Understanding Eating Disorders

Eating disorders come in all shapes and sizes—we’ll address the most common ones in this article. Sometimes they involve eating too much too fast. Other times they result in eating too little. One thing that all eating disorders have in common is the mental health aspect. Eating disorders involve thoughts about food, weight, and body shape, and these thoughts can translate into eating behaviors that can become concerning and detrimental.

Eating disorders are not lifestyle choices. They’re not your normal concerns about health, weight, and nutrition. Eating disorders involve problematic eating behaviors and distorted body image, and often result in signficant malnutrition. They can lead to life-altering, dangerous, even critical health conditions of the heart, kidney, liver, brain, lung, gastrointestinal, metabolic, skin, hormone, teeth, blood, and bone. In some cases, eating disorders can lead to death. 

Anyone can develop an eating disorder. This means that they affect people of all ages, sizes, ethnicities, abilities, genders, and socioeconomic backgrounds. While disordered eating most often appears in women during the teen or early adult years, many eating disorders affect men and children, and may continue into midlife and beyond. The causes of eating disorders are not clear, but they seem to result from complex interactions between genetic, biological, behavioral, psychological, and social factors. 

If there is one takeaway about eating disorders it’s this: Eating disorders are treatable. There is hope and there is help. Many people recover completely from eating disorders—especially if they get the support they need.

Medical disclaimer: If you or someone you love struggles with disordered eating, please see your healthcare professional or book an appointment with me to discuss your needs and goals to help get on track with a healthful eating pattern and lifestyle.

The three most common eating disorders

There are many different types of eating disorders. The three most common in the U.S. include binge-eating disorder, bulimia, and anorexia. Note that it’s possible for one person to experience multiple eating disorders.

Binge-eating disorder

Binge-eating disorder is the most common eating disorder in the U.S. It’s when eating feels out of control; like there is no ability to stop. Eating resembles gorging and continues well after the stomach is full. Binge-eating results in feelings of physical discomfort, often followed by guilt, shame, and distress. It can lead to weight gain, obesity, and related medical conditions.

Bulimia nervosa (binging-purging)

Bulimia nervosa is the second most common eating disorder in the U.S. Bulimia occurs when episodes of binge-eating are followed by purging. Purging is trying to make the binged food leave the body to prevent weight gain (e.g., by making themselves throw up, using laxatives, etc.). People with bulimia may appear to be overweight, normal weight, or underweight. 

Anorexia nervosa

Anorexia nervosa is the third most common eating disorder in the U.S. It happens when people avoid or severely restrict food. This often occurs along with a relentless pursuit of thinness and feelings of overweight, even when the affected person is malnourished and underweight. People experiencing anorexia may feel the need to suppress the body’s cravings for food. They may feel a sense of pride or strength from their level of control, self-denial, and perfectionism. Anorexia can become very serious. In fact, it has the highest death rate of any mental illness. 

Signs and symptoms of eating disorders

Many people are concerned about their health, weight, and nutrition. This in no way means that there is an eating disorder. One of the main differences is that people with eating disorders become fixated and obsessed with their weight and body shape. People with eating disorders may deny, minimize, rationalize, or hide their symptoms and the seriousness of the disorder.

These disorders may or may not be linked to a person’s current weight or body shape. They may also not be linked with rapid changes in weight. Simply put, there is more to diagnosing an eating disorder than a person’s appearance—especially due to the mental health component.

Eating disorders can be diagnosed by a healthcare provider using medical history, physical exams, and other tests (e.g., blood, urine, electrocardiogram, kidney function, etc.). Different eating disorders have different signs and symptoms.

Signs of binge-eating disorder include:

• Uncontrollably eating very large amounts of food in a short period of time

• Eating when not hungry or after feeling full

• Eating very quickly

• Continuing to eat until fullness becomes uncomfortable

• Eating alone or in secret

• Feeling distressed, ashamed, or guilty about eating

• Frequently going on diets

Symptoms of bulimia nervosa can include any of the binge-eating symptoms above, plus one or more of:

• Purging (making oneself throw up, or using laxatives, diuretics, diet pills, or enemas)—and the frequent bathroom trips and medications associated with this behavior

• Participating in intensive and excessive exercise

• Periods of fasting

Signs of anorexia nervosa include:

• Skipping meals or eating very small amounts of food during meals

• Repeatedly weighing themselves and a profound fear of gaining weight

• Participating in intensive and excessive exercise

• Extreme thinness and low body weight

• Denial of the seriousness of very low body weight

Eating disorders are often associated with mental health challenges such as mood disorders, depression, anxiety, obsessive-compulsive disorder, impulse control disorder, and/or substance use.

