What is an Eating Disorder?

Eating Disorder (ED) is a severe condition characterized by irregular eating behavior, extreme concern about body weight and shape, and unrealistic body goal. 

This abnormal eating behavior may include food restriction, binge eating, or vomiting, fasting, etc. ED can negatively impact your health, emotions, and the ability to function in all aspects of life. It can affect your heart, brain, bones, and can lead to other diseases. 

Although ED can appear at any age, it’s most often developed in teenagers or adolescents.

What are the types of Eating Disorder?

There are so many different types of ED. The following are 5 most common types of eating disorder:

      1. Anorexia Nervosa: Anorexia nervosa (AN) is a life-threatening disorder. An individual with AN has an obsessive fear of gaining weight, a distorted perception of body weight or shape. People with AN view themselves as overweight, even if they’re dangerously underweight.

Many people use extreme efforts to control their weight and limit calorie intake, even to starvation. Additional control includes excessive exercise to lose weight, which badly affects health and life activities.

Common symptoms of AN include:

          a. Restricted eating pattern

          b. Intense fear of gaining weight

          c. Irritable behavior to avoid gaining weight, despite being underweight

          d. Distorted body image 

     2. Bulimia nervosa: Episodes of bingeing and purging characterize bulimia nervosa (BN). During a binge episode, a person may eat uncontrollably and eat a large portion of food at a time. The individual feels helpless to stop eating and will attempt to purge the consumed food to compensate for the gained calories. Purging may include forced vomiting, fasting, laxatives, and excessive exercise.

Common symptoms of BN include:

          a. Episodes of binge eating

          b. Recurrent episodes of purging behaviors to prevent weight gain

          c. Fear of weight gain despite having an average weight

          d. Self-esteem influenced by body shape and weight

          e. Poor body image 

BN may result in sore throat, swollen salivary glands, acid reflux, and irritation of the gut, dehydration, and hormonal disturbances caused by the purging process.

     3. Binge Eating Disorder (BED): People with BED might have some symptoms like Bulimia nervosa. In BED, the individual eats an unusually large amount of food at a single time. The individual feels helpless in control of the urge to binge eating. However, people with BED do not purge the consumed food, vomit, fast, or perform the excessive exercise.

People with BED suffer from obesity, joint pain, heart problem, and other body weight-related issues.

Common symptoms of BED include:

           a. Eat large amounts of food at one go

           b. Feel a lack of control

           c. Feel guilt and shame after binge-eating behavior

           d. Avoid social gatherings to avoid embarrassment

           e. May lose confidence due to unusual eating behavior

           f. May eat secretly

     4. Avoidant/restrictive food intake disorder (ARFID): People with ARFID avoid eating due to a lack of interest in food, or get turned off by the smell, color, texture, and taste of the food. Some people with ARFID reject food due to fears related to vomiting, choking, and other food purging problems. 

Other concerns on food intake include: – 

          a. Not consuming required food nutrients

          b. Food avoidance

          c. Not consuming food for fear of gaining weight

          d. Poor physical health

          e. Body image is not distorted 

     5. Pica: Pica is a fatal eating disorder characterized by eating things that are not considered food. Individuals with Pica crave non-food substances such as chalk, dirt, clothes, paint, wool, and detergent. Pica can appear in all ages and all genders, but is more observed in children, pregnant women, and mentally disabled people. 

Pica can be life-threatening due to food poisoning, infectious, or hurt by any of these non-food substances.

How prevalent is Eating Disorder?

According to Oxford Clinical Psychology, in the United States, between 1-2 million Americans have ED. Among them, 8% have Anorexia, 15% have Bulimia, and 20% have Binge Eating Disorder. ED occurs more in women 8 times more than men. 

Bulimia Nervosa and Binge Eating Disorder tend to run in families. As a result of ED, more than half of all women are unhappy with their bodies. Fortunately, cognitive-behavioral therapy is found to be more effective as compared to other known treatments. 50% to 70% of people with ED will recover after receiving treatments, but only less than 50% of people with ED get the treatment they need. 

97% of people with ED are found to have at least 1 co-occurring mental disorder, and 94% are found to have mood disorders. 69% of people with Anorexia Nervosa have Obsessive-Compulsive Disorder, and 81% of people with Bulimia Nervosa have an anxiety disorder. 25% of people with ED are found to have Post-Traumatic Stress Disorder.

Unfortunately, in light of current Covid-19 pandemic, ED has been seen on the rise due to lock down measures imposed by governments and added stress on the individual. 

What are the causes of Eating Disorder:

The apparent cause of ED is still unknown. However, researchers believe that all of the following factors collectively might cause eating Disorder. 

     1. Biological Factor: Many identified biological factors that cause ED include:

           a. Parental genes. A person having a family history in ED has a higher chance of getting it

           b. Nutrients deficiency

           c. Chemical abnormality in the brain

           d. Irregular hormone function 

     2. Psychological Factor:

          a. Individuals having negative body image issues

          b. Individuals having low self-esteem issues

          c. Mental disorders such as anxiety, depression, and OCD, can play a role in developing ED

          d. Individuals with some personality traits such as neuroticism, impulsivity, and perfectionism

     3. Environmental Factor:

          a. A cultural preference for thinness

          b. A profession which demands specific body shape such as modeling

          c. Dysfunctional family dynamic

          d. Sports which prohibit having extra weight such as gymnastic

What are the symptoms of an Eating Disorder?

Symptoms of ED may include:

      1. Constant weight fluctuation

      2. Chronic dieting

      3. Depression or anxiety

      4. Avoiding social gathering

      5. Low self-esteem

      6. Poor body image

      7. Switching between a period of over- and undereating

      8. Always counting consumed calories

      9. Obsessed with maintaining a specific body shape

What are the treatments of an Eating Disorder?

Recovery from ED is challenging. ED is a complex disorder and needs proper food guidance and management during treatment. The treatment process of ED requires an appropriate team of professionals that includes doctors, nutritionists, and therapists. The expert panel will discuss the ED symptoms, possible causes, risks, and limitations before deciding the prescribed treatment.

Treatment of ED includes a combination of the following options: –

     1. Medical care: Identifying the specific causes of ED is essential to prescribe the appropriate medical care to address the causes. Before ED treatments, a body checkup helps to provide insights and avoiding potential biological pitfalls. 

     2. Nutrition: Taking notes of past food intake provides insight into the nutritional values and addresses Anorexia nervosa and bulimia nervosa. A nutritionist will prescribe a comprehensive dietary meal plan to restore and stabilize the body weight.

     A proper meal plan is essential to counter the medical complications caused by ED

     3. Psychotherapy: Psychotherapies play a significant role in treating ED, where counseling helps the ED individual to overcome traumatic past and fears. The psychotherapies can be individual- or family-based. These therapies help address the underlying causes of ED and other potential disorders caused by ED, such as depression and anxiety disorders.

     4. Medication: Medications are commonly used in conjunction with other treatments, that include: –

           a. Prozac

           b. Anticonvulsant Topiramate

           c. Antidepressant

     5. Mindfulness activities: Some mindfulness programs such as meditation, yoga, breathing exercise, etc., are known to be useful in the control against ED. However, results of these mindfulness activities are not known to be collective, but individually based. 

Co-Authored by Shereen Sakhawat (M.sc Applied Psychology)