Eating Disorders: Mental And Physical Health Considerations For Treatment

If you or a loved one experiences an eating disorder, you may be aware of the potential effects on mental and physical health. Eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder don't just affect how someone eats. They may also lead to higher rates of anxiety, depression, and other serious health problems, making it important to seek effective treatment.

The different types of eating disorders

There are various types of eating disorders, with some of the most common including anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia nervosa

Anorexia nervosa is typically characterized by an intense fear of gaining weight and a distorted body image. It often involves behaviors like severe restriction of food intake, excessive exercise, and an intense worry about food, dieting, and body weight. Individuals may avoid social situations involving food and have rituals around eating, such as cutting food into tiny pieces.

Bulimia nervosa

Bulimia nervosa usually involves episodes in which a person eats a lot of food quickly, during which they may perceive a loss of control. After binge eating, they may try to prevent weight gain by making themselves vomit, exercising too much, or using laxatives. People with bulimia may eat secretly and experience a sense of shame about their eating habits. 

Binge eating disorder

Binge eating disorder is normally characterized by regular episodes in which a person eats large amounts of food in a short time. Unlike bulimia, people with this disorder do not usually try to compensate for their eating by vomiting or overexercising. They might eat when they're not hungry and may continue eating even when they’re full.

Avoidant/restrictive food intake disorder (ARFID)

Avoidant/restrictive food intake disorder (ARFID) generally involves a limited range of foods a person is willing to eat. Individuals with ARFID may avoid certain textures, colors, or food smells, making mealtimes stressful. They might also refuse to eat foods they once enjoyed. Unlike other eating disorders, ARFID is not typically driven by a desire to lose weight.

Other specified feeding or eating disorder (OSFED)

Other specified feeding or eating disorder (OSFED) can be seen as an umbrella term that includes a variety of eating behaviors that don’t fit the criteria for other specific eating disorders but still cause significant distress. 

A mental health professional typically diagnoses an eating disorder based on a complete medical history and other factors. Symptoms can vary in frequency and severity, so a diagnosis can be key for getting the right treatment. 

What causes eating disorders?

Mental health risks associated with eating disorders

Eating disorders can severely affect mental health, and these mental health challenges can impact everyday life, relationships, and personal well-being.

Depression

People with eating disorders often experience depression. The constant worry about food, body weight, and shape may lead to a sense of hopelessness and exhaustion. They might lose interest in activities they once enjoyed and experience persistent sadness. In addition, low self-esteem and guilt over eating habits or body image may exacerbate depression symptoms.

Anxiety

Anxiety often coexists with eating disorders. Individuals might worry excessively about food, weight, and body image. This anxiety can present as intense fear, panic attacks, or chronic worry. The unpredictability and stress around mealtimes may amplify these emotions. Social settings involving food can increase anxiety, making social interactions stressful.

Social isolation

Social isolation can be another serious concern for people with eating disorders. They may withdraw from social activities to avoid situations where food is involved. Withdrawal may lead to loneliness and further worsen mental health challenges. They might skip meals with friends and family, resulting in disconnection from their loved ones.

Substance misuse

Substance misuse may develop as a way to cope with mental health issues. People with eating disorders might turn to alcohol or various substances to manage their emotional pain. This misuse can quickly become another dangerous cycle, worsening both physical and mental health. The substances may offer temporary relief but create long-term challenges like addiction.

Mood swings

Mood swings can be common in individuals with eating disorders. These rapid changes in mood might arise from nutritional deficiencies or the stress linked to their eating habits. Hormonal imbalances due to extreme restriction or binge eating may also contribute to mood changes. Managing mood swings can be challenging without professional help.

Obsessive-compulsive disorder (OCD)

Many people with eating disorders also show signs of obsessive-compulsive disorder. They might have repetitive behaviors related to their eating habits, such as excessive exercise, strict calorie counting, or frequent body checking. These compulsive rituals may consume their daily lives, causing significant distress.

Addressing underlying mental health conditions tends to be a key aspect of treating eating disorders. 

Physical health risks of eating disorders

Eating disorders may carry serious physical risks. These disorders may cause severe physical complications, including malnutrition, electrolyte imbalances, and bone density loss.

Malnutrition

Malnutrition can be a common result of eating disorders like anorexia nervosa and bulimia nervosa. People may be more susceptible to illness and infection when they deprive their bodies of essential nutrients. The body may use muscle and organ tissue for energy, making individuals less able to recover from even minor injuries or illnesses.

