Eating disorders are a form of mental illness that seriously affects a person’s relationship with food and their daily eating patterns.
A person with an eating disorder (ED) may consume very little (restriction) or they may eat large amounts (binging). Most often these disorders start during the tempestuous adolescent years, but they can start later in on in life. They show up in men as well as women, though females with the illness still outnumber males.
Among the most commonly diagnosed disorders are: bulimia, anorexia and binge eating disorder. However, in the majority of instances patients are given a diagnosis of Eating Disorder Not Otherwise Specified (EDNOS). This diagnosis is given to those who meet several criteria for a disorder but not enough to warrant a specific diagnosis. That does not mean that EDNOS is not serious — because it is.
Eating disorders usually appear alongside another mental health condition such as anxiety, depression or substance abuse. Eating disorders are serious illnesses and are the most deadly of all mental health conditions. For example, a person with untreated anorexia faces an 18 times greater risk of early death compared to those without the disorder.
A person with anorexia shows physical and psychological signs of their illness. These include:
- Extreme fear of weight gain
- Severe food restriction (food types and portion sizes)
- Unhealthy thinness
- Seriously distorted self-image and a refusal to acknowledge their dangerously low weight
- A compulsive fixation on being thin
- Cessation of menstrual cycle
A person with anorexia perceives themselves as fat or overweight even when everyone around them can see that they are grossly underweight. The person often weighs themselves several times per day and is obsessed with calories, fat grams and portion sizes. If the disease continues, various problems may occur, including:
- Constipation (due to laxative abuse and dehydration)
- Dry, yellowed skin
- Bone and muscles deterioration and weakness (men with EDs may be fixated on bulking up rather than thinning down and therefore may have hyper-developed muscles thanks to steroid use)
- Brain damage
- Heart damage
- Multi-organ failure
Bulimia is characterized by a pattern of binge eating followed by compensating behaviors like excessive exercise, self-induced vomiting and abuse of diuretics or laxatives. Persons with bulimia are not as obvious to the eye as those with anorexia since many of them are of normal weight or even very slightly overweight. The binge-purge cycle may occur several times a day or per week, but it is often hidden from the view of others. Common symptoms are:
- Swollen glands in the neck and throat
- Thinned tooth enamel — a result of stomach acid in the mouth when vomiting
- Intestinal problems — due to laxative abuse
- Dehydration — related to use of diuretics, laxatives and vomiting
Binge eating disorder was diagnosed as EDNOS for many years. Only the newest edition of the Diagnostic and Statistical Manual of Mental Health recognizes binge eating as a separate disorder. People with this illness exhibit uncontrolled eating with no compensating behavior. The disorder often leads to obesity. Being excessively overweight then leads to increased risk for other health problems, such as high blood pressure or cardiovascular disease.
Treating an eating disorder
Patients with anorexia frequently suffer with problems connected to malnutrition. Since this poses the most imminent health threat, helping the person regain a healthy body weight and teaching them the facts of proper nutrition are both extremely important.
Whether treating anorexia, bulimia, binge eating disorder or EDNOS, psychotherapy is an integral part of recovery. Patient behaviors stem from wrong thinking and poor coping skills so counseling will be focused on teaching new thinking patterns and coping mechanisms. It may also be necessary to utilize medications, such as anti-anxiety or anti-depressant drugs, during initial stages of treatment.