Eating disorders (EDs) involve extreme behaviors, attitudes, and feelings regarding food, weight, and body-related issues. They are serious illnesses that can be deadly.  Besides the danger to physical health, EDs destroy the quality of life and relationships of those who suffer.   EDs are often misunderstood to be problems for teenage girls, but the reality is that no one is immune.  EDs do not discriminate by age, gender, race, religious belief, or socioeconomic status.  The prevalence of EDs among children, men, older adults and non-European Americans is growing at alarming rates.  If you are struggling with food, weight, or body image issues, or if you have a friend or family member who you suspect may have an ED, please seek professional help now.  Early diagnosis and intervention can make a big difference in recovery.


Types of Eating Disorders

The spectrum of disordered eating ranges from extreme starvation to extreme overeating.  What separates a disorder from disordered is the frequency/intensity of behaviors and the sometimes paradoxical loss of control.  A diagnosis could be one of the following: 

Anorexia Nervosa (AN) is characterized by excessive food restriction and weight loss, intense fear of weight gain, and distorted body image.  

Bulimia Nervosa (BN) is charactized by a chaotic cycle of binge eating followed by purging, either through self-induced vomiting, laxative abuse, exercise, or the use of a substance to rid the body of the ingested food.  

Binge Eating Disorder (BED) is characterized by periods of uncontroled, impulsive, or continuous eating beyond the point of comfortable fullness.  

Other Specified Feeding or Eating Disorder (OSFED) is a diagnosis given when symptoms cause significant distress but full criteria for AN, BN, or BED are not met.  


Eating Disorder Treatment

Treatment of an ED requires professional help.  Early diagnosis and intervention can make a big difference in recovery. If not identified and treated in its early stage, an ED can become chronic and life threatening.  Treatment begins with an assessment and diagnosis.  Once an ED is diagnosed, a treatment team is assembled.  Treatment teams vary, but are generally composed of a therapist, a dietician, and a physician.  This three-pronged approach ensures that the physical, nutritional, and psychological components of the eating disorder are all fully monitored and attended to.   There are several levels of care available depending on psychological and medical need.  Treatment options range in scope from outpatient to long term residential care.  


Warning Signs of Eating Disorders 

These are some behaviors that can be warning signs of an ED.  Please note that EDs thrive in secrecy, so many of these behaviors may be difficult to detect.    

  • Makes excuses to avoid family meals or stays away from social situations involving food.
  • Goes through rituals to make eating small amounts of food less obvious. 
  • Fluctuates between excessive eating and restricting food. 
  • Obsessively exercises without enjoyment regardless of bad weather, illness, or injury. 
  • Often disappears to the bathroom after eating. 
  • Preoccupation and dissatisfaction with body shape. 
  • Wears layers of baggy clothing to hide body, even in warm weather. 
  • Is always cold. 
  • Develops dental problems or callouses on knuckles. 
  • ​Disgusted with former favorite foods, only eats certain foods ("safe foods"). 
  • Has frantic fear of weight gain and repeatedly diets. 
  • Simplistic, black and white, all or nothing thinking. 
  • Has trouble talking about feelings. 
  • Seems moody, irritable, and withdrawn more than normal. 
  • Engages in self-harm behaviors (cutting, burning, risk-taking) 
  • Secretive eating, hiding food wrappers, food disappears without explanation. 
  • Preoccupation with food and eating - increased interest in food channels, recipes, and cooking.  


What Causes Eating Disorders?  

There is no cause of an ED.  Some patients can point back to an age or time in their life when their ED developed, but there is rarely one simple cause to point to.  This can be frustrating for families wanting something to blame.  Parents often blame themselves.  It is important to remember that guilt can be paralyzing and hold families back from fully engaging in support and recovery.  Following are risk factors that can lead to the development of an ED. Understanding the risks can give guidance toward adequate support.  

Personality

  • High achiever
  • Perfectionist
  • Obedient "rule follower" 
  • Tend to repress emotions
  • Low self-esteem
  • Negative, pessimistic
  • Sensitive
  • Impulsive/volatile

Biological

  • Genetics
  • Body type
  • Co-morbid disorders
  • Developmental history

Psychological

  • ​Feelings of inadequacy or lack of self-control in life 
  • Lack of a sense of self/identity 
  • Depression, anxiety, anger, loneliness

Interpersonal

  • Troubled family and personal relationships
  • Difficulty expressing feelings and emotion
  • History of teasing or ridicule about appearance
  • History of physical or sexual abuse

Social

  • Cultural pressures that glorify "thinness" and place value on obtaining the "perfect body"
  • Narrow definitions of beauty that include only specific body weight and shapes
  • Cultural norms that value people on the basis of physical appearance and not inner qualities 

Other Factors 

  • Competitive Sports
  • Diets