So You Think You Know What Eating Disorders Are? Do You?

Listening to the radio the other day, I got pretty heated. Y’all probably heard that the popstar Ke$ha admitted herself into treatment for an eating disorder. Well, this radio talk show host was reporting on it and made a VERY ignorant statement. It went something like this: “I don’t know why she has an eating disorder. She’s always been really hot and skinny.” REALLY?!? If this is WHY people think people get an eating disorder, then there needs to be more education on this mental illness…

So, instead of throwing a hissy-fit, I decided to write a blog post to EDUCATE people on what an eating disorder really is, its contributing factors, signs and symptoms, as well as what to do if you have a friend who you think has an eating disorder. I know, I know, a lot of you are all like “Pshhhhhh, I know what an eating disorder is!” You probably do not… So read on my friends! 🙂

What is an Eating Disorder?

An eating disorder is defined by the Encyclopedia as, “any of several PSYCHOLOGICAL disorders (as anorexia nervosa or bulimia) characterized by serious disturbances of eating behavior.” See, eating disorders are severe mental illnesses.

According to the National Eating Disorders Association, “Eating disorders — such as anorexia, bulimia, and binge eating disorder – include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.”

In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified (EDNOS) (Wade, Keski-Rahkonen, & Hudson, 2011). For various reasons, many cases are likely not to be reported.

A new study estimates that approximately a half million teens struggle with eating disorders or disordered eating.

Despite the prevalence of eating disorders, they continue to receive inadequate research funding.

Illness                                            Prevalence                    NIH Research Funds (2011)
Alzheimer’s Disease                        5.1 million                     $450,000,000
Autism                                            3.6 million                     $160,000,000
Schizophrenia                                3.4 million                     $276,000,000 
Eating disorders                             30 million                      $28,000,000

Research dollars spent on Alzheimer’s Disease averaged $88 per affected individual in 2011. For Schizophrenia the amount was $81. For Autism $44. For eating disorders the average amount of research dollars per affected individual was just $0.93. (National Institutes of Health, 2011). Doesn’t make sense does it?

Types of Eating Disorders

((Information gathered from NEDA))

Anorexia Nervosa

Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.  Anorexia nervosa has one of the highest death rates of any mental health condition.

Symptoms

  • Inadequate food intake leading to a weight that is clearly too low.
  • Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain.
  • Self-esteem overly related to body image.
  • Inability to appreciate the severity of the situation.
  • Binge-Eating/Purging Type involves binge eating and/or purging behaviors during the last three months.
  • Restricting Type does not involve binge eating or purging.

Eating disorders experts have found that prompt intensive treatment significantly improves the chances of recovery.  Therefore, it is important to be aware of some of the warning signs of anorexia nervosa.

Warning Signs

  • Dramatic weight loss.
  • Preoccupation with weight, food, calories, fat grams, and dieting.
  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
  • Frequent comments about feeling “fat” or overweight despite weight loss.
  • Anxiety about gaining weight or being “fat.”
  • Denial of hunger.
  • Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate).
  • Consistent excuses to avoid mealtimes or situations involving food.
  • Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in.
  • Withdrawal from usual friends and activities.
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Health Consequences of Anorexia Nervosa

Anorexia nervosa involves self-starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing.  The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in dry, brittle bones.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.
  • Dry hair and skin, hair loss is common.
  • Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

Bulimia Nervosa

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.

Symptoms

  • Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting.
  • A feeling of being out of control during the binge-eating episodes.
  • Self-esteem overly related to body image.

The chance for recovery increases the earlier bulimia nervosa is detected. Therefore, it is important to be aware of some of the warning signs of bulimia nervosa.

Warning Signs of Bulimia Nervosa

  • Evidence of binge eating, including disappearance of large amounts of food in short periods of time or finding wrappers and containers indicating the 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.
  • Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury, the compulsive need to “burn off” calories taken in.
  • Unusual swelling of the cheeks or jaw area.
  • Calluses on the back of the hands and knuckles from self-induced vomiting.
  • Discoloration or staining of the teeth.
  • Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.
  • Withdrawal from usual friends and activities.
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
  • Continued exercise despite injury; overuse injuries.

Health Consequences of Bulimia Nervosa

Bulimia nervosa can be extremely harmful to the body.  The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.  Some of the health consequences of bulimia nervosa include:

  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death.  Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture is an uncommon but possible side effect of binge eating.

Binge Eating Disorder

Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.

Symptoms

  • Frequent episodes of consuming very large amount of food but without behaviors to prevent weight gain, such as self-induced vomiting.
  • A feeling of being out of control during the binge eating episodes.
  • Feelings of strong shame or guilt regarding the binge eating.
  • Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.

Health Consequences of Binge Eating Disorder

The health risks of BED are most commonly those associated with clinical obesity.  Some of the potential health consequences of binge eating disorder include:

  • High blood pressure
  • High cholesterol levels
  • Heart disease
  • Diabetes mellitus
  • Gallbladder disease
  • Musculoskeletal problems

Other Specified Feeding or Eating Disorder

Formerly described at Eating Disorders Not Otherwise Specified (EDNOS) in the DSM-IV, Other Specified Feeling or Eating Disorder (OSFED), is a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder.

