Eating Disorders

Introduction to Eating Disorders

Eating Disorders

We live in an image conscious culture, which urges all of us (especially women) to improve our appearance. The messages sent by magazines, t.v., and other media include "buy certain clothes and products; straighten and whiten your teeth; get rid of your wrinkles; and most commonly, LOSE WEIGHT and you will be happy, admired, and loved." The recent and recurrent debate concerning the unhealthy, stick thin models used in the fashion industry is a perfect example of how strongly entrenched our notion of "thinness equals happiness" has become.

Although many of us would benefit from eating a bit less and exercising more in order improve our health and fitness, simply watching what you eat is NOT an eating disorder. Eating Disorders are potentially life-threatening illnesses which are simultaneously psychological and physical in nature. They are characterized by a range of abnormal and harmful eating behaviors which are accompanied and motivated by unhealthy bel...More

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What are eating disorders?

  • There are three primary eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
  • Each one is characterized by a pattern of disordered and harmful eating behavior.
  • Anorexia generally involves the severe and extreme restriction of eating in an effort to lose weight.
  • Bulimia is characterized by binges, which are episodes of consuming abnormally large amounts of food in a short period of time, that are often followed by purging behaviors, such as inducing vomiting, taking laxatives and excessive exercising, in an attempt to get rid of the calories that have just been eaten.
  • Binge Eating Disorder is similar to Bulimia because the person eats in binges. However, they do not purge or get rid of what they have eaten.
  • All 3 disorders can impair daily functioning and destroy general health.
  • Individuals typically experience painful emotions before, during and after the eating behaviors.
  • They often fear gaining any weight, and their self-esteem is highly influenced by their body weight.
  • This can develop into a distorted body image where they feel badly about how they think their body looks and are not able to accurately see themselves as others perceive them.

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How common are eating disorders?

  • The National Institute of Mental Health (NIMH) estimates that 5 to 10% of the U.S. population has an eating disorder with between 5 and 10 million Americans having anorexia or bulimia and another 25 million suffering with binge eating disorder.
  • Binge eating is the most common eating disorder, affecting approximately 2% of all adults.
  • Eating disorders typically begin in adolescence or early adulthood.
  • The start of an eating disorder is often associated with a stressful life event such as exposure to violence, family conflict, stress at school, puberty, peer pressure, or loss.
  • These disorders affect people from all walks of life and do not seem to be associated more or less with any particular race or wealth level.
  • Experts believe that approximately 75%-80% suffer with these disorders for one to fifteen years and that between 6% and 20% of eating disordered individuals will die as a result of their disease.

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What are the causes of eating disorders?

  • There are many factors that can cause an eating disorder including biological ones, personality traits, family issues, and cultural standards.
  • Eating disorders are often biologically inherited and tend to run in families. Research suggests that these genetic factors contribute approximately 56% of the risk for developing an eating disorder.
  • Studies suggest that the hypothalamus, a part of the brain, of bulimics may not trigger a normal feeling of being full after eating.
  • Research suggests that several different neurotransmitters in the brain are involved in eating disorders.
  • Personality traits such as emotional stability, obsessiveness, and perfectionism play a large role in anorexia and bulimia.
  • Individuals with anorexia and bulimia tend to be competitive and driven to succeed. They often compare their appearance and accomplishments against unrealistic standards and then find themselves lacking.
  • Research indicates that families of individuals with eating disorders tend to be overprotective, perfectionistic, rigid, and focused on success. They have high, sometimes unreasonable expectations for achievement.
  • Some people turn to an eating disorder after they've experienced a trauma such as sexual or physical abuse, or neglect.
  • Culture, particularly in Western societies, also plays a part as young girls and adolescents are influenced to think that the women portrayed in television, movies, and magazines are of normal weight and body shape. They then begin to believe that being thin makes those people popular, successful and happy and that they need to have the same appearance in order to be happy.

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What characteristics or traits help maintain an eating disorder?

