Eating Disorders Education: Understanding Types of Eating Disorders and Effective Eating Disorder Treatment
Raising awareness and spreading eating disorders education can be important because early identification may help a person with an eating disorder recover. Parents, teachers, doctors, friends, and family members alike may become attuned to the signs and symptoms of eating disorders, helping those who have them receive early diagnoses. When a person is diagnosed with an eating disorder, they can begin treatment that fosters healing.
Organizations like the government-funded National Center of Excellence for Eating Disorders (NCEED) and the nonprofit organization National Eating Disorders Awareness (NEDA) primarily work to educate and raise awareness related to eating disorders. Both organizations provide facts and statistics related to how eating disorders can impact physical and mental health. They also discuss how others can identify eating disorder signs and symptoms and support people living with these conditions. In this article, we describe the importance of eating disorders education, signs and symptoms of common eating disorders, and potential treatment options, including therapy.
Early eating disorders detection
Experts stress the benefits of detecting eating disorders early, reporting that the early detection of eating disorders can improve outcomes, decrease mortality, and prevent physical and psychiatric complications.
In peer-reviewed articles, experts have suggested that early eating disorder detection could be promoted by educating teachers, school personnel, coaches, doctors, and parents on eating disorders. This education could make people more likely to notice when an eating disorder is present and be more confident to speak up about it and take action.
Since eating disorders often first appear in adolescence, educating those who care for, teach, or otherwise regularly interact with adolescents can be one strategy for increasing the early detection of eating disorders.
Signs of eating disorders
Early detection of eating disorders usually begins with a person recognizing certain signs. Different eating disorders have different diagnostic criteria, which we will discuss below. However, there are some general signs for which to look, according to the National Eating Disorders Association.
Here are some of the potential signs of eating disorders:
- A preoccupation with weight loss, dieting, calories, or food in general
- A preoccupation with body size, body shape, or one's appearance
- A refusal to eat certain foods or whole food groups
- Excuses to avoid meals
- Noticeable weight changes
- Menstrual cycle irregularities
- Physical symptoms, like digestive complaints, frequently feeling cold, muscle weakness, dry skin and hair, sleep problems, dental problems, nutrient deficiencies, or dizziness
- Excessively exercising
- Eating in secret or hiding food
Types of eating disorders
Eating disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Currently, there are five main categories of eating disorders.
Anorexia nervosa generally involves restricted eating fueled by a negative body image, in which a person believes they are overweight even when they are of a normal weight or even underweight.
Like anorexia nervosa, bulimia nervosa usually involves a preoccupation with weight loss and attaining a low body weight. Instead of restriction, bulimia nervosa is typically characterized by binge eating large quantities of food, often quickly. Binges are usually followed by what is called “compensatory behavior,” or actions intended to compensate for the binge.
Compensatory behaviors may include vomiting, taking laxatives or diuretics, fasting, or engaging in excessive exercise. While people with anorexia nervosa are often underweight, those with bulimia nervosa may have a fluctuating weight and at times may have a normal weight or be overweight.
Binge eating disorder
In binge eating disorder, a person normally has recurring binge eating episodes. During these moments, they usually sense they are out of control and believe they are unable to stop themselves from eating.
People with binge eating disorder often feel great shame and distress over their eating. For this reason, they may hide food or eat in secret. People with binge eating disorder often, but not always, are overweight or obese. Binge eating can differ from bulimia nervosa in that people do not usually engage in compensatory behaviors after binge eating.
People who have avoidant/restrictive food intake disorder (ARFID) often undereat and may avoid entire categories of food. ARFID usually begins in childhood. To many, ARFID may look like "picky eating," but it can come with serious consequences, like nutritional deficiencies and developmental delays.
Unlike people with other eating disorders, those with ARFID don't usually fear gaining weight. Instead, they often avoid foods out of fear of vomiting or choking, disgust, or other negative feelings related to the food's taste or texture. People with ARFID are generally not preoccupied with weight, size, or body image.
Other specified feeding or eating disorder (OSFED)
Some eating patterns that involve disordered eating but do not fit clearly in one of the already mentioned categories are categorized as other specified feeding or eating disorders (OSFEDs).
Depending on the type of OSFED a person has, they may restrict their food or engage in binge eating and purging. Although OSFED is sometimes discussed as if it's a less serious eating disorder, NEDA emphasizes that OSFED is actually the most common eating disorder, and it is just as serious as anorexia nervosa, bulimia nervosa, and binge eating disorder.
Disordered eating habits research
Although updated evidence may be needed, research suggests that many people engage in disordered eating habits, even those who do not meet the criteria for an eating disorder. Disordered eating can negatively impact a person's health and nutrition. As with eating disorders, identifying disordered eating habits early may prevent negative outcomes and complications.
In general, disordered eating involves many of the same symptoms seen in eating disorders. Often, these symptoms occur on their own or do not occur frequently or severely enough to be considered an eating disorder. Indicators of disordered eating may include skipping meals, using food substitutes, eating very little, taking diet pills, vomiting, taking laxatives or diuretics, and binge eating.
Healthy eating habits
Healthy eating habits generally refer to those that provide adequate nutrition, which can protect against deficiencies and mental and physical health challenges. When a person is recovering from an eating disorder or trying to break disordered eating habits, they generally try to replace disordered practices with healthy eating habits.
Healthy eating habits may include eating breakfast, lunch, and dinner every day, eating meals that contain protein, complex carbohydrates, and vegetables, and eating when a person feels hungry, among other practices.
A fear of gaining weight and eating disorders
A fear of gaining weight often underlies common eating disorders. Most notably, a fear of gaining weight is thought to drive behaviors in anorexia nervosa and bulimia nervosa. A fear of gaining weight can also be present in OSFED disorders that involve restricting food or engaging in purging or other compensatory behaviors.
Signs of a fear of gaining weight
Knowing that a fear of gaining weight is present in many eating disorders could help a person become more aware of eating disorder warning signs. When a person has an immense fear of gaining weight, that could indicate they have or are at risk of developing anorexia nervosa, bulimia nervosa, or OSFED.
Signs of a fear of gaining weight often overlap with other eating disorder signs and may include a preoccupation with one's weight or size, undereating, avoidance of certain foods or categories of food, and compensatory behaviors, like vomiting, taking laxatives, or over-exercising.
Eating disorder treatment
Research suggests that people who receive treatment for eating disorders usually have better outcomes than those who don't receive treatment. Recovery from an eating disorder is not always a linear process. A person may see symptoms gradually fade and then eventually enter remission, during which time they may no longer qualify for an eating disorder diagnosis.
However, an external event may eventually trigger the eating disorder to reoccur, which is usually referred to as a relapse. A person may go through multiple remissions and relapses before recovering for good. Different eating disorders can have