According to National Eating Disorders Association, as many as 10 million females and 1 million males in the United States suffer from anorexia or bulimia, and millions more struggle with binge eating disorder. The American Dietetic Association suggests that prevalence statistics such as these may be underestimates due to patients going undetected clinically and the secretive behaviors associated with these disorders. Regardless, eating disorders are life-threatening illnesses that are difficult to treat and have complex and varied symptom profiles.
Types of Eating Disorders
There are 5 major categories of disordered eating.
- Anorexia Nervosa involves an intense fear of gaining weight and a refusal to maintain minimally acceptable body weight for a person's height and age.
- Bulimia Nervosa involves repeated binge eating followed by behaviors meant to prevent weight gain (e.g., vomiting, use of laxatives, use of diuretics, excessive exercise).
- Avoidant/Restrictive Food Intake Disorder is the lack of interest in eating or in food; avoidance of sensory characteristics of food; concern about adverse effects of eating; or failure to meet appropriate nutritional/energy needs. There is, however, no fear of gaining weight or disturbance in body image.
- Binge-Eating Disorder involves recurrent periods of quick binge eating with a sense of having no control over when to stop eating. Significant distress about binge eating is present.
- Other Specified Feeding or Eating Disorders is a broad and varied category of eating disorders that are similar to but do not fit into the first four categories, yet they still have disordered eating as a main feature (e.g., sub-threshold eating disorders, night eating disorder, and childhood eating disorders).
Signs of Anorexic Tendencies
- Dieting despite being thin. This includes avoiding "bad" foods that contain carbohydrates or fat, eating only low-calorie foods, and fasting on a frequent basis.
- Intense focus on calories, fat grams, and carbohydrates.
- Pretending to eat or lying about eating meals.
- Secretive, strange, or ritualistic behavior around food. This includes chewing food and spitting it out, eating food in a particular order or chewing a specific number of times, consuming only liquids, refusing to eat in front of others, etc.
Signs of Binge Eating Tendencies
- Eating past the feeling of fullness or to the point of physical discomfort.
- Secretive eating. For example, eating after others in the home are in bed, avoidance of eating in front of someone, hiding food or making secret food runs to a grocery or restaurant.
- Alternating between eating large amounts of food and fasting.
Signs of Purging Tendencies
- Vomiting after eating or going to the bathroom immediately after meals.
- Using diet pills; use of enemas, laxatives, or diuretics frequently or when not needed, medically.
- Exercising multiple times per day or exercising longer periods of time than the recommended average time for your age, weight, or frame per day.
- Consuming high amounts of caffeine, use of energy drinks on a frequent basis, or use of other types of stimulants to burn calories.
Effects of Disordered Eating
Given the range of behaviors involved in disordered eating, there is also a range of serious physical effects on the body of someone who engages in these behaviors. For example, those who have anorexic and/or bulimic tendencies are at risk for heart failure, kidney failure, liver failure, bone loss, stomach ruptures and ulcers, mental confusion and cognitive impairment, depression and anxiety, and many other serious medical conditions. Those who engage in binge eating behaviors are at risk for developing Type II Diabetes, heart disease, high blood pressure, obesity, sleep apnea, and osteoarthritis, as well as other physical ailments.
Why Do People Develop Disordered Eating Behaviors?
Eating disorders are rarely about food. Generally, the factors leading to the development of disordered eating are a combination of biological, social, and psychological influences. Research suggests that people may have a genetic predisposition to anorexia or binge eating. There can be issues with hormones or brain chemistry, as well. Socially, media images and cultural norms in the United States dictate that "thin" is better than "fat." Families may have their own attitudes about body image and body size that create shame or negative self-image issues in children and adolescents. In addition, a high number of those with disordered eating have a history of sexual abuse in childhood and/or adulthood, perfectionism, difficulty managing emotions, depression, anxiety, or low self-esteem. Those who cannot cope with the demands of their life situation may turn to disordered eating to control at least some aspect of their world, to hide or manage emotions, or to avoid or distract themselves from harsh realities of life.
Getting Help to Change Disordered Eating Behaviors
If you or a loved one struggles with disordered eating, there are three major components to the recovery process.
- Seek assistance from your support system and a mental health professional. Talking to friends or family members about disordered eating can be difficult, but breaking the silence and shame associated with the behaviors is essential to recovery. Therapy or counseling can assist in improving understanding and management of the causes of the disordered behaviors, as well as help people learn how to talk about their problems with supportive friends and family members.
- Consult an expert in nutrition. A registered dietician can help a person understand the need for certain foods in his or her daily meal plan, develop healthy weight loss/weight gain goals, design a reasonable exercise program, challenge negative attitudes about food, and support healthy lifestyle choices.
- Inform your primary care physician and seek support from a psychiatrist, if needed. Many people with disordered eating can have low levels of magnesium, sodium, and potassium and serious physical problems that need monitoring and treatment. A psychiatrist can recommend medications that can assist in managing negative thought processes or mood disturbances that lead to disordered eating behaviors as coping.
Those looking for more information or resources for eating disorder assessment, diagnosis, and treatment can make an appointment with Work/Life Connections – EAP.
You can also visit the following websites for more information about services and helping yourself or a loved one to recover from an eating disorder:
Local Eating Disorder Treatment Facilities:*
*WLC-EAP does not recommend any particular treatment center. The places listed are for information purposes only.
Keywords: Eating, Disorder, Anorexia, Bulimia, Binge, Purge