Electrolyte imbalances

Electrolytes like potassium, sodium, and calcium are important for bodily functions, including heart and muscle performance. Eating disorders often cause severe electrolyte imbalances due to vomiting, laxative misuse, and inadequate food intake. When electrolyte levels are abnormal, people can experience heart palpitations, muscle weakness, and even heart failure. 

Gastrointestinal problems

Gastrointestinal problems tend to be common in people with eating disorders. Conditions like chronic constipation, bloating, and stomach pain frequently occur. These problems often result from poor eating habits, laxative use, and vomiting. The constant cycle of binging and purging in bulimia can cause a swollen or sore throat, inflamed esophagus, and severe acid reflux. 

Bone density loss

Bone density loss, also known as osteoporosis, tends to be particularly common in those with anorexia nervosa. Due to a lack of essential nutrients, especially calcium and vitamin D, bones can become weak and brittle, which may make individuals more prone to fractures and breaks. 

Fatigue and weakness

Fatigue and general weakness tend to be common complaints among those with eating disorders. Inadequate nutrition and calorie intake often mean the body lacks the necessary energy to perform daily functions. Iron deficiency anemia can also be common, adding to a sense of lethargy. 

Dental problems

Dental problems can be especially common in those with bulimia nervosa due to frequent vomiting. The stomach acid that comes into contact with the teeth typically erodes the enamel, leading to cavities and tooth decay. Gum disease and chronic dry mouth can also be concerns. Over time, these dental problems may cause severe oral health problems, requiring extensive dental care.

Eating disorders may not only impact mental health but can also severely affect physical well-being. Taking these risks seriously can be important for those struggling with these conditions.

How is an eating disorder treated?

Eating disorders can be treated in various ways. Therapy and medication are common approaches. 

Types of therapy include the following:

• Enhanced cognitive behavioral therapy (CBT-E): This type of therapy usually focuses on adjusting behaviors, thoughts, and emotions. It may be most effective for bulimia nervosa and binge eating disorder.
• Family-based therapy (FBT): This type of therapy usually involves family members in the treatment process. It is often used for children and adolescents with eating disorders.
• Interpersonal therapy (IPT): This type of therapy generally focuses on improving relationships and communication skills. It can be especially helpful for people with eating disorders because it may help them manage personal challenges that may be connected to their eating habits.

Medications for eating disorders can be used to help people manage the anxiety and depression symptoms that can co-occur with these conditions. There are medications that the FDA has approved for certain eating disorders. While medication usually isn’t the main solution, it can be useful alongside therapy and balanced eating habits. Meanwhile, regular check-ups can track weight, nutrition, and general health, which may prevent serious health complications. Never start, stop, or change any medications without first consulting your doctor.

Support for anorexia nervosa, binge eating disorder, and other eating disorders

When living with eating disorders like anorexia nervosa or binge eating disorder, support from friends, family, and professionals may be helpful. 

Friends and family

Friends and family can provide emotional support and encouragement. By being patient and nonjudgmental, they may be able to educate themselves about the specific disorder their loved one has and provide better support. Simple acts like listening and avoiding negative comments about food and body weight may be useful.

Eating disorder support groups

Support groups can offer spaces for people with eating disorders to share their experiences. These groups may help members connect with others who understand what they're going through. Many local communities and online platforms have support groups. They can be led by someone with professional training or peers with personal experience. 

Healthcare professionals

Therapists and psychologists can provide support for mental health challenges. They can facilitate therapy to manage symptoms and cope with difficult situations. Doctors may also prescribe medication to manage symptoms of anxiety and depression. Dietitians can create plans that support nutritional needs and healthy eating habits while considering the emotional aspects of eating.

Online therapy for eating disorders

Online therapy may be a useful resource for people with eating disorders. Therapy platforms like BetterHelp can offer a flexible and accessible option for those seeking help with mental health challenges. 

Is online therapy effective for eating disorders?

Research shows that online therapy may be effective in treating eating disorders. A 2022 study compared the effectiveness of in-person and online therapy for treating eating disorders during the COVID-19 pandemic. 

Researchers studied 49 adults who received traditional therapy and 76 who participated in virtual sessions. Both groups showed similar improvements in eating disorder symptoms.