WHAT ARE EATING DISORDERS?

Eating disorders are a group of conditions in which individuals display abnormal eating habits -- either consuming too much or too little food -- until their lives and well-being are negatively impacted. Individuals with eating disorders are obsessed with their weight, body image and/or the consumption of food. No one knows the precise cause of eating disorders, but they seem to coexist with psychological and medical issues such as low self-esteem, depression, anxiety, trouble coping with emotions, and substance abuse.


Eating disorders are particularly devastating because they impact every aspect of an individual's life. They are not fads, phases or lifestyle choices but considered a mental disorder and a bio-psycho-social disease, meaning they affect the person's:

• Biology
• Psychology
• Social interaction

Eating disorders don't discriminate. They affect people across the age spectrum, cross-culturally, and include both men and women. Social media and our current culture are contributing factors to the prevalence of eating disorders. With approximately 4% of the population suffering from an eating disorder, it is a national epidemic. It's a serious one too. If not treated, approximately 20% of individuals with eating disorders will die from health related issues or medical complications. Early treatment provides hope and a greater chance for full recovery.


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WHAT ARE THE DIFFERENT TYPES OF EATING DISORDERS

There are three common types of eating disorders in the United States:

• Anorexia Nervosa - An eating disorder characterized by the refusal to eat food and an inability to maintain healthy body weight due to a distorted self-image. The highest occurrence is in women ages 12-25. While it is most common among females, about 10-15% of all individuals with anorexia are males. Anorexia Nervosa has the highest rate of mortality among all mental illnesses and is one of the most common psychiatric diagnoses in young women.


• Bulimia Nervosa - An eating disorder in which individuals secretly binge (eat excessive amounts of food) and then purge (ridding their bodies of what they have just eaten). Purging may include vomiting, excessive exercise, or improper use of laxatives. Everyone overeats at one time or another, but the defining characteristic of a binge is that the individual experiences of lack of control and generally feels powerless over how much or what type of food they are eating. In certain populations, prevalence rates are much higher, such as on college campuses where up to 20% of college-age females endorse symptoms of bulimia.


• Binge Eating Disorder (BED) - An eating disorder characterized by repeated episodes of binge eating similar to bulimia but without the purging. Individuals ingest very large amounts of food over a short period of time, often feeling a lack of control during episodes, then experiencing shame, distress or guilt afterwards. BED is not a choice, it's an illness, that requires recognition and treatment. It is the most common eating disorder in the United States, affecting 3.5% of women, 2% of men, and up to 1.6% of adolescents.

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WHEN TO WORRY: SIGNS & SYMPTOMS

Do you or someone you love:

• Skip meals, eat in secret or withdraw from normal social activities?
• Persistently worry about being fat, or expresses disgust or guilt about eating habits?
• Excessively exercise, no matter their health or the weather?
• Leave frequently during meals to use the toilet?
• Eat much more food in a meal or snack than is considered normal?

There are numerous red flags for eating disorders, and many are the same as for drinking or drug use. In fact, 33% of individuals diagnosed with eating disorders also had substance abuse problems. A simple list of symptoms includes:

• Social isolation such as withdrawal from family and friends
• Dramatic mood shifts
• Dieting
• Substantial weight loss
• Over exercising
• And, in the case of bulimia, hoarding food and visits to the bathroom after meals.

There is a lot of shame and guilt around eating disorders so many people try to hide the signs they are suffering. Keep a look out for the above behaviors and also note that individuals with eating disorders may display signs of depression, a perfectionist personality, denial of hunger or hide their shape under baggy clothes and feel their happiness fluctuate with the numbers on the scale.

WARNING SIGNS FOR COMMON EATING DISORDERS

• Anorexia Nervosa:
1. Dramatic weight loss.
2. Preoccupation with weight, food, calories, fat grams, and dieting.
3. Denial of hunger or consistent excuses avoiding mealtimes or situations involving food.
4. Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate).
5. Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury.


• Bulimia Nervosa:
1. Evidence of binge eating: Disappearance of large amounts of food in short periods of time; finding wrappers and containers indicating consumption of large amounts of food.
2. Evidence of purging behaviors: Frequent trips to the bathroom after meals, smells of vomiting, wrappers or packages of laxatives or diuretics.
3. Excessive, rigid exercise regimen or a compulsive need to "burn off" calories taken in.
4. Unusual swelling of the cheeks or jaw area, or calluses on knuckles from induced vomiting.


