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Eating disorders

What is it?

What causes it?

Signs/

Symptoms

Treatments/ Therapies

Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological and social function. Types of eating disorders include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder, Pica and Rumination Disorder, and other specified feeding and eating disorders. 

Taken together, eating disorders affect up to 5% of the population and most often develop in adolescence and young adulthood. Several, especially Anorexia Nervosa and Bulimia Nervosa, are more common in women, but they can all occur at any age and affect any gender. Eating disorders are often associated with preoccupations with food, weight or shape, or with anxiety about eating or the consequences of eating certain foods.

Behaviors associated with eating disorders include:

  • Restrictive eating or avoidance of certain foods

  • Binge eating

  • Purging by vomiting

  • Laxative misuse

  • Compulsive exercise

 

These behaviors can become driven in ways that appear similar to an addiction.   

Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA),

The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes, such as: 

  • Genetics and biology. Certain people may have genes that increase their risk of developing eating disorders. Biological factors, such as changes in brain chemicals, may play a role in eating disorders.

  • Psychological and emotional health. People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may exhibit low self-esteem, perfectionism, impulsive behavior and troubled relationships.

Eating disorders often co-occur with other psychiatric disorders most commonly mood and anxiety disorders, Obsessive Compulsive Disorder and alcohol and drug abuse problems. Evidence suggests that genes and inheritability play a part in why some people are at higher risk for an eating disorder, but these disorders can also afflict those with no family history of the condition.

Treatment should address psychological, behavioral, nutritional and other medical complications. The latter can include consequences of malnutrition or of purging behaviors including heart and gastrointestinal problems, as well as other potentially fatal conditions. Ambivalence towards treatment, denial of a problem with eating and weight, or anxiety about changing eating patterns is not uncommon. With proper medical care, however, those with eating disorders can resume healthy eating habits, and recover their emotional and psychological health.      

Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA),

The chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder. 

(This isn’t intended as a checklist. Someone struggling with an eating disorder generally won’t have all of these signs and symptoms at once, and the warning signs vary across eating disorders and don’t always fit into neat categories. Rather, these lists are intended as a general overview of the types of behaviors that may indicate a problem.)

 

If you have any concerns about yourself or a loved one, please contact the NEDA Helpline and seek professional help.     

                                                                                                                         

Emotional and Behavioral Signs:

 

  • In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns

  • Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting

  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

  • Uncomfortable eating around others

  • Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)

  • Skipping meals or taking small portions of food at regular meals

  • Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

  • Withdrawal from usual friends and activities

  • Frequent dieting

  • Extreme concern with body size and shape

  • Frequent checking in the mirror for perceived flaws in appearance

  • Extreme mood swings

Physical Signs:

 

  • Noticeable fluctuations in weight, both up and down

  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

  • Menstrual irregularities - missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

  • Difficulty concentrating

  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)

  • Dizziness, especially upon standing

  • Fainting/syncope

  • Feeling cold all the time

  • Sleep problems

  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)

  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity

  • Dry skin and hair, and brittle nails

  • Swelling around area of salivary glands

  • Fine hair on body (lanugo)

  • Cavities, or discoloration of teeth, from vomiting

  • Muscle weakness

  • Yellow skin (in context of eating large amounts of carrots)

  • Cold, mottled hands and feet or swelling of feet

  • Poor wound healing

  • Impaired immune functioning

Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA)

For parents/ caregivers:

Although there's no sure way to prevent eating disorders, here are some strategies to help your child develop healthy-eating behaviors:

 

  • Avoid dieting around your child. Family dining habits may influence the relationships children develop with food. Eating meals together gives you an opportunity to teach your child about the pitfalls of dieting and encourages eating a balanced diet in reasonable portions.

  • Talk to your child. For example, there are numerous websites that promote dangerous ideas, such as viewing anorexia as a lifestyle choice rather than an eating disorder. It's crucial to correct any misperceptions like this and to talk to your child about the risks of unhealthy eating choices.

  • Cultivate and reinforce a healthy body image in your child, whatever his or her shape or size. Talk to your child about self-image and offer reassurance that body shapes can vary. Avoid criticizing your own body in front of your child. Messages of acceptance and respect can help build healthy self-esteem and resilience that will carry children through the rocky periods of the teen years.

  • Enlist the help of your child's doctor. At well-child visits, doctors may be able to identify early indicators of an eating disorder. They can ask children questions about their eating habits and satisfaction with their appearance during routine medical appointments, for instance. These visits should include checks of height and weight percentiles and body mass index, which can alert you and your child's doctor to any significant changes.

If you notice a family member or friend who seems to show signs of an eating disorder, consider talking to that person about your concern for his or her well-being. Although you may not be able to prevent an eating disorder from developing, reaching out with compassion may encourage the person to seek treatment.       

                                                                                                                                                                                     Treatment of an eating disorder generally includes a team approach. The team typically includes primary care providers, mental health professionals and dietitians - all with experience in eating disorders.

 

Treatment depends on your specific type of eating disorder, but in general, it typically includes nutrition education, psychotherapy and medication. If your life is at risk, you may need immediate hospitalization.

  • Healthy eating: No matter what your weight, the members of your team can work with you to design a plan to help you achieve healthy eating habits.

  • Psychotherapy: Psychotherapy, also called talk therapy, can help you learn how to replace unhealthy habits with healthy ones. This may include:

    • Family-Based Therapy (FBT): FBT is an evidence-based treatment for children and teenagers with eating disorders. The family is involved in making sure that the child or other family member follows healthy eating patterns and maintains a healthy weight.

    • Cognitive Behavioral Therapy (CBT): CBT is commonly used in eating disorder treatment, especially for Bulimia and Binge-Eating Disorder. You learn how to monitor and improve your eating habits and your moods, develop problem-solving skills, and explore healthy ways to cope with stressful situations.

 

  • Medications: Medication can't cure an eating disorder. However, certain medications may help control urges to binge or purge or to manage excessive preoccupations with food and diet. Drugs such as antidepressants and anti-anxiety medications may help with symptoms of depression or anxiety, which are frequently associated with eating disorders.

  • Hospitalization: If an individual has serious health problems, such as Anorexia, that has resulted in severe malnutrition, a doctor may recommend hospitalization. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.

Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA) 

"With Hope, the Amber Craig Memorial Foundation is dedicated to suicide prevention through improving mental health awareness and education in our schools and throughout our community."

DISCLAIMER: The diagnosis and treatment of depression and other psychiatric disorders requires a trained medical professional. Information contained in this website reflects the opinions of With Hope Foundation, and is intended for educational purposes only. It should NOT be used as a substitute for professional diagnosis and treatment of any mental/psychiatric disorders. Please consult a medical professional if the information here leads you to believe you or someone you know may be depressed.

© 2022 Copyright With Hope, the Amber Craig Memorial Foundation. All rights reserved.
With Hope, the Amber Craig Memorial Foundation | P.O. Box 550 | Placentia, CA 92871 | (714)-524-1996

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