By Heather Millar
Although the term “eating” is in the name, eating disorders are about more than food. They’re complex mental health conditions that often require the intervention of medical and psychological experts to alter their course.
These disorders are described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) .
In the United States alone, an estimated 28 million Americans have or have had an eating disorder at some point in their life.
What is an eating disorder?
Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop. They might start with an obsession with food, body weight, or body shape.
In severe cases, eating disorders can cause serious health consequences and may even result in death if left untreated. In fact, eating disorders are among the deadliest mental illnesses, second to opioid overdose.
People with eating disorders can have a variety of symptoms. Common symptoms include severe restriction of food, food binges, and purging behaviors like vomiting or overexercising.
Although eating disorders can affect people of any gender at any life stage, they’re increasingly common in men and gender nonconforming people. These populations often seek treatment at lower rates or may not report their eating disorder symptoms at all.
What causes eating disorders?
Experts believe that a variety of factors may contribute to eating disorders. One of these is genetics. People who have a sibling or parent with an eating disorder seem to be at an increased risk of developing one.
Personality traits are another factor. In particular, neuroticism, perfectionism, and impulsivity are three personality traits often linked to a higher risk of developing an eating disorder, according to a 2015 research review.
Other potential causes include perceived pressures to be thin, cultural preferences for thinness, and exposure to media promoting these ideals.
More recently, experts have proposed that differences in brain structure and biology may also play a role in the development of eating disorders. In particular, levels of the brain messaging chemicals serotonin and dopamine may be factors. However, more studies are needed before strong conclusions can be made.
Types of eating disorders
Eating disorders are a group of related conditions involving extreme food and weight issues, but each disorder has unique symptoms and diagnosis criteria. Here are six of the most common eating disorders and their symptoms.
Anorexia nervosa is likely the most well-known eating disorder. It generally develops during adolescence or young adulthood and tends to affect more women than men.
People with anorexia generally view themselves as overweight, even if they’re dangerously underweight. They tend to constantly monitor their weight, avoid eating certain types of foods, and severely restrict their calorie intake.
Anorexia is officially categorized into two subtypes — the restricting type and the binge eating and purging type.
• Individuals with the restricting type lose weight solely through dieting, fasting, or excessive exercise.
• Individuals with the binge eating and purging type may binge on large amounts of food or eat very little. In both cases, after they eat, they purge using activities such as vomiting, taking laxatives or diuretics, or exercising excessively.
• Anorexia can be very damaging to the body. Over time, individuals living with it may experience thinning of their bones, infertility, and brittle hair and nails. In severe cases, anorexia can result in heart, brain, or multi-organ failure and death.
Like anorexia, bulimia tends to develop during adolescence and early adulthood and appears to be less common among men than women. People with bulimia frequently eat unusually large amounts of food in a specific period of time. Each binge eating episode usually continues until the person becomes painfully full. During a binge, the person usually feels that they cannot stop eating or controlling how much they are eating.
Binges can happen with any type of food but most commonly occur with foods the individual would usually avoid. Individuals with bulimia then attempt to purge to compensate for the calories consumed and to relieve gut discomfort. Common purging behaviors include forced vomiting, fasting, laxatives, diuretics, enemas, and excessive exercise.
Symptoms may appear very similar to those of the binge eating or purging subtypes of anorexia nervosa. However, individuals with bulimia usually maintain a relatively typical weight rather than losing a large amount of weight. In severe cases, bulimia can also create an imbalance in levels of electrolytes, such as sodium, potassium, and calcium. This can cause a stroke or heart attack.
3.Binge eating disorder
Binge eating disorder is the most prevalent form of eating disorder and one of the most common chronic illnesses among adolescents. It typically begins during adolescence and early adulthood, although it can develop later on.
Individuals with this disorder have symptoms similar to those of bulimia or the binge eating subtype of anorexia. For instance, they typically eat unusually large amounts of food in relatively short periods of time and feel a lack of control during binges.
People with binge eating disorder do not restrict calories or use purging behaviors, such as vomiting or excessive exercise, to compensate for their binges. They often consume an excessive amount of food and may not make nutritious food choices. This may increase their risk of medical complications such as heart disease, stroke, and type 2 diabetes.
Pica is an eating disorder that involves eating things that are not considered food and that do not provide nutritional value. Individuals with pica crave non-food substances such as ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent, or cornstarch.
Pica can occur in adults, children, and adolescents. It is most frequently seen in individuals with conditions that affect daily functioning, including intellectual disabilities, developmental conditions such as autism spectrum disorder, and mental health conditions such as schizophrenia.
Individuals with pica may be at an increased risk of poisoning, infections, gut injuries, and nutritional deficiencies. Depending on the substances ingested, pica may be fatal. However, for the condition to be considered pica, the eating of non-food substances must not be a typical part of someone’s culture or religion. In addition, it must not be considered a socially acceptable practice by a person’s peers.
Rumination disorder is another newly recognized eating disorder. It describes a condition in which a person regurgitates food they have previously chewed and swallowed, re-chews it, and then either reswallows it or spits it out. This rumination typically occurs within the first 30 minutes after a meal.
This disorder can develop during infancy, childhood, or adulthood. In infants, it tends to develop between 3 and 12 months of age and often disappears on its own. Children and adults with the condition usually require therapy to resolve it.
If not resolved in infants, rumination disorder can result in weight loss and severe malnutrition that can be fatal. Adults with this disorder may restrict the amount of food they eat, especially in public. This may lead them to lose weight and become underweight.
6.Avoidant/restrictive food intake disorder
Avoidant/restrictive food intake disorder (ARFID) is a new name for an old disorder. The term has replaced the term “feeding disorder of infancy and early childhood,” a diagnosis previously reserved for children under age 7.
Individuals with this disorder experience disturbed eating due to either a lack of interest in eating or a distaste for certain smells, tastes, colors, textures, or temperatures.
Common symptoms of ARFID include:
• avoidance or restriction of food intake that prevents the person from eating enough calories or nutrients
• eating habits that interfere with typical social functions, such as eating with others
• nutrient deficiencies or dependence on supplements or tube feeding
• weight loss or poor development for age and height
It’s important to note that ARFID goes beyond common behaviors such as picky eating in toddlers or lower food intake in older adults. Moreover, it does not include the avoidance or restriction of foods due to lack of availability or religious or cultural practices.
How do you know if you have an eating disorder?
If you have an eating disorder, identifying the condition and seeking treatment sooner will improve your chances of recovering. Being aware of the warning signs and symptoms can help you decide whether you need to seek help.
Not everyone will have every sign or symptom at once, but certain behaviors may signal a problem, such as:
• behaviors and attitudes that indicate that weight loss, dieting, and control over food are becoming primary concerns
• discomfort with eating around others
• extreme concern with body size, shape, and appearance
• extreme mood swings
• food rituals (not allowing foods to touch, eating only particular food groups)
• frequent dieting or fad diets
• frequently checking in the mirror for perceived flaws in appearance
• preoccupation with weight, food, calories, fats, grams, and dieting
• refusal to eat certain foods
• skipping meals or eating only small portions
If these symptoms resonate with you and you think you may have an eating disorder, it’s important to reach out to a medical professional for help.