When and where to get help for eating disorders

Make no mistake, there is help!

Remember that disordered eating involves extreme food behaviors that are not the result of fads, phases, or lifestyle choices. No one chooses to have an eating disorder. If at any point, it feels that thoughts and behaviors about food, weight, and body shape are taking over one’s life, it’s time to seek out help.

According to the National Institute of Mental Health, fewer than half of those affected by binge-eating disorder, bulimia, or anorexia seek help—and I want to help change that.

The goals of treating an eating disorder are to restore physical and mental wellness. This may include:

• Restoring optimal levels of vitamins, minerals, and other nutrients

• Moving toward a more healthful weight

• Ensuring exercise is at a level that promotes health

• Stopping binging and/or purging behaviors

How are these goals achieved? Eating disorders may be successfully treated in many different ways. They may involve one or more of: medical care, medicine, psychotherapy, and/or nutritional counseling.

Medical care

Eating disorders may cause medical complications of the heart, kidneys, liver, etc. If medical symptoms or abnormal test results are found, those may be treated. 

Medicines

Depending on symptoms, people with eating disorders may be treated with medications that can also help with weight management, mood disorders, or other conditions related to the disordered eating.

Psychotherapy

Psychotherapy (talk therapy) may involve individual, group, or family counseling. This can help to identify and change negative thoughts and behaviors about food and weight. Psychotherapy can also help to build coping skills to manage situations that trigger disordered eating. This may involve cognitive behavioral therapy or other types of counseling.

Nutrition Counseling

If an eating disorder is diagnosed or suspected, it’s very important to get professional nutrition counseling. An effective nutrition strategy must be personalized to achieve optimal nutrient levels, and to promote healthy eating habits and weight management goals. This is why consulting with a Master’s level registered dietitian nutritionist is necessary for successful treatment.

The bottom line

Eating disorders are serious health concerns that can be successfully treated. Whether they involve binge-eating, bulimia, or anorexia, there is help.

The first step is to reach out to a healthcare professional who can help to confirm whether an eating disorder exists, and if so, which disorder it is. Once an informed diagnosis is obtained, then getting a personalized treatment plan is key. The goal is to restore nutrition, prevent or treat other related medical conditions, move toward a healthier weight, and provided coping skills and behavioral modification for long-term health.

Need help with food, nutrition, weight, or eating? As a licenced Master’s level registered dietitian nutritionist, I’d love to help.

Wondering how to distinguish between food and weight concerns, and disordered eating? Want support toward embracing more health-promoting and nutritious eating and lifestyle habits? Need professional nutrition counseling to help you reach your health goals? Book an appointment with me today to see if I can help you.

References

Academy for Eating Disorders. (n.d.). Resources. https://www.aedweb.org/resources/about-eating-disorders

Harvard Health Publishing. (2019, March 13). Anorexia nervosa. https://www.health.harvard.edu/a_to_z/anorexia-nervosa-a-to-z

Harvard Health Publishing. (2022, December 1). Eating disorders in midlife. https://www.health.harvard.edu/womens-health/eating-disorders-in-midlife

MedlinePlus. (2021, June 16). Eating disorders. https://medlineplus.gov/eatingdisorders.html

MedlinePlus. (2022, April 30). Binge eating disorder. https://medlineplus.gov/ency/article/003265.htm

MedlinePlus. (2022, April 30). Bulimia. https://medlineplus.gov/ency/article/000341.htm

National Institute of Mental Health. (2021). Eating disorders: About more than food. https://www.nimh.nih.gov/health/publications/eating-disorders

National Institute of Mental Health. (n.d.). Eating disorders. https://www.nimh.nih.gov/health/statistics/eating-disorders

National Institute of Mental Health. (n.d.). Let’s talk about eating disorders. https://www.nimh.nih.gov/health/publications/lets-talk-about-eating-disorders