Food is a basic human need, but it can quickly turn into a weapon when misused or abused. Such is the case with eating disorders, which are estimated to affect 8 million people in the United States, including men and women.
While eating disorders are commonly linked to white women in the Western world who come from wealthier and well-educated households, the truth is, “Eating disorders are prevalent in many different cultures and have been for a long time. This just continues to prove there are no barriers when it comes to eating disorders. Males, females, Caucasians, African Americans, Asian Americans, Mexican Americans and other ethnic minorities all can struggle with eating disorders,” writes EatingDisorderHope.com.
Serious conditions arising from disturbances in eating behaviors can affect health and well-being and all areas of life, and—if left untreated—they can lead to serious health consequences and possibly death.
What Is an Eating Disorder?
An eating disorder is a complex, serious illness that involves irregular eating habits and severe distress and behaviors concerning weight, body image, and food issues. The Centers for Disease Control and Prevention (CDC) notes that while eating disorders are characterized by severe disturbances in eating behavior, they are more than just a problem with food.
According to the National Eating Disorders Association, “eating disorders have the highest mortality rate of any psychiatric illness.” The organization also says suicide is common among people with eating disorders and the quality of their lives are severely affected by their illness.
Eating disorders can affect anyone of any age, gender, culture, or socioeconomic background. They typically develop during adolescence or early adulthood, but they also can emerge during childhood or in later adulthood, says the CDC. They also can re-emerge at any age for someone who previously had an illness in the past.
Nearly 50% of individuals with an eating disorder are also abusing drugs and/or alcohol, a rate 5 times greater than what is seen in the general population.
A variety of factors cause eating disorders to develop and each person’s experience may differ from someone else’s. According to Eating Disorder Hope’s website, “it is generally believed that a combination of biological, psychological, and environmental abnormalities contribute to the development of these illnesses.”
Biological factors include genetics, irregular functioning hormones, and nutritional deficiencies. Psychological factors include negative feelings about body image and low self-esteem, and environmental factors, such as dysfunctional family dynamic, trauma, peer pressure, and careers that promote thinness, such as ballet and modeling, are also contributors.
WHICH EATING DISORDERS ARE COMMON?
There are a number of disorders involving disturbances in eating behaviors, but Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder are the three most common ones. A new category of eating disorder, called Avoidant-Restrictive Food Intake Disorder (ARFID), was added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Keep reading to learn more about each one.
People with Anorexia Nervosa have a distorted view of body image that drives their obsessive fear of gaining weight. Because of this fear, they maintain an abnormally low body weight and will go to extreme efforts to control their weight and shape. This includes starving oneself, skipping meals altogether, or eating foods they consider low enough in calories that won’t result in weight gain if consumed.These efforts, writes the Mayo Clinic, interfere with their daily activities.
Dramatic weight loss, anxiety over weight gain, denying hunger, and excessive exercise are all warning signs of this illness. A person with Anorexia Nervosa may even develop “food rituals,” to combat weight gain, such as eating food in a specific order, chewing excessively, or rearranging food items on a plate.
Typical signs of anorexia nervosa include:
Severely low body weight
Seeing themselves as obese or overweight when they are not
Constant and unsatisfying pursuit of weight loss
Failure to maintain a healthy body weight
Severely distorted body image, regardless of what others say
Health consequences of Anorexia Nervosa include:
Abnormally low heart rate and blood pressure
Bone density reduction
Emaciation (extreme thinness)
Muscle loss and weakness
Dryness and loss of skin and hair
Bulimia Nervosa is an eating disorder that describes when an abnormally large amount of food is quickly eaten in a short period, to the point of being uncomfortably full, and then regurgitated, or purged, immediately after it was consumed. Purging is brought about through vomiting, excessive use of laxatives or diuretics, or extreme periods of exercise.
Bulimia sufferers often report a complete and utter lack of control over their actions when it comes to food. The regurgitation is a direct cause from the guilt felt during the binge-eating episode that took place before.
Bulimia is different from anorexia in that it is not always noticeable that a person has the eating disorder. That’s because unlike anorexia, people with Bulimia Nervosa typically don’t have the severe weight loss that is often exhibited by those with anorexia.They may actually maintain a healthy weight despite having the disorder.
There still are, however, warning signs that one should be on the lookout for if bulimia is suspected. People with this condition will exhibit binge-eat, take frequent bathroom trips to purge food, and/or exercise excessively. They also may have unusual swelling of the cheeks and jaw, calluses on the hands and knuckles, and teeth discoloration or teeth stains.
Typical signs of Bulimia Nervosa are:
Chronic bowel movements
Deteriorating tooth enamel
Gastric rupture, acid reflux disorder
The health consequences of Bulimia Nervosa include:
Imbalance of electrolytes
Inflammation and possible rupture of the esophagus because of frequent vomiting
Peptic ulcers and pancreatitis
Binge Eating Disorder (BED) is reportedly the most common type of eating disorder in the United States. Binge eaters often have lost control of their eating. This illness is characterized by recurrent episodes of consuming large amounts of food to a quick point of discomfort. These episodes are accompanied by a feeling of a loss of control that is then followed by guilt, shame, disgust, and distress. Those who engage in binge eating may engage in purging behavior in an effort to fight off or manage this obsessive and compulsive disorder.
