From Diagnosis To Recovery: Understanding Eating Disorders And Mental Health
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Eating disorders are mental illnesses, meaning that their symptoms can significantly affect mental health in a variety of ways. Navigating the path from the diagnosis of an eating disorder to recovery may involve various challenges. However, with the right support and knowledge, it is possible for people to address their symptoms and rebuild a sense of control over their well-being. Here, we’ll examine eating disorders, their connection to mental health, and the steps typically involved in the process from initial diagnosis to sustained recovery.
The connection between mental health and eating disorders
Eating disorders are serious mental illnesses that can significantly impact an individual's physical and emotional well-being. Research indicates that around five million Americans experience eating disorders annually. Exploring the relationship between eating disorders and mental health can provide helpful insights for addressing these conditions more effectively.
How mental health impacts eating behaviors
Additionally, certain mental health conditions, including obsessive-compulsive disorder (OCD) or anxiety disorders, can manifest in food-related behaviors. For example, someone with OCD might develop rigid rules around eating or become preoccupied with food safety, leading to restrictive eating patterns.
The role of emotional regulation in eating disorders
Individuals with eating disorders often have trouble with emotional regulation, or effectively managing and responding to one's feelings. Food-related behaviors often serve as coping mechanisms for challenging emotions or experiences. For instance, some might restrict their eating to gain a sense of control, while others may engage in excessive consumption to temporarily escape emotional distress.
That’s why developing healthy emotional coping mechanisms usually serve as a fundamental aspect of eating disorder treatment. Learning to recognize, articulate, and handle emotions without relying on food-related behaviors frequently results in enhanced overall mental health and lower chances of relapse.
Recognizing the symptoms of eating disorders
Early recognition of eating disorder symptoms can promote timely interventions and targeted treatment strategies. Below, we’ll cover key symptoms of some of the most common eating disorders.
Early warning signs of anorexia, bulimia, and binge eating
Anorexia nervosa may present with symptoms such as:
- Significant weight loss
- Failure to maintain a healthy weight
- Intense fear of gaining weight
- Distorted body image
- Restrictive eating behaviors
Bulimia nervosa symptoms often include:
- Recurrent episodes of binge eating
- Compensatory behaviors, including self-induced vomiting or excessive exercise
- Preoccupation with body shape and weight
Binge eating disorder symptoms may involve:
- Consuming large amounts of food in a short period
- Feeling a lack of control during binge episodes
- Eating when not physically hungry
- Feelings of shame or guilt after binging
Medical professionals can also assist in identifying the unique symptoms associated with less common eating disorders like avoidant/restrictive food intake disorder (ARFID) and orthorexia. While eating disorders—from avoidant restrictive food intake disorder to anorexia and others—can affect individuals across various demographics, including different genders, ages, and body types, specific factors may increase susceptibility. These include genetic makeup, environmental circumstances, and underlying mental health conditions.
How eating disorder symptoms can be mistaken for other mental health conditions
Eating disorder symptoms occasionally intersect with or resemble those of other mental health conditions. For example, the social isolation and mood alterations observed in anorexia nervosa might be erroneously attributed to depressive disorders. Similarly, the impulsivity and mood swings seen in bulimia nervosa could be confused with bipolar disorder.
Recognizing the broad spectrum of symptoms and their context aids in differentiating eating disorders from other conditions, potentially leading to more targeted therapeutic approaches. A thorough evaluation conducted by an experienced mental health professional can ensure precise diagnosis and tailored treatment strategies.
Understanding anorexia: more than just weight loss
Anorexia nervosa is an eating disorder characterized by restrictive eating behaviors and an intense fear of weight gain. However, anorexia is about more than just weight loss.
Psychological factors contributing to anorexia
Anorexia often develops as a coping mechanism for underlying psychological challenges. Some factors that may contribute to the development of anorexia include:
- A history of mental health conditions
- Perfectionism and a need for control
- Low self-esteem and poor body image
- Trauma or difficult life experiences
- High exposure to cultural pressures and societal ideals of thinness
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Physical and mental health consequences of anorexia and extreme weight loss
Anorexia can have several impacts on both physical and mental health. Examples of physical consequences may include:
- Malnutrition
- Electrolyte imbalances
- Weakened bones and muscles
- Cardiovascular problems
- Hormonal imbalances
- Organ failure, in extreme cases
Mental health consequences can be equally serious, including:
- Increased risk of depression and anxiety
- Social isolation
- Irritability
- Harsh self-criticism
- Difficulty concentrating and making decisions
- Thoughts or actions related to self-harm
If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.
The complexities of binge eating disorder and mental health
Binge eating disorder (BED) is characterized by recurrent episodes of consuming large amounts of food in a short period, accompanied by feelings of loss of control and distress. This cycle can have significant impacts on mental health, including:
- Increased feelings of shame and low self-esteem
- Symptoms of anxiety
- Symptoms of depression
- Social isolation
- Difficulty maintaining relationships
Breaking this cycle often requires addressing the eating behaviors as well as the underlying emotional factors contributing to the binge eating episodes. Understanding the relationship between binge eating and mental health can lead to more effective treatment strategies and improved overall well-being.