  • Research has suggested that eating disordered individuals have difficulty coping with and managing strong emotions, such as anger. These feelings are often turned inward, instead of being expressed in healthy, manageable ways.
  • Anorexics punish themselves for their perceived failures and self-hatred by restricting their food intake, while bulimics attempt to make up for binging and the resulting sense of shame through vomiting, exercising, and laxatives.
  • Binge eating disorder does not revolve around depriving the body of food, but instead uses food as a source of comfort during times of distress.
  • Many individuals with eating disorders search for an escape from their misery and are desperate to find peace.
  • Food restriction or purging often develops out of a sense of shame. However, a sort of trap occurs when individuals realize that their eating behavior is no longer manageable and they become embarrassed to admit that they are out of control and believe that asking for help would be an admission of ultimate failure.
  • Dysfunctional thinking, such as body image distortions, also contributes to eating disorders continuing.
  • Peer pressure to be thin and stay thin is also a factor.
  • Biological factors that cause eating disorders often continue to promote them as well, such as neurotransmitter levels in the brain and the effects of malnutrition on the body.

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What are the symptoms of eating disorders?

  • Each disorder has different symptoms and behaviors that appear.
  • Anorexics refuse to maintain body weight at or above a minimally normal weight for their age and height, and they experience intense fear of gaining weight or becoming fat, even though they are underweight and misunderstand the seriousness of their weight loss.
  • The diagnostic criteria for bulimia includes episodes of binge eating at least twice per week for at least three months, along with compensating behavior, such as vomiting, in order to prevent weight gain and a self-evaluation that is unduly influenced by body shape and weight.
  • Binge Eating Disorder is characterized by periods of eating large quantities of food in a short amount of time, often in isolation, due to embarrassment.

For more information on symptoms and characteristics of Anorexia Nervosa
For more information on symptoms and characteristics of Bulimia Nervosa
For more information on symptoms and characteristics of Binge Eating Disorder 

How is an eating disorder diagnosed?

  • One of the first steps to getting well is being evaluated by mental health and medical professionals.
  • This evaluation will generally include an interview with the patient who is displaying the eating disorder symptoms and also their family.
  • The interviewer will ask for a detailed medical and mental health history, and will ask verbal questions, as well as give standardized paper and pencil (or computerized) tests to fill out, such as the Perceived Body Image Scale (PBIS), Beck Depression Inventory (BDI), Trauma Symptom Inventory (TSI), Bulimia Test (BULIT-R), Eating Disorder Inventory (EDI), or the Eating Attitudes Test (EAT).
  • It is important to be as honest as possible when answering questions, even though they may be difficult or painful to answer or you may feel ashamed and embarrassed.
  • The doctor will complete a routine physical, as well as ask about eating habits, diet, and physical symptoms of the disease.
  • Lab and other tests to check for any medical complications and to evaluate organ functioning will be done. Test results will also serve as a baseline for future comparisons to determine whether treatment is helping.
  • During treatment, a medical doctor will continue to monitor physical health, including consistent checks on vital signs, hydration level and electrolytes.
  • A dental exam should also be completed if purging behavior has been done.

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What are the treatments for an eating disorder?

  • The first priority of treatment is to regain physical health and decrease the medical dangers of the disease.
  • Nutritional rehabilitation is often one of the primary goals in the beginning and the ongoing stages of treatment.
  • This involves working with a licensed registered dietitian to return to a normal weight in a healthy manner, stop using laxatives (if necessary), set realistic and healthy eating and exercise goals, plan meals, recognize hunger cues, and make healthy food choices. The dietitian can also teach how to recognize distorted thinking about food and weight, as well as teach about the nutritional dangers of the behaviors.
  • Individual outpatient therapy is designed to provide the person with education, insight, and support and to address how and why the eating disorder developed and why it continues, as well as to learn new coping skills.
  • The most common type of therapy used for eating disorders is Cognitive Behavior Therapy (CBT).
  • If the patient is in grave physical danger and cannot be treated or maintained safely without immediate medical interventions, the mental health professional may arrange for intensive treatment, including hospitalization or partial-hospitalization.
  • Residential treatment facilities offer 24-hour care to patients who may not be in acute medical danger but who continue to engage in eating disordered behaviors and as a result need intensive support to continue functioning on a daily basis.
  • Group therapy is an excellent source of treatment and support for bulimic individuals and binge eaters, but has not been as successful for helping those with anorexia.
  • Family therapy can be used to provide family members with education, support, communication skills, and conflict resolution.

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Can an eating disorder be prevented?

