Eating disorders

Overview

There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Signs and Symptoms

Anorexia nervosa

People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight. Anorexia nervosa has the highest mortality rate of any mental disorder. While many people with this disorder die from complications associated with starvation, others die of suicide.

If you or someone you know is in crisis and needs immediate help, call the toll-free National Suicide Prevention Lifeline (NSPL) at 1-800-273-TALK (8255), 24 hours a day, 7 days a week.

Symptoms include:

  • Extremely restricted eating
  • Extreme thinness (emaciation)
  • A relentless pursuit of thinness and
  • unwillingness to maintain a normal or healthy weight
  • Intense fear of gaining weight
  • Distorted body image, a self-esteem that is heavily influenced by
  • perceptions of body weight and shape, or a denial of the seriousness of low body weight

Other symptoms may develop over time, including:

  • Thinning of the bones (osteopenia or osteoporosis)
  • Mild anemia and muscle wasting and weakness
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Severe constipation
  • Low blood pressure slowed breathing and pulse
  • Damage to the structure and function of the heart
    Brain damage
    Multiorgan failure
    Drop in internal body temperature, causing a person to feel cold all the time
  • Lethargy, sluggishness, or feeling tired all the time
  • Infertility

Bulimia nervosa

People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or over overweight.

Symptoms include:

Chronically inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
Acid reflux disorder and other gastrointestinal problems
Intestinal distress and irritation from laxative abuse
Severe dehydration from purging of fluids
Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack
Binge-eating disorder
People with binge-eating disorder lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.

Symptoms include:

  • Eating unusually large amounts of food in a specific amount of time, such as a
  • 2-hour period
  • Eating even when you’re full or not hungry
  • Eating fast during binge episodes
  • Eating until you’re uncomfortably full
  • Eating alone or in secret to avoid embarrassment
  • Feeling distressed, ashamed, or guilty about your eating
  • Frequently dieting, possibly without weight loss

Risk Factors

Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. These disorders affect both genders, although rates among women are higher than among men. Like women who have eating disorders, men also have a distorted sense of body image.

Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Researchers are using the latest technology and science to better understand eating disorders.

One approach involves the study of human genes. Eating disorders run in families. Researchers are working to identify DNA variations that are linked to the increased risk of developing eating disorders.

Brain imaging studies are also providing a better understanding of eating disorders. For example, researchers have found differences in patterns of brain activity in women with eating disorders in comparison with healthy women. This kind of research can help guide the development of new means of diagnosis and treatment of eating disorders.

Treatments and Therapies
It is important to seek treatment early for eating disorders. People with eating disorders are at higher risk for suicide and medical complications. People with eating disorders can often have other mental disorders (such as depression or anxiety) or problems with substance use. Complete recovery is possible.

Treatment plans are tailored to individual needs and may include one or more of the following:

  • Individual, group, and/or family
  • psychotherapy
  • Medical care and monitoring
  • Nutritional counseling
  • Medications

Psychotherapies

Psychotherapies such as a family-based therapy called the Maudsley approach, where parents of adolescents with anorexia nervosa assume responsibility for feeding their child, appear to be very effective in helping people gain weight and improve eating habits and moods.

To reduce or eliminate binge-eating and purging behaviors, people may undergo cognitive behavioral therapy (CBT), which is another type of psychotherapy that helps a person learn how to identify distorted or unhelpful thinking patterns and recognize and change inaccurate beliefs.

Medications

Evidence also suggests that medications such as antidepressants, antipsychotics, or mood stabilizers may also be helpful for treating eating disorders and other co-occurring illnesses such as anxiety or depression. Check the Food and Drug Administration’s (FDA) website: (http://www.fda.gov/), for the latest information on warnings, patient medication guides, or newly approved medications.