• Binge Eating Disorder (BED):
1. Recurrent episodes of binge eating* that occurs on average, at least once a week for 3 months.
2. The binge eating episodes include three, or more, of the following:
1. Eating much more rapidly than normal.
2. Eating until feeling uncomfortably full.
3. Eating large amounts of food when not feeling physically hungry.
4. Eating alone because of feeling embarrassed by how much is being eaten.
5. Feeling disgusted with oneself, depressed, or very guilty afterward.

* Binge eating is defined as consuming an unusually large amount of food while feeling out of control about what or how much is being ingested.

If any of the above signs and symptoms are a cause of concern for you or someone you love, it's time to talk, get informed and get help. Eating disorders have a high recovery rate when treated early. Check out the resource section on this site for hotline information. Also, the assess section of this website can help you on the path to healthier habits and recovery.

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UNDERSTANDING EATING DISORDERS & THEIR HEALTH RISKS

Whether you are concerned about anorexia, bulimia or binge eating disorders, understanding why one starts is an initial step to recovery. Eating disorders usually develop during puberty or late adolescence but have also been shown to develop later in life, starting with a diet that often becomes an obsession. Some cases of eating disorders have been linked to genetics, but further studies need to be conducted in order to determine how strong this link might be. A chemical imbalance also has been seen in certain individuals with eating disorders (similar to depression).

A national survey of nearly 3,000 men and women diagnosed with eating disorders, showed that:

• More than 50% of the individuals with bulimia had major depression
• 50% had phobias
• More than 33% had a substance abuse problem

The same survey showed that about 65% of individuals with an eating disorder had been previously diagnosed with at least one other psychiatric illness.

Although the exact causes for developing an eating disorder are not known, a variety of biological, social and environmental factors can put someone at risk, including:

• Genetic and biological factors or traits such as anxiety or perfectionism
• Participating in activities that encourage low weight, such as ballet, long distance running
• Low self-esteem
• Pressure from society
• Dysfunctional family dynamics
• Family and childhood traumas (childhood sexual abuse, severe trauma)
• Stressful transitions or life changes, such as starting college

Eating disorders are coping mechanisms. Just as someone might use drugs or alcohol to relieve stress, individuals with eating disorders turn to food. The particular relationship that the individual has with food may help them calm down during a time of anxiety, help manage the way they are feeling or be a coping mechanism during high-stress situations. Individuals may or may not be aware that they are using food as a companion. Because the eating disorder provides a temporary feeling of comfort, it can be difficult to stop without professional treatment.

Talking with family and friends, seeking professional medical help or calling a hotline such as the National Eating Disorder Association (1-800-931-2237) are the best steps forward to recovery. FutureHealth's goal setting tool can help you begin your path to wellness. Remember an eating disorder is not just about food, it is a complex mental illness that needs to be addressed.

Health Risks & Consequences

Eating disorders are a serious medical problem that can have long-term health consequences if left untreated. It's common for people with eating disorders to hide their unhealthy behaviors and some also have trouble holding a job. If you have a feeling you or your child isn't well, it's important not to be silent and seek professional help. Eating disorders have the highest mortality rate of any mental disorder in the U.S. and account for a suicide rate that is 75% higher than the general population.

It is common for eating disorders to occur with one or more other psychiatric disorders such as depression. This can makes diagnosis even more complex and compounds the health consequences.

As the eating disorder progresses, the signs of depression get worse. The longer the anorexia, bulimia or BED continues the more the body's normal functions are strained and become deprived of essential nutrients, which can lead to a number of health complications including:

• Bone problems such as osteopenia and osteoporosis
• Irreversible neurological damage (in severe cases)
• Anemia
• Cardiovascular issues such as tachycardia and heart attack
• Mild to severe dental problems
• Hair loss
• Dehydration
• Ongoing stomach problems -- GERD and acid reflux

In addition to the above health complications, individuals with bulimia put a dangerous strain on their body during purging episodes. Click here to learn about the effects of purging on specific parts of the body

A CONVERSATION ABOUT OVEREATING

When talking about eating disorders it is important to discuss overeating. Many wonder if overeating is an eating disorder. Over 61% of American adults are overweight or obese and many of these individuals are binge eaters who consume large amounts of food even when they aren't hungry, and tend to binge in secret. When binge eating becomes compulsive it has crossed over to become a type of eating disorder referred to as binge eating disorder (BED). According to the National Eating Disorders Association (NEDA):

• As many as 40% of obese individuals are binge eaters whom require treatment
• The other 60% are overeaters who can reverse their habits with healthy eating and exercise

Binge eating is a much more common illness, according to researchers. To those who suffer from it, the food they consume makes them feel good and gives them comfort. These people will describe their relationship to food as a companion relationship.