  • Because most eating disorders start in adolescence, parents and other important adults have the best shot at helping to prevent them from occurring.
  • Educating both male and female children about healthy eating and body image is an important prevention task.
  • Children also need to be taught about critical thinking - how to recognize when media images are unrealistic and how not to use those images as comparisons for themselves.
  • Parents can be big advocates in building healthy body images, self-esteem and lifestyles for their children.
  • It's important to encourage children to be involved in sports and other activities that build self-esteem and promote healthy physical activity.
  • Actively teach children how to make healthy food choices.
  • Plan and eat meals together.
  • Compliment kids - a lot. Praise them for their strengths, their talents, and their efforts.
  • Allow lots of opportunities for children to talk about their insecurities, their body image, and their efforts to fit in.
  • Educate children about the unrealistic messages supplied in endless number by the media, and help them understand that thinness does not equal happiness.
  • Avoid giving food for rewards.
  • Striking a balance based on family lifestyle and the temperament of the child seems to be key by actively teaching how to make healthy choices, eat junk food in moderation, recognize when they are full after eating, and incorporate exercise into their life.

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News Articles

  • Psychostimulants May Be Helpful in Treatment of Bulimia Nervosa

    For select patients, psychostimulants may be beneficial for treating bulimia nervosa, according to a study of six cases published online Jan. 23 in the Journal of Clinical Pharmacology. More...

  • Eating Disorders Rampant on the Runway

    Over half of models surveyed said they'd been asked to lose weight or change their body shape. More...

  • Study Explores Electrical Brain Stimulation to Treat Bulimia

    Though preliminary, it found symptoms of eating disorder lessened in first 24 hours after treatment. More...

  • Many Women With Eating Disorders Do Recover, Study Finds

    But it may take years or longer, researchers acknowledge. More...

  • Two-Thirds With Anorexia, Bulimia Recover in Long-Term

    About two-third of females with anorexia nervosa and bulimia nervosa achieve recovery by the time of follow-up at 22 years, with earlier recovery for bulimia nervosa, according to a study published online Dec. 20 in the Journal of Clinical Psychiatry. More...

  • 11 More
    • Economic Burden of Binge-Eating Disorder Quantified

      Individuals with binge-eating disorder have significantly greater economic burden compared to those without the disorder, according to a study published online Nov. 16 in the International Journal of Eating Disorders. More...

    • Study Links Disasters to Dementia

      Losing home was tied to greater mental decline among elderly tsunami survivors. More...

    • Compulsive Exercise Test Valid for Adults With Anorexia

      The Compulsive Exercise Test is a valid and reliable self-report measure of compulsive exercise for adults with anorexia nervosa, according to a study published online Oct. 3 in the International Journal of Eating Disorders. More...

    • Pudendal Nerve Entrapment Can Lead to Eating Disorder

      Pudendal nerve entrapment leading to avoidant/restrictive food intake disorder has been described in a case report published online Aug. 19 in the International Journal of Eating Disorders. More...

    • Binge-Eating Disorders May Be Linked to Suicidality

      Adults and adolescents with binge-eating disorder may have increased risk of suicidality, according to research published online July 20 in the International Journal of Eating Disorders. More...

    • PMS, PMDD Linked to Increased Odds of Bulimia Nervosa

      Premenstrual syndrome and premenstrual dysphoric disorder are associated with increased odds of bulimia nervosa, but not with binge-eating disorder, according to a study published in the July issue of the International Journal of Eating Disorders. More...

    • Several Treatments Efficacious for Binge-Eating Disorder

      Patients struggling with binge-eating disorder have several efficacious treatment options available, according to a review published online June 28 in the Annals of Internal Medicine. More...

    • Eating Disorders Seem More Common in Schools Where Girls Predominate

      And schools with kids from more educated parents also had higher rates, study found. More...

    • More Risky Drinking Behaviors for Women With Eating Disorders

      Women with eating disorders more often exhibit risky drinking behaviors than their unaffected peers, according to a study published online April 1 in the International Journal of Eating Disorders. More...

    • Elevated Carcinoembryonic Antigen Described in Anorexia

      In a case report published online March 25 in the International Journal of Eating Disorders, elevated serum carcinoembryonic antigen levels are observed in a male patient with anorexia nervosa. More...

    • Transcranial Stimulation May Ease Symptoms of Anorexia

      Repetitive transcranial stimulation may ease major symptoms of anorexia nervosa, according to a study published online March 23 in PLOS ONE. More...

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