Eating Disorders

What are eating disorders?

An eating disorder is a mental health condition. It is an obsession with food and weight that harms a person’s emotional and physical well-being and interferes with their everyday life. Many people worry about their weight. However, people who have an eating disorder go to extremes to keep from gaining weight. The 3 most common eating disorders are:

• Anorexia nervosa
• Bulimia
• Binge eating

What is anorexia nervosa?

Anorexia nervosa (often shortened to anorexia) is an illness that usually occurs in teenage girls. It also can occur in teenage boys, and in adult women and men. People who have anorexia are obsessed with being thin. They don’t want to eat. They may try to hide their eating disorder by pretending to have eaten. They are afraid of gaining weight. They may constantly worry about how many calories they consume or how much fat is in their food. They may take diet pills, laxatives, or water pills to lose weight. They may exercise too much.

People who have anorexia usually think they’re fat even though they’re very thin. They may get so thin that they look like they’re sick. Anorexia isn’t just a problem with food or weight. It’s an attempt to use control over food and weight to deal with emotional problems.

People who have anorexia may feel cold all the time, and they may get sick often. They are often in a bad mood. They have a hard time concentrating and are always thinking about food. It is not true that anorexics are never hungry. They are always hungry. Feeling hunger gives them a feeling of control over their lives and their bodies. It makes them feel like they are good at something—they are good at losing weight. People who have severe anorexia may be at risk of death from starvation.

What is bulimia?

Bulimia is eating an unusual amount of food at once (called bingeing), and then getting rid of it. This includes throwing up or using laxatives to remove the food from the body (called purging). After a binge, some bulimics fast (don’t eat) or over-exercise to keep from gaining weight. People who have bulimia may also use water pills, laxatives, or diet pills to “control” their weight. People who have bulimia often try to hide their bingeing and purging. They may hide food for binges. People who have bulimia are usually close to normal weight, but their weight may go up and down.

What is binge eating?

Binge eating disorder is eating an excessive amount of food at once and not purging it. People who have a binge eating disorder are typically overweight or have obesity. It is the most common eating disorder in the U.S.

Symptoms of eating disorders

What are the warning signs of an eating disorder?

The following are possible warning signs of anorexia and bulimia:

• Unnatural concern about body weight (even if the person is not overweight)
• Obsession with calories, fat grams, and food
• Using any medicines to keep from gaining weight (diet pills, laxatives, water pills)
• Eating large amounts of food at one setting (and being overweight or having obesity)
• Physical complications, such as declining dental health, hair, skin, and nail disorders, heart problems and other conditions that arise from poor nutrition

More serious warning signs may be harder to notice because people who have an eating disorder are skilled at keeping it a secret. Watch for these signs:

• Throwing up after meals
• Fainting with no explanation
• Increased anxiety about weight
• Calluses or scars on the knuckle (from forced throwing up)
• Dental breakdown
• Denying that there is anything wrong

What are the warning signs of anorexia?

• Deliberate self-starvation with weight loss
• Fear of gaining weight
• Refusal to eat or skipping meals
• Denial of hunger
• Wearing baggy clothes
• Constant exercising
• Greater amounts of hair on the body or the face
• Sensitivity to cold temperatures
• Absent or irregular periods in girls or women
• Loss of scalp hair
• A self-perception of being fat when the person is actually too thin

What are the warning signs of binge eating?

• Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
• Eating even when you’re full or not hungry
• Eating fast while bingeing
• Eating until you’re painfully full or sick
• Eating alone or in secret because you’re embarrassed
• Feeling stressed, ashamed, or guilty when bingeing
• Trying to diet on occasion without success

What causes eating disorders?

Doctors don’t know exactly. Possible causes include genetic, environmental, peer pressure, and emotional health. Certain risk factors contribute to an eating disorder, including:

• Age
• Gender (women and girls are more likely to be diagnosed than men and boys)
• Family history
• Dieting
• Life changes

How are eating disorders diagnosed?

Eating disorders are most often diagnosed by examining physical health as well as mental health. Your doctor will evaluate your eating habits and order tests to help determine a diagnosis. They will also likely refer you to a mental health provider for evaluation.

Can eating disorders be prevented or avoided?

There is no known way to prevent eating disorders. The reason some people develop eating disorders isn’t known. People who have anorexia may believe they would be happier and more successful if they were thin. They want everything in their lives to be perfect. People who have this disorder are usually good students. They are involved in many school and community activities. They blame themselves if they don’t get perfect grades, or if other things in life are not perfect.

Treatment for eating disorders

Most of the time, eating disorders are treated with a combination of prescription medicine (anti-depressants, anti-anxiety), talk therapy, and nutritional counseling.

If you’re malnourished or very thin, you may be admitted to the hospital to treat the serious side effects of an eating disorder. Your doctor will probably want you to see a dietitian to learn how to pick healthy foods and eat at regular times. Family and individual counseling (talking about your feelings about your weight and problems in your life) is helpful for people who have eating disorders.

For people who have anorexia, the first step is getting back to a normal weight. Treatment of anorexia is difficult, because people who have anorexia believe there is nothing wrong with them. Patients in the early stages of anorexia (less than 6 months or with just a small amount of weight loss) may be successfully treated without having to be admitted to the hospital. But for successful treatment, patients must want to change and must have family and friends to help them.

People who have more severe anorexia need care in the hospital, usually in a special unit for people who have anorexia and bulimia. Treatment involves more than changing the person’s eating habits. Anorexic patients often need counseling for a year or more so they can work on changing the feelings that are causing their eating problems. These feelings may be about their weight, family problems, or problems with self-esteem. Some anorexic patients are helped by taking medicine that makes them feel less depressed.

How can family and friends help?

The most important thing that family and friends can do to help a person who has anorexia is to love them. People who have anorexia feel safe, secure, and comfortable with their illness. Their biggest fear is gaining weight, and gaining weight is seen as loss of control. They may deny they have a problem. People who have anorexia will beg and lie to avoid eating and gaining weight, which is like giving up the illness. Family and friends should not give in to the pleading of the anorexic patient.

Living with an eating disorder

It’s healthy to watch what you eat and to exercise. What isn’t healthy is worrying all the time about your weight and what you eat. People who have eating disorders do harmful things to their bodies because of their obsession about their weight. If it isn’t treated, anorexia can cause the following health problems:

• Stomach problems
• Heart problems
• Irregular periods or no periods
• Fine hair all over the body, including the face
• Dry, scaly skin
• Poor dental health

If it isn’t treated, bulimia can cause the following health problems:

• Stomach problems
• Heart problems
• Kidney problems
• Dental problems (from throwing up stomach acid).
• Dehydration (not enough water in the body).

If it isn’t treated, binge eating can lead to multiple health conditions, including:

• Heart disease
• Diabetes
• High blood pressure

Questions to ask your doctor

• What treatment is best for me?
• Will I have to be in treatment for the rest of my life?
• What can I do to help my child get better?
• Does my child have an eating disorder?
• Do I need counseling?
• Why do I have an eating disorder?
• Is there a medicine I should take?
• Do we need family counseling?
• Will my child need to be hospitalized?
• If I suspect my child has an eating disorder, what should I do?

Resources

National Alliance on Mental Illness: Eating Disorders

National Association of Anorexia Nervosa and Associated Disorders

National Eating Disorders Association

National Institute of Mental Health: Eating Disorders

Substance Abuse and Mental Health Services Administration: Eating Disorders