Binge eating is related to emotional eating, which involves the behavior of coping with emotional highs and lows linked to stress by overeating in large and frequent amounts. In May 2015, the DSM-5 released binge eating disorder as a diagnosable illness in May 2015.
Typical signs of Binge-Eating Disorder are:
Eating in secret, hiding
Eating even when full or not hungry
Extreme dieting and/or fasting
Health consequences of Binge-Eating Disorder include:
High blood pressure
Type ll diabetes
Binge eaters often have a higher tendency to also abuse drugs and alcohol in addition to food. Because of the nature behind addiction in general, especially that of a binge-eating disorder, the origin of the problem begins in the brain, making it a nuanced and complex issue that often requires the help of medical and addiction professionals.
Avoidant/Restrictive Food Intake Disorder, referred to as ARFID, is when a person’s lack of interest in eating or poor appetite causes a failure to meet the minimum daily nutritional requirements. This typically results in significant weight loss or failure to gain weight in childhood, according to the Mayo Clinic.
People with ARFID avoid foods with certain colors, textures, smells or tastes, not because of a distorted view of body image or fear of gaining weight.
ARFID is said to be the second most common eating disorder in children age 12 and younger, according to NationalEatingDisorders.org, which also reports the condition affects 20 percent of males. However, in addition to children, it can be diagnosed in adolescents and adults.
Typical signs of Avoidant/Restrictive Food Intake Disorder are:
Restricted or reduced intake accompanied by frequent somatic (i.e., pertaining to bodily symptoms and discomfort) complaints with no organic cause.
Lack of appetite or interest in food.
Fear of choking or vomiting associated with reduced intake or refusal to eat meals or snacks.
Inability or reluctance to eat in front of others in social settings (e.g., at school, at a friend’s house, in a restaurant).
Picky eating that extends beyond late childhood
Limited range of preferred foods that becomes narrower over time (i.e., picky eating that progressively worsens).
Health consequences of Avoidant/Restrictive Food Intake Disorder include:
Stunted growth, increased risk of failing to meet expected standards of growth because of inadequate nutritional intake.
Nutritional deficiencies (e.g., anemia or iron deficiency) and malnutrition which may be characterized by fatigue, weakness, brittle nails, dry hair/hair loss, difficulty concentrating, and reduction in bone density.
Weight loss or being severely underweight.
People with ARFID also are susceptible to psychiatric disorders, such as anxiety disorders and depression.
HOW SUBSTANCE ABUSE, EATING DISORDERS ARE RELATED
There is a strong link between eating disorders and Substance Abuse Disorders and addiction. According to an article published by the National Eating Disorders Association, alcohol abuse is common in the population of people who have eating disturbances. Alcohol, for instance, is used to assist in regurgitation and dehydration.
The article also goes on to say, “In addition to alcohol and illicit drugs (i.e., marijuana, cocaine, crack, methamphetamine, hallucinogens and club drugs such as ecstasy), individuals with eating disorders also abuse prescription (i.e., steroids, insulin, minor tranquilizers [sic], thyroid medications and psychostimulants such as Ritalin®) and over-the-counter drugs (i.e., diet pills, laxatives, diuretics, syrup of ipecac, and weight loss supplements such as Orlistat and Alli®).”
Substance abuse can develop before, during, or after treatment for an eating disorder. If both conditions are present at the same time, that is known as co-occurring disorders, or dual diagnosis.
If substance abuse and alcohol or drug addiction are issues in addition to an eating disorder, it is important to seek help from a licensed health professional who can address both conditions at the same time. An evaluation will have to be made first before determining the level of care that is needed. A 12-step program may also be helpful for people working to overcome addiction and an eating disorder.
TREATMENT FOR AN EATING DISORDER
Once an eating disorder has developed, professional help is recommended as it can be difficult to manage on one’s own. If you or someone you love are at risk of developing an eating disorder, getting help sooner rather than later can help prevent and avoid any long-term damage left over from the eating disorder.
Chronic eating disorders—if left untreated—can leave behind several different vascular and heart health issues on the individual. Complete recovery, however, is possible.
To determine whether a person has an eating disorder, a health care professional will ask questions about symptoms, medical history, and other areas. Diagnostic tests that check the blood and urine, as well as other kinds of tests that check the heart and gall bladder, also may be done before an assessment is completed.
According to WomensHealth.gov, treatment plans for eating disorders may include one or more of the following:
This will vary according to the illness being addressed. In anorexia cases, for example, the focus might be getting the client to reach and maintain a healthy weight.
Counseling that aims to help people change harmful thoughts or behaviors. Talking about feelings and triggers can help focus on the importance of talking about your feelings and how they affect what you do. For example, you might talk about how stress triggers a binge. You may work one-on-one with a therapist or in a group with others who have binge eating disorder.
A registered dietitian can promote healthier eating habits.
To help people with eating disorders share their experiences with others.
That can assist with helping address the disorder. The medicines prescribed will vary according to treatment for that particular illness.