessive hair (lanugo), particularly on the face and trunk
- Constipation
- Edema or swelling
- Dehydration or kidney failure
- Muscle loss or weakness
- Heart failure
Bulimia Nervosa
Symptoms
- Recurrent episodes of binge eating, characterized by both eating in a discrete amount of time large amounts of food and a sense of lack of control over eating
- Recurrent inappropriate compensatory behavior in order to prevent weight gain (e.g. self-induced vomiting, laxative use, excessive exercise)
- The binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
- Self-evaluation is unduly influenced by body shape and weight
Warning Signs
- Secretive eating
- Missing food or hiding food
- Visiting the bathroom after eating
- Preoccupation with food
- Weight fluctuations
- Excessive exercise routines
- Laxative, diuretic, or diet pill use
- Swollen glands in the cheeks and neck
- Discoloration of the teeth
- Broken blood vessels in the eyes or face
- Calluses on knuckles or backs of hands
- Sore throat
- Acid reflux/heartburn
- Feelings of shame or guilt
- Low self-esteem
- Self-criticism
Health Consequences
- Electrolyte imbalances
- Irregular heartbeat
- Seizures
- Tooth decay
- Chronic irregular bowel movements and constipation
- Inflammation or rupture of the esophagus
- Tears in stomach lining
- Gastrointestinal problems
- Chronic kidney problems or kidney failure
- Tooth decay
- Edema/swelling
- Dehydration
- Vitamin and mineral deficiencies
Binge Eating Disorder
Symptoms
- Recurrent episodes of binge eating, characterized by both eating in a discrete period of time an amount of food that is larger than most people would eat under similar circumstances within a similar period of time and a sense of lack of control over what one is eating
- Binge episodes are associated with three or more of the following:
o Eating much more rapidly than normal
o Eating until uncomfortably full
o Eating large amounts of food when not feeling physically hungry
o Eating alone because of feeling embarrassed by how much one is eating
o Feeling disgusted with oneself, depressed, or guilty afterwards - Marked distress about the binge eating
- Binge eating occurs on average at least once a week for three months
- The binge eating is not associated with the recurrent use of inappropriate compensatory behavior
Warning Signs
- Eating large amounts of food when not hungry
- Weight gain/fluctuations
- Feelings of shame and guilt
- Self-medicating with food
- Eating alone or being secretive about eating
- Hiding food
- Low self-esteem
Health Consequences
- Obesity
- Type II Diabetes
- Lipid abnormalities
- Increased blood pressure
- Osteoarthritis
- Kidney problems
- Gastrointestinal problems
- Heart disease
- Gallbladder disease
- Joint and muscle pain