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An overview of Eating Disorders

What are Eating disorders?

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact your health, your emotions and your ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

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

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

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There are three main types of eating disorders

Anorexia nervosa. This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation. People with anorexia feel they can never be thin enough and continue to see themselves as “fat” despite extreme weight loss.

Bulimia nervosa. The condition is marked by cycles of extreme overeating, known as bingeing, followed by purging or other behaviors to compensate for the overeating. It is also associated with feelings of loss of control about eating.

Binge eating disorder. This is characterized by regular episodes of extreme overeating and feelings of loss of control about eating.

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

Signs and symptoms of Eating Disorder

Eating disorders manifest in varying ways as they are complicated disorders that impact psychological, physical, and sociological health. Determining whether someone is struggling with an eating disorder is not an exact science due to the many manifestations of these disorders, but, there are some symptoms that can present as warning signs.

Emotional & Behavioral Eating Disorder Symptoms

Our physical bodies, psychological, functioning, cognitive wellness, and choices and behaviors are all deeply intertwined and impactful of one another. Below are a few emotional and behavioral symptoms that may indicate an individual is struggling with eating disorder beliefs or behaviors.

1. Tangential thought process and difficulty concentrating.

2. Distorted body image.

3. Intense fear of gaining weight.

4. Skipping meals.

5. Eating alone or hiding food.

6. Presenting as hyper-focused on weight, food, calories, nutritional content of food.

7. Withdrawing from others, decreased socializing, especially when food is involved.

8. Checking in the mirror often.

9. Extreme mood swings.

10. Beliefs/patterns/choices that indicate a focus on weight loss, dieting, food rules, or eating patterns.

Physical Warning Signs of an Eating Disorder

A starved brain and body cannot function optimally. Therefore, an individual struggling with an eating disorder will present with at least some, if not all, of the physical signs of an eating disorder below:

1. Impaired immune system functioning.

2. Muscle weakness.

3. Dizziness/fainting/lightheadedness.

4. Stomach/gastrointestinal issues.

5. Growth of soft hair all over body (lanugo).

6. Loss of menstrual cycle (amenorrhea).

7. Dry, yellowish skin.

8. Lethargy, sluggishness, or consistent reports of feeling tired.

9. Slowed breathing and pulse.

10. Weight fluctuations (both up and down) that occur rapidly.

11. Severe constipation.

12. Low blood pressure

Prevention

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.

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.

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.

Complications

Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications, such as:

1. Serious health problems

2. Depression and anxiety

3. Suicidal thoughts or behavior

4. Problems with growth and development

5. Social and relationship problems

6. Substance use disorders

7. Work and school issues

8. Death

Eating disorder treatment

Eating disorder treatment plans are specifically tailored to each person and may include a combination of multiple therapies.

Treatment will usually involve talk therapy, as well as regular health checks with a physician

It’s important to seek treatment early for eating disorders, as the risk of medical complications and suicide is high

Treatment options include:

Individual, group, or family psychotherapy : A type of psychotherapy called cognitive behavioral therapy (CBT) may be recommended to help reduce or eliminate disordered behavior such as binge eating, purging, and restricting. CBT involves learning how to recognize and change distorted or unhelpful thought patterns

Medications : A doctor may recommend treatment with medications such as antidepressants, antipsychotics, or mood stabilizers to help treat an eating disorder or other conditions that may occur at the same time, such as depression or anxiety

Nutritional counseling : This involves working with a dietitian to learn proper nutrition and eating habits and may also involve restoring or managing a person’s weight if they have experienced significant weight changes. Studies suggest that combining nutritional therapy with cognitive therapy may significantly improve treatment outcomes

Complications?

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

1. Excess weight or obesity, which can lead to heart disease and diabetes.

2. Pain or physical illness.

3. Alcohol or drug misuse.

4. Anxiety, panic disorder or social phobia.

5. Family conflicts, relationship difficulties, and work or school problems.

6. Social isolation.

7. Suicidal feelings, suicide attempts or suicide

8. Suicidal feelings, suicide attempts or suicide

9. Premature death from medical conditions

Risk factors

Teenage girls and young women are more likely than teenage boys and young men to have anorexia or bulimia, but males can have eating disorders, too. Although eating disorders can occur across a broad age range, they often develop in the teens and early 20s.

Certain factors may increase the risk of developing an eating disorder, including:

1. Family history : Eating disorders are significantly more likely to occur in people who have parents or siblings who've had an eating disorder.

2. Other mental health disorders : People with an eating disorder often have a history of an anxiety disorder, depression or obsessive-compulsive disorder.

3. Dieting and starvation : Dieting is a risk factor for developing an eating disorder. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. There is strong evidence that many of the symptoms of an eating disorder are actually symptoms of starvation. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.

4. Stress : Whether it's heading off to college, moving, landing a new job, or a family or relationship issue, change can bring stress, which may increase your risk of an eating disorder.

Frequently Asked Questions About Eating Disorders

The eating disorders anorexia nervosa and bulimia nervosa, respectively, affect 0.5 percent and 2-3 percent of women over their lifetime. The most common age of onset is between 12-25. Although much more common in females, 10 percent of cases detected are in males. Binge eating disorder and OSFED are more common and rates of ARFID are not yet known as this diagnosis was defined relatively recently.

Individuals who develop eating disorders, especially those with the restricting subtype of anorexia nervosa are often perfectionistic, eager to please others, sensitive to criticism, and self-doubting. They may have difficulty adapting to change and be routine bound. A smaller group of patients with eating disorders have a more extroverted temperament and are novelty-seeking and impulsive with difficulty maintaining stable relationships. There is no one personality associated with eating disorders, however.

Both anorexia nervosa and bulimia are characterized by an overvalued drive for thinness and a disturbance in eating behavior. The main difference between diagnoses is that anorexia nervosa is a syndrome of self-starvation involving significant weight loss of 15 percent or more of ideal body weight, whereas patients with bulimia nervosa are, by definition, at normal weight or above.

Bulimia is characterized by a cycle of dieting, binge-eating and compensatory purging behavior to prevent weight gain. Purging behavior includes vomiting, diuretic or laxative abuse. When underweight individuals with anorexia nervosa also engage in bingeing and purging behavior the diagnosis of anorexia nervosa supercedes that of binge/purging type.

Overeating on occasion, or at festive events such as Thanksgiving, is normal. By contrast, binge eating is the frequent consumption of a large amount of food associated with a sense of loss of control over eating. Bingeing is usually secretive and accompanied by feelings of embarrassment, shame, depression and guilt over the behavior. It often includes eating rapidly, until uncomfortably full, or when not hungry. Food addiction is a controversial term used by some researchers to describe parallels between the difficulties some people experience in limiting eating and substance addiction. Unlike in addiction however, where an individual is addicted to one particular class of drug, it is difficult to identify one food that underlies “food addiction.” Similarly, the withdrawal syndrome caused by dependence on a drug of abuse is hard to demonstrate in overeaters. Despite the similarities between eating disorders and substance abuse, and evidence of the involvement of brain reward circuits in both conditions, the neurobiology of binge eating and of drug addiction are not the same.