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Eating Disorders

An eating disorder is a behavioral condition defined as a severe preoccupation with eating, exercise, and body shape, which becomes an unhealthy obsession in a person’s life. While anorexia nervosa is perhaps the most well-known eating disorder in TV and media, there are many different types of eating disorders, including bulimia nervosa (BN), binge eating disorder (BED), and avoidant/restrictive intake disorder (ARFID). An eating disorder is a coping mechanism to deal with other aspects of life, mainly by controlling food.

Did You Know?

Eating disorders are the deadliest mental illness. While all eating disorders are serious and require professional treatment, anorexia nervosa is considered the deadliest of them all, with about 6% of sufferers dying primarily from nutrient insufficiency.
Signs of an Eating Disorder

Some of the common signs of any eating disorder include frequent dieting, constantly worrying about the nutrition content of food, restricting certain foods or food groups, feeling uncomfortable eating around other people, skipping meals, feeling the need to burn off calories with exercise, unexplained gastrointestinal issues, using the bathroom right after a meal, hiding food, and food rituals or rules. Some common food rules include eating at specific times, weighing and measuring food, and chewing food a particular number of times. These thoughts and behaviors are unique to eating disorders when the overall goal is weight loss or manipulating your body size.

Disordered Eating vs. Eating Disorder

Many people do not qualify for an eating disorder diagnosis but may struggle with disordered eating patterns. Disordered eating may present as being obsessed with only eating “clean” or perfectly healthy foods and being afraid to eat certain foods. Some people experience “yo-yo dieting,” a term for weight cycling related to constantly trying new diets. While this may not be an official diagnosis, it can still cause the same emotional distress as an eating disorder. Disordered eating can also be physically dangerous and put the body at risk. Rapid weight loss caused by food restriction or overexercise can cause deleterious effects on the heart, brain, bones, and kidneys. The health consequences of bulimia, especially, in which someone engages in binge and purge behavior, include tooth decay, ulcers, gallbladder disease, and heart failure after severe electrolyte imbalance. Eating disorders can also strain the digestive system and put an individual at risk for a rupture in the digestive tract.

Many people struggling with an eating disorder experience body dysmorphic disorder (BDD), in which you can’t stop thinking about perceived flaws in your appearance. Some signs of BDD include avoiding social situations due to fear of judgment, anxiety about other people’s perceptions, attempting to hide flaws with makeup or clothes, constantly comparing appearance to others, frequent grooming, and skin picking. Studies show that many people with an eating disorder may struggle with BDD and use food and exercise to manipulate their body size. If left unaddressed, BDD can severely impair a person’s quality of life and cause difficulty in maintaining relationships.

Disordered Eating vs. Eating Disorder

Eating disorders affect about 5% of the population and most often develop in childhood. Most eating disorders affect people between 12 and 35. They are more common in women, but this illness does not discriminate—it equally affects people of all weights, sizes, gender identities, sexualities, and ethnicities. Many experts believe that 1 in 3 people with an eating disorder are male. The stereotypical image of a thin, emaciated person is perilous as it only perpetuates the idea that someone must look “sick” to struggle with their eating habits. Less than 6% percent of people with an eating disorder are considered medically underweight. Therefore, it is not always obvious to tell when someone is struggling, and body size is rarely an indicator of someone’s emotional or mental well-being.

Stigma and Treatment

Unfortunately, these stigmas only cause more difficulty when seeking treatment for this condition. Because of the shame and negative connotations associated with eating disorders, many people suffer in silence. However, it is imperative to ask for help if you are worried about your relationship with food, body image, or exercise. Asking for help can help reduce your risk of complications related to the eating disorder. Anorexia, for example, has the highest mortality rate of all mental health disorders. There is also a strong link between eating disorders and other psychiatric disorders, including depression, OCD, anxiety, and substance abuse. Conversely, a pre-existing mental health condition early in life is thought to increase a person’s risk of developing an eating disorder later.

Many risk factors may contribute to developing an eating disorder, including a history of mental health struggles, family dynamics, societal pressures, and trauma. Family history also plays a role, and individuals with a family member who struggles are 11 times more likely to develop one themselves. The field of eating disorder research has also identified several genetic factors that may contribute, and many studies show biology’s role in this disease. 40-60% of the risk of developing an eating disorder is thought to be due to genetic factors.

While we may never know the exact cause of an eating disorder, the treatment remains the same. Support by way of trained mental health professionals, dietitians, and medical staff is the best way to begin the journey of healing. Treatment depends on the type and severity of the eating disorder but typically includes a combination of therapy, nutrition education, and medical monitoring. With proper care, an individual struggling with an eating disorder can resume healthy eating habits and recover their health and well-being.

References:

  1. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Arch Gen Psychiatry. 2011;68(7):724–731. doi:10.1001/archgenpsychiatry.2011.74
  2. Himmerich, H., Bentley, J., Kan, C., & Treasure, J. (2019). Genetic risk factors for eating disorders: an update and insights into pathophysiology. Therapeutic advances in psychopharmacology, 9, 2045125318814734. https://doi.org/10.1177/2045125318814734
  3. Nationaleatingdisorders.org. 2020. What Are Eating Disorders?. [online] Available at: <https://www.nationaleatingdisorders.org/what-are-eating-disorders> [Accessed December 2020].
  4. Papadopoulos, F. C., Ekbom, A., Brandt, L., & Ekselius, L. (2009). Excess mortality, causes of death and prognostic factors in anorexia nervosa. The British journal of psychiatry : the journal of mental science, 194(1), 10–17. https://doi.org/10.1192/bjp.bp.108.054742
  5. Redgrave, G. W., Coughlin, J. W., Heinberg, L. J., & Guarda, A. S. (2007). First-degree relative history of alcoholism in eating disorder inpatients: relationship to eating and substance use psychopathology. Eating behaviors, 8(1), 15–22. https://doi.org/10.1016/j.eatbeh.2006.01.005
  6. Sardar, M. R., Greway, A., DeAngelis, M., Tysko, E. O., Lehmann, S., Wohlstetter, M., & Patel, R. (2015). Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review. Heart views : the official journal of the Gulf Heart Association, 16(3), 88–92. https://doi.org/10.4103/1995-705X.164463

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