Examples of OSFED Include:

  • Atypical anorexia nervosa (weight is not below normal)
  • Bulimia nervosa (with less frequent behaviors)
  • Binge-eating disorder (with less frequent occurrences)
  • Purging disorder (purging without binge eating)
  • Night eating syndrome (excessive nighttime food consumption)

The commonality in all of these conditions is the serious emotional and psychological suffering and/or serious problems in areas of work, school or relationships. If something does not seem right, but your experience does not fall into a clear category, you still deserve attention. If you are concerned about your eating and exercise habits and your thoughts and emotions concerning food, activity and body image, we urge you to consult an ED expert.

Orthorexia

Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.”  Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity.  They become consumed with what and how much to eat, and how to deal with “slip-ups.”

Do I Have Orthorexia?

Consider the following questions.  The more questions you respond “yes” to, the more likely you are dealing with orthorexia.

  • Do you wish that occasionally you could just eat and not worry about food quality?
  • Do you ever wish you could spend less time on food and more time living and loving?
  • Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?
  • Are you constantly looking for ways foods are unhealthy for you?
  • Do love, joy, play and creativity take a back seat to following the perfect diet?
  • Do you feel guilt or self-loathing when you stray from your diet?
  • Do you feel in control when you stick to the “correct” diet?
  • Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?

There are other eating disorders out there – but the ones listed are the most common. If you want more information on types of eating disorders, please visit the National Eating Disorders Associations’ website by clicking here.

What Causes an Eating Disorder?

I hear it ALL the time. The answer to WHY people, especially young women, form an eating disorder is because of the media and our society’s impeding expectations of how our bodies should look – THIN. Nope, no prize for you! Cultural expectations may CONTRIBUTE to a possible eating disorder, BUT only when other factors are already there, such as having a family member who suffered from an eating disorder (eating disorders are genetic like many other mental illnesses).

So, saying one single factor causes an eating disorder many be incorrect. X does NOT = an eating disorder. X + Y + B + D + C may CONTRIBUTE to an eating disorder.

Shoot, if our culture’s expectations of our bodies were the only culprit contributing to eating disorders, EVERYONE would have one. But that’s not the case, fortunately.

Below are factors that CONTRIBUTE to an eating disorder.

Psychological Factors that Can Contribute to Eating Disorders:

  • Low self-esteem
  • Feelings of inadequacy or lack of control in life
  • Depression, anxiety, anger, stress or loneliness

Interpersonal Factors that Can Contribute to Eating Disorders:

  • Troubled personal relationships
  • Difficulty expressing emotions and feelings
  • History of being teased or ridiculed based on size or weight
  • History of physical or sexual abuse

Social Factors that Can Contribute to Eating Disorders:

  • Cultural pressures that glorify “thinness” or muscularity and place value on obtaining the “perfect body”
  • Narrow definitions of beauty that include only women and men of specific body weights and shapes
  • Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths
  • Stress related to racial, ethnic, size/weight-related or other forms of discrimination or prejudice

Biological Factors that Can Contribute to Eating Disorders:

  • Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be unbalanced. The exact meaning and implications of these imbalances remain under investigation.
  • Eating disorders often run in families. Current research indicates that there are significant genetic contributions to eating disorders.

Eating disorders are complex conditions that can arise from a variety of potential causes. Once started, however, they can create a self-perpetuating cycle of physical and emotional destruction. Successful treatment of eating disorders requires professional help.

I Think Someone I Love May Be Suffering from an Eating Disorder…

If you or someone you know is suffering from an eating disorder, there’s help!

What to Say—Step by Step

  • Set a time to talk. Set aside a time for a private, respectful meeting with your friend to discuss your concerns openly and honestly in a caring, supportive way. Make sure you will be some place away from distractions.
  • Communicate your concerns. Share your memories of specific times when you felt concerned about your friend’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.
  • Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating disorders. If you feel comfortable doing so, offer to help your friend make an appointment or accompany your friend on their first visit.
  • Avoid conflicts or a battle of wills with your friend. If your friend refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.
  • Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes. Do not use accusatory “you” statements such as, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
  • Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”
  • Express your continued support.Remind your friend that you care and want your friend to be healthy and happy.
  • After talking with your friend, if you are still concerned with their health and safety, find a trusted adult or medical professional to talk to. This is probably a challenging time for both of you. It could be helpful for you, as well as your friend, to discuss your concerns and seek assistance and support from a professional.

If you or someone you know is struggling with an eating disorder, please call the National Eating Disorders Association’s Helpline

NEDA_Helpline_WebHeader

Eating disorders are SERIOUS, LIFE-THREATENING mental illnesses – not to be joked about or taken lightly. I encourage you all to further educate yourself on eating disorders and be an advocate for positive body image.