Eating Disorders
Eating disorders are serious bio-psycho-social diseases that affect millions of adolescents across the country. They are both physical and mental illnesses, as they affect eating behaviors, causing serious medical implications, AND related thoughts and emotions. It is crucial for a disorder to be recognized and diagnosed early, as the earlier the diagnosis, the more likely a complete recovery will happen. However, this may be difficult, as teens often go to great lengths to hide their behavior, OR may be in denial or even unaware of their disorder.
The three most common eating disorders are: anorexia nervosa, bulimia nervosa, and binge-eating disorder.
Anorexia Nervosa
Those with anorexia nervosa have a distorted body image and feel that they are overweight or fat, even if they are very underweight. They have an intense fear of gaining weight and attempt to control these feelings by extremely limiting their food intake or excessively dieting. Their self-esteem depends on their perception of their own body weight and shape. Patients diagnosed with anorexia nervosa weigh at least 15% less than normal healthy body weight for their height so may be abnormally thin, but have a denial of the severity of their low body weight. Anorexia nervosa has the highest mortality rate of any mental disorder due to either starvation complications or suicide.
Signs of Anorexia Nervosa:
Extreme restriction of food
Weighing self repeatedly and excessively
Compulsively or obsessively exercising
Using laxatives or forcing self to vomit to lose weight
Obsessively counting calories
Denial of feelings of hunger
Hiding or discarding food
Developing rituals for preparing or eating food
Social withdrawal: removal of self from relationships, social activities, and pleasurable experiences
Heightened emotional changes (irritability, depression, anxiety, etc.)
Physical Symptoms of Anorexia Nervosa:
Rapid and/or excessive weight loss
Thinning hair
Feeling cold, tired or weak
Absence of menstrual cycles (females)
Dizziness and/or fainting
Severe constipation
Brittle hair/nails
Depression and lethargy
Dry, slightly yellow skin
Osteoporosis (bone thinning)
Drop in blood pressure, slowed breathing & pulse
Bulimia Nervosa
Bulimia nervosa is constituted by a binge-and-purge cycle. Those with this disorder first binge eat frequently by eating extremely large amounts of food in a short time without feeling any control over the episodes. Then, they purge to compensate for these binge eating episodes by forcing themselves to vomit, using laxatives, enemas, or diuretics, fasting, and excessively exercising. These binge and purge episodes happen frequently and can occur as often as several times a day. The attempts to compensate and purge are because of a fear of gaining weight as well as stomach pain from having binge ate too much. Those suffering from bulimia nervosa have a distorted body image and preoccupation with body weight and shape. However, people with bulimia nervosa can be anywhere from underweight to normal weight to overweight. This is a common disorder to go unnoticed because the person suffering tried very hard to hide their binges and may not even lose or gain weight. Bulimia Nervosa is diagnosed if the person binges an average of once a week for at least three consecutive months.
Signs of Bulimia Nervosa:
Eating abnormally large amounts of food with no apparent great weight gain
Hiding food or discarded food
Frequent trips to bathroom after eating
Overachieving and impulsive behaviors
Excessive exercising or fasting
Frequently clogged showers or toilets
Physical Symptoms of Bulimia Nervosa:
Discolored teeth
Breath odor
Stomach pain
Inflamed and sore throat
Dehydration
Puffy “chipmunk” face (due to swollen salivary glands in neck)
Calluses or scarring on hands (caused by self-induced vomiting)
Acid reflux or other gastrointestinal problems
Irregular or absent menstrual cycles (females)
Weakness
Fatigue
Binge-Eating Disorder
Binge-Eating disorder is similar to bulimia nervosa, as it is defined by one uncontrollably and excessively eating in short binge eating periods of time. However, unlike bulimia nervosa, those with binge-eating disorder don’t purge and compensate for their binges by force vomiting, using laxatives, or any other measures. Those with binge eating disorder may be overweight or even obese. It is the most common eating disorder in U.S. and is diagnosed if binges occur an average of once a week for at least three consecutive months.
Signs of Binge-Eating Disorder:
Eating an unusually large amount of food in a specific time period (such as 2 hours)
Eating when full or not hungry
Eating unusually fast
Eating until uncomfortably full
Eating alone or in secret because of embarrassment due to the amount of food one is consuming
Eating when stressed or when feeling uncertain or unable to cope
Feeling guilty, ashamed, distressed, or depressed after eating
Frequent experimentation with dieting
Physical Symptoms of Binge-Eating Disorder:
Weight gain
High blood pressure
Diabetes
Irregular menstrual cycle (females)
Skin disorders
Heart disease
Eating Disorder Treatment
Eating disorder treatment attempts to help an individual struggling with an eating disorder learn and gain skills in order to create a healthy relationship with food. Eating disorder treatment is a multidisciplinary treatment process.
It involves all of the following areas of treatment: psychiatric, medical, individual, group (and family) therapy, as well as nutritional rehabilitation, which includes getting one’s body weight and health back to normal and modifying their eating and exercise behavior.
Physical well-being steps in treatment occur first. For those suffering from anorexia nervosa, one first regains their body weight. For bulimia nervosa, those suffering must interrupt their binge-purge cycle, and for binge-eating disorder, those suffering must interrupt and stop their binges. Then, those suffering from any of the three must address and treat underlying emotional and psychological problems. This is because co-occurring (potentially psychiatric) disorders are common for those with eating disorders. These co-occurring disorders can include anxiety, depression, OCD, trauma or substance abuse, and self-harming behavior (cutting and/or burning) and may require medication to treat.
Eating disorders encompass both the body and the mind, and it is therefore extremely important that eating disorder treatment also addresses these psychological issues as well.
Myth vs. Facts of Eating Disorders
MYTH: You can tell if someone has an eating disorder based off of their physical appearance.
FACT: Anyone can have an eating disorder, regardless of body shape and size. Someone with anorexia may not appear drastically underweight and someone with binge-eating disorder may not appear greatly overweight. Even an apparently fit athlete can have an eating disorder. You cannot determine a person’s health by just their weight or how you see them.
MYTH: Eating disorders are benign (not that harmful).
FACT: Eating disorders can not only cause serious physical problems for one’s body, but are also serious psychological conditions. They are considered a mental illness, one with the highest mortality rate and are also associated with an increased risk of suicide.
MYTH: Eating disorders are a lifestyle choice.
FACT: Eating disorders are actually illnesses with both mental and physical consequences. One doesn’t “choose” to have this illness. The only choice one can make is to pursue the path of recovery which can be extremely difficult, as one has to learn how to overcome this illness that may be their primary way of coping with intense emotions and difficult life events.