They may become obsessed with food or may display signs of hoarding food (storing large quantities of food secretly).

Although non-compulsive overeating is not considered an eating disorder, it can often lead to the development of a true eating disorder and comes with negative symptoms of its own including high blood pressure, cholesterol, diabetes and arthritis.

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MYTHS & FACTS

There are widespread stereotypes and myths about eating disorders. These myths can lead to stigmas which create barriers to treatment. Below are some common ones and the truths to counter them.

Myth: Only white, middle class young girls suffer from anorexia or bulimia.
Fact: Eating disorders do not discriminate. It affects people off all ages, socio-economic brackets and cultures. While anorexia and bulimia are more common in females, men also suffer.

Myth: You can tell someone suffers from an eating disorder if they are severely underweight.
Fact: While many sufferers of anorexia nervosa may look emaciated that is not true for everyone or for those suffering from bulimia or binge eating disorder. Many individuals can be underweight, normal weight, overweight or obese and often fluctuate in weight.

Myth: The average American woman looks like the women in magazine ads.
Fact: The average American woman is 5 feet 4 inches tall and weighs 140 pounds. The average American model is 5 feet 11 inches tall and weighs 117 pounds. (Source: NEDA)

Myth: Eating disorders are a choice; someone can stop if they want.
Fact: Eating disorders are a serious illnesses. They are not fads, phases or lifestyle choices but considered a mental disorder and a bio-psycho-social disease. The choice a person can make is to pursue recovery, which often involves medical monitoring, nutritional rehabilitation and learning healthier ways to manage stress.

Myth: You only need medical help with an eating disorder if your health is in obvious danger.
Fact: Any symptom is cause for concern. Early treatment provides hope and a greater chance for full recovery. When disordered eating has a negative impact on quality of life, it's time to seek help.

Did you know?

• Eating disorders have the highest mortality rate of any mental disorder in the U.S. and account for a suicide rate that is 75% higher than the general population.
• Approximately 4% of the population and 20% of college students are inflicted with an eating disorder, including 10 million females and 1 million males, mostly between the ages of 12 and 25.
• Approximately 20% of these individuals will die from health related issues and/or medical complications.
• Women are consistently more likely than men to develop an eating disorder. They are three times more likely to experience anorexia (0.9% women vs. 0.3% in men).
• Women are also 75% more likely to experience some type of binge eating disorder
• The rate of development of new cases of eating disorders has been increasing since 1950.
• The prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, with the exception that anorexia nervosa is more common among Non-Hispanic Whites.

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RESOURCES FOR HOPE & RECOVERY

HOW TO HELP

Eating disorders will NOT go away without help. Treatment is necessary for recovery and early detection is very important. Talking in schools and homes about early warning signs and prevention, as well as symptoms and treatment can help avoid many of the issues associated with eating disorders.

Parents should talk one-on-one with their children, and should not be afraid to ask them about eating habits if they suspect any type of disordered eating.

If you suspect someone has an eating disorder, don't be silent. Talk and try to educate them about it. Don't comment about their weight or size in any way. Instead, try saying something like, "I noticed you're more withdrawn, do you need help?" The first step should be guiding them to the NEDA website for more information. Recovery is possible if the individual is willing to do what is necessary. This may require a family or medical intervention.

Denial is a common issue and deters individuals from seeking recovery. During recovery individuals are taught techniques to relieve stress and feel good about themselves. Sometimes medical intervention is necessary if the individual is malnourished, and must be brought to a hospital to avoid severe damage.

Enrolling in aftercare programs such as Overeaters Anonymous or group support is very important for long term recovery.

Hotline: National Eating Disorder Association's free, confidential Helpline at 1-800-931-2237

Overeaters Anonymous meetings

Online Resources:

• Womens Health - Learn more about body image and eating disorders.
• National Eating Disorders Association (NEDA) - Find helpful resources for recovery: treatment center directories and free toolkits for parent and educators.
• Multi-Service Eating Disorder Association (MEDA)- Inspirational stories of recovery.
• Walden Center- Information on eating disorders for college students.
• Child Mind Institute - Advice on how to help someone with an eating disorder in college.
• Eating Disorder Hope - Education, support and inspiration.

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