How binge eating disorder differs from other eating disorders
While bulimia nervosa involves compensatory behaviors after eating, people with binge eating disorder do not typically engage in purging or excessive exercise. Over time, this may lead to body weight increases for some, although not all individuals with BED become overweight or face unhealthy weight changes.
Binge eating disorder is also distinct from occasional overeating. BED episodes are more frequent, involve larger amounts of food, and are accompanied by significant emotional distress.
The role of food intake in eating disorder recovery
A healthy relationship with food is key to eating disorder recovery. This process involves both physical and psychological aspects of eating. As such, developing regular, balanced eating patterns is usually an important step in recovery. This process may involve:
- Eating at consistent times throughout the day
- Including a variety of foods from all food groups
- Learning to recognize and respond to hunger and fullness cues
- Challenging food rules or restrictions
What constitutes "healthy" food intake can vary depending on the individual and their specific recovery needs. Working with a registered dietitian who specializes in eating disorders can help you develop a nutritional plan that supports physical and mental health recovery. Adequate nutrition is essential for:
- Stabilizing mood and energy levels
- Supporting cognitive function
- Helping repair physical damage caused by an eating disorder
- Reducing obsessive thoughts about food and weight
Navigating the journey from diagnosis to recovery
The path from receiving an eating disorder diagnosis to recovery is unique for each individual. However, some common elements can support this journey, including early intervention, an accurate diagnosis, and social support.
Research indicates early intervention may improve the chances of recovery from an eating disorder, and an accurate diagnosis can help determine appropriate treatment and support strategies. Diagnosis typically involves a comprehensive assessment by a mental health professional, which may involve:
- A detailed medical and psychiatric history
- A physical examination
- Psychological evaluations
- Discussion of eating behaviors and attitudes towards food and body image
In addition, a strong support network can provide accountability, encouragement, and understanding throughout recovery. A support system may include:
- Family and friends
- Support groups
- Treatment team (therapists, dietitians, medical professionals)
Treatment options for eating disorders
Effective treatment for eating disorders typically involves a multidisciplinary approach, addressing both the eating behaviors, the underlying mental health symptoms and causes, and any co-occurring mental health conditions. While treatment plans may vary depending on individual needs, some common options include:
- Psychotherapy, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT)
- Medication
- Nutrition counseling and meal planning with a registered dietitian
- Family-based therapy for adolescents
- Inpatient or outpatient treatment programs
Medication and its role in treatment of food intake disorders
While medication is not generally the primary treatment for some eating disorders, it can sometimes help manage co-occurring mental disorders such as depression or anxiety. Some medications that may be prescribed include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Antidepressants
- Anti-anxiety medications
For binge eating disorder and bulimia, there are specific FDA-approved prescription medications available.
Be sure to consult with your doctor before starting, stopping, or changing any medication.
Strategies for maintaining recovery and improving mental health
Recovery from an eating disorder is typically an ongoing process that extends beyond the initial treatment phase. Developing strategies to nurture overall mental health can support long-term well-being. Remember that eating disorders will rarely resolve without professional treatment, so seeking support in this process is typically essential for recovery.
Some strategies for maintaining recovery may include:
- Engaging in self-care activities that promote physical and mental wellness
- Building a strong support system and staying connected to it
- Challenging negative thoughts and behaviors related to food and body image
- Practicing mindfulness techniques for managing stress and difficult emotions
Again, continued mental health support is often beneficial even after the acute phase of eating disorder treatment. This type of support may involve:
- Regular check-ins with a therapist or counselor
- Participation in support groups
- Periodic sessions with a dietitian
Online therapy for ongoing care
Ongoing support can help individuals maintain their recovery and address new challenges. While each person’s needs are unique, many can benefit from online therapy as a component of long-term recovery and care. Platforms like BetterHelp allow an individual to connect with a licensed therapist virtually from the comfort of home—no commuting required. Online therapy is also often more affordable than in-person care without insurance, which can be especially important for those participating in long-term treatment.
Evidence indicates the potential effectiveness of online therapy, including in treating eating disorders. For example, consider a 2022 study that suggests that online therapy can be a well-accepted, practical, and effective approach for addressing symptoms of anorexia. While more research is needed on the effectiveness of online therapy for eating disorders, these results show promise.
Takeaway
How do eating disorders that cause extreme weight loss affect mental health?
Eating disorders frequently affect mental health in many different ways, especially those that have the potential to put a person far below a healthy or normal weight, as in some cases of anorexia and bulimia. People with either of these disorders may fear that they will gain weight, so they may severely restrict food intake or use forced vomiting or other methods to “compensate” for food eaten.
In addition to potentially causing medical complications like damaged tooth enamel, acid reflux, a low internal body temperature, yellowish skin growth, an increasingly sensitive stomach, swelling in the neck and jaw area, and a dangerously underweight body, these illnesses can also affect mental health. They may cause low self-esteem, feelings of guilt and shame, and social isolation and loneliness, and they may also put a person at increased risk of other psychiatric disorders like depression.
What is the link between food intake and mental health?
The food a person eats can affect their mental health in many ways. For example, healthy eating habits may help benefit brain function, energy levels, sleep quality, mood, and even longevity. Eating nutrient-dense foods may also decrease a person's risk of developing a mental illness like depression or anxiety.
In contrast, eating patterns that lack sufficient calories or nutrients can cause problems in all of these areas. Patterns that qualify as eating disorders affect overall health and daily functioning in many ways too. That's why a person may be taught to improve eating habits with the help of a nutrition counselor as part of eating disorder recovery.
How does unhealthy eating or binge eating affect your mental health?
Eating patterns that don't include enough nutrients can affect mental health in various ways. They may put a person at greater risk for developing a mental illness like depression, and they can also affect mood, stress resilience, and energy levels. Binge eating can also affect mental health, such as by causing low self-esteem, feelings of shame and guilt, social isolation, and a greater risk of comorbid mental health conditions.
How do eating disorder symptoms affect emotions?
Eating disorder symptoms can affect emotions in different ways, depending on the type of disorder. For example, a person with binge eating disorder—the most common eating disorder in the United States today—may feel uncomfortably full eating large quantities in one sitting, which may lead to guilt, shame, and low self-esteem. Someone with typical eating behavior related to anorexia may also experience mental health effects due to food restriction and self-starvation to prevent weight gain. Without sufficient nutrients, they may experience mood swings, trouble concentrating, and irritability. They may also be at greater risk of developing depression or other mental disorders.
What happens to your mind when you have an eating disorder like anorexia?
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), anorexia “is an eating disorder in which people avoid or severely restrict food.” Instead of eating frequently, dieting or not eating at all is common in those with this potentially life-threatening illness. Unlike those with bulimia or binge eating disorder for whom, even when not hungry, eating fast and eating unusually large amounts is common, those with anorexia often self-starve because they fear that they might gain weight. This symptom is key to the disorder regardless of the person’s body mass index—whether they’re already extremely or slightly underweight, an average weight, or overweight.
The reason a person with anorexia restricts their food and engages in other unhealthy behaviors is often due to a distorted body image. They may view themselves as an undesirable body weight or shape regardless of how they actually look, driving them to try and lose weight at any cost. Their perceptions may be distorted, and they may face other mental health challenges as well. Low self-esteem, anxiety, and depression are common effects on the mind in individuals with anorexia.
It's recommended that those showing symptoms of this serious illness seek treatment and proper medical care as soon as possible. Eating disorders treated with the support of a professional care team—and, in some cases, a residential treatment program—may improve or resolve in many cases.
What does psychology say about eating disorders?
There's a wealth of psychology research available on the topic of eating disorders, though research is always ongoing. As one example, although researchers haven't identified an exact cause of this type of illness yet, studies suggest that eating disorders run in families—meaning they likely have a genetic component. Other risk factors for developing an eating disorder may include traumatic events in childhood or young adulthood, tendencies toward perfectionism, high social media use, and cultural or peer pressure related to body size or weight.
Having a co-occurring mental health condition may also put a person at increased risk of developing eating disorders. For example, those with autism spectrum disorder may be more likely to develop avoidant/restrictive food intake disorder (ARFID) where eating only certain foods in a dangerously narrow range is a key symptom. Similarly, those with post-traumatic stress disorder (PTSD) may be at a higher risk of developing binge eating disorder, where eating large quantities in a single sitting is a key symptom.
Is depression associated with eating disorders?
Yes; depression and eating disorders are often comorbid with each other. For example, according to a study published in 2021, individuals with major depressive disorder or an anxiety disorder were four times as likely as those without to have an eating disorder. This may be because certain risk factors and symptoms of both types of conditions can overlap. For instance, a person with anorexia may fear gaining weight so deeply that they try to avoid embarrassment and loss of control by severely restricting their eating. They may have perfectionist tendencies and trouble regulating emotions when they’re feeling distressed, which people with depression often have as well.
What do therapists do for eating disorders?
The approach a therapist will take to treat someone with an eating disorder will depend on that person's individual needs. In general, however, a therapist may aim to help the person address any past trauma, learn to shift distorted thinking patterns, and develop healthier coping mechanisms for stress and difficult emotions.
Am I mentally ill if I have an eating disorder?
An eating disorder qualifies as a mental illness. As with depression, anxiety, and other mental health conditions, only a licensed healthcare professional can diagnose an eating disorder.
How does having an eating disorder affect your life?
Symptoms of an eating disorder can affect a person's life in many different ways. It can cause changes in mood, social withdrawal and isolation, trouble with daily functioning, increased risk of other mental health conditions, and potentially serious or even life-threatening medical complications. That's why seeking immediate professional support for any signs of an eating disorder is generally recommended.
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