Eating Disorders

Eating disorders are complex and involve a combination of psychological, behavioral, genetic, biological, interpersonal and social factors. Eating disorders are about much more than food and eating. They may begin with a diet or the desire to “eat healthy,” but they are really a way for an individual to manage and cope with underlying issues that can feel overwhelming, painful and stressful. Food and the control of food through restricting, bingeing, uncontrolled eating and/or purging is an attempt to:

– Distract or “numb” the uncomfortable and distressing feelings
– Communicate an underlying problem, feeling and/or conflict
– Provide a sense of control over one’s life

Regardless of the cause or purpose, eating disorders are intense, self-destructive and life-threatening illnesses affecting millions of Americans.

Disordered Eating

Disordered eating probably constitutes the largest part of the population and ranges from mild to severe in intensity. One may ebb and flow in and out of disordered eating after returning to normal eating following bouts of dieting or during recovery from an eating disorder. Three general patterns of dysfunctional eating include irregular or chaotic eating, consistent undereating, and consistent overeating beyond bodily food needs and wants to a point of uncomfortable fullness. Examples of disordered eating are emotional eating, yo-yo dieting, and restrained eating.

Anorexia Nervosa

Self-Starvation
Anorexia is characterized by an attempt to control body weight and shape through severely restrictive eating and includes an intense fear of gaining weight, even as weight continues to drop.

Signs

  • Dramatic or continuous weight loss in a relatively short time period
  • Avoidance of meal times or social eating situations
  • Restriction of food intake even when thin
  • Preoccupation with calories, nutrition, food, portion sizes or cooking
  • Frequent weight monitoring
  • Denies feeling hungry or reports fullness after eating small amounts of food
  • Excessive or compulsive exercise
  • Food rituals (i.e. cutting food into small pieces, eating very slowly or quickly, excessive intake of fluids)
  • Feels cold all the time despite normal temperatures
  • Stops menstruating

Bulimia Nervosa

Restrict – Binge – Purge Cycle
Bulimia is characterized by repeated cycles of consuming large amounts of food followed by some form of purging (self-induced vomiting, abuse of laxatives or diuretics) and/or non-purging (excessive exercise, fasting) behaviors to prevent weight gain.

Signs

  • Signs of binge eating including eating quickly, gulping food in large quantities, disappearance of large amounts of food in short time periods, or the presence of food wrappers/containers in unusual places indicating food hoarding
  • Signs of purging, including frequent trips to the bathroom immediately following meals, presence of laxative or diuretic wrappers and sounds or smells of vomiting
  • Weight fluctuations and/or frequent dieting
  • Extreme concern with body weight or shape
  • Extreme and rigid exercise regardless of weather, fatigue or injury
  • Intense preoccupation with thoughts of food, weight and cooking
  • Puffiness of cheeks
  • Discoloration or staining of teeth
  • Bruised or callused knuckles, bloodshot eyes, light bruising under the eyes and on the cheeks
  • Average or slightly above average weight despite eating a lot; looks “normal”

Binge Eating Disorder

Compulsive Overeating
Individuals binge or eat uncontrollably without purging and feel intense shame and guilt afterwards.

Signs

  • Visible bingeing or eating a lot of food when not physically hungry
  • Disappearance of large amounts of food
  • Rapid weight gain
  • History of yo-yo dieting
  • Hoarding/hiding food or secretive eating
  • Eating abnormally fast
  • Feeling depressed, disgusted or shameful after eating

Eating Disorder Not Otherwise Specified

This diagnosis applies to the many individuals with eating disorders who have only some of the characteristics for a specific eating disorder. Examples include a woman with all the other symptoms of anorexia who continues to menstruate or a person who purges less than two times a week. These individuals’ eating disorders are not necessarily less dangerous and should be taken seriously.