Eating Disorders

Eating Disorders

Eating disorders involve extreme disturbances in eating behavior such as following rigid diets, gorging on food in secret, throwing up after meals, or obsessively counting calories. Causes of eating disorders are more complicated than just unhealthy dietary habits. At their core, eating disorders involve distorted, self-critical attitudes about weight, weight loss, food, dieting, and body image. It’s these negative thoughts and feelings that fuel the damaging behaviors.

Teens, women and men with eating disorders use food to deal with uncomfortable or painful emotions. Restricting food is used to gain a feeling of control. Binging on food or overeating temporarily soothes sadness, anger, or loneliness. Purging (throwing up after eating) is used to combat feelings of helplessness and self-loathing. Over time, people with eating disorders lose the ability to see themselves objectively, and obsessions over food and weight come to dominate everything else in life.

Affects of Eating Disorders on the Body

Anorexia Nervosa is characterized by an irrational dread of becoming fat coupled with a relentless pursuit of thinness. People with anorexia go to extremes­ to reach and maintain a dangerously low body weight. But no matter how much weight is lost, no matter how emaciated they become, it’s never enough. The more the scale dips, the more obsessed they become with food, dieting, and weight loss.

The key features of anorexia nervosa are:

• Refusal to sustain a minimally normal body weight
• Intense fear of gaining weight, despite being underweight
• Distorted view of one’s body or weight, or denial of the dangers of one’s low weight

Anorexia is most common in adolescent girls and young women, with a typical age of onset between the ages of 13 and 20. But people of all ages­—including men and children—can suffer from anorexia.

Eating disorders, including anorexia, often begin with normal dieting. A person may start dieting and exercising to get in shape, but as the pounds come off, a desire to lose even more weight is triggered. This cycle continues until the person almost completely stops eating.

Many factors influence this destructive progression from healthy dieting to full-blown anorexia. For many anorexics, self-starvation is a way to feel in control. People with anorexia may feel powerless in their everyday lives, but they can control what they eat. Restricting food is a way to cope with painful feelings such as anger, shame, and self-loathing. Saying “no” to food, getting the best of hunger, and controlling the number on the scale make them feel strong and successful—at least for a short while.

Unfortunately, this boost to self-esteem is short-lived. Anorexics believe that their lives will be better—that they’ll finally feel good about themselves—if they lose more weight. But no amount of dieting or weight loss can repair the negative self-image at the heart of anorexia. In the end, anorexia only leads to greater emotional pain, isolation, and physical damage.

Bulimia/Compulsive Bulimia Nervosa (bulemia) is characterized by frequent episodes of binge eating, from twice a week to multiple times a day, followed by frantic efforts to avoid gaining weight.

During an average binge, a bulimic consumes 3,000 to 5,000 calories in one short hour. After it ends, the person turns to drastic measures to “undo” the binge, such as taking ex-lax, inducing vomiting, or going for a ten-mile run.

The key features of bulimia nervosa are:

• Regular episodes of out-of-control binge eating
• Inappropriate behavior to prevent weight gain
• Self-worth is excessively influenced by weight and physical appearance

There are two types of bulimia, distinguished by the methods the bulimic uses to compensate for the binge eating. In the purging type of bulimia, people physically purge the food from the body by throwing up or using laxatives, enemas, or diuretics. In the nonpurging type of bulimia—which is much less common—bulimics make up for their lack of restraint by fasting, exercising to excess, or going on crash diets.

Women are much more likely than men to develop bulimia; approximately 90% of those with the disorder are female. Younger women are particularly at risk. Bulimia typically begins during the late teens or early twenties, often following a strict period of dieting or a stressful life event. Contrary to popular belief, purging isn’t very effective at getting rid of calories, which is why most bulimics end up gaining weight over time. Vomiting immediately after eating will only eliminate 50% of the calories consumed at best—and usually much less. This is because calorie absorption begins the moment you put food in the mouth. Laxatives and diuretics are even less effective. Just because an individual is not losing weight, it does not mean that they don’t suffer from bulimia.

Binge-eating disorder is characterized by compulsive overeating in which people consume huge amounts of food while feeling out of control and powerless to stop.

A binge eating episode typically lasts around two hours, but some people binge on and off all day long. Binge eaters often eat even when they’re not hungry and continue eating long after they’re full. They may also gorge themselves as fast as they can while barely registering what they’re eating or tasting.

The key features of binge eating disorder are:

• Frequent episodes of uncontrollable binge eating
• Feeling extremely distressed or upset during or after bingeing
• No regular attempts to “make up” for the binges through vomiting, fasting, or over-exercising.

People with binge eating disorder struggle with feelings of guilt, disgust, and depression. They worry about what the compulsive eating will do to their bodies and beat themselves up for their lack of self-control. They desperately want to stop binge eating, but they feel like they can’t. According to the National Institutes of Health, 2 percent of all U.S. adults suffer from compulsive overeating—making binge eating disorder more common than bulimia or anorexia. Unlike other eating disorders, which primarily occur in women, binge eating disorder also affects a significant number of men. Binge eating usually begins in late adolescence or early adulthood, often after a major diet. But most people don’t seek help until much later when weight gain from their binge eating is causing obesity or other health problems.

Other Eating Issues: While anorexia, bulimia, and binge-eating disorder are the most recognized eating disorders, other eating issues can cause health problems as well. For example, purging disorder carries the problems associated with purging in bulimia. Night eating syndrome and Compulsive overeating syndrome or Compulsive Eating involves unhealthy eating patterns. Some people have many of the signs and symptoms of anorexia or bulimia but do not meet the full diagnostic criteria. These persons are said to have “eating disorders not otherwise specified,” and they still have significant health risks that a doctor should evaluate.

Treatment, Recovery, and Rehabilitation For Eating Disorders

There are many treatment options and solutions for eating disorders. The right approach for each individual depends on his or her specific symptoms and awareness of the dangerous effects issues, and strengths, as well as the severity of the disorder. To be most effective, treatment for an eating disorder must address both the physical and psychological aspects of the problem. The goal is to treat any medical or nutritional needs, promote a healthy relationship with food, and teach constructive ways to cope with life and its challenges. Often, a combination of therapy, nutritional counseling, support groups works best. Organizations such as the National Eating Disorders Association can provide helpful information. A residential treatment program or clinic tailored to individuals with eating disorders can help in treating these disorders. In some cases, hospitalization may be necessary. After initial treatment for eating disorders, prolonged use of support groups and therapy may be helpful in maintaining a healthy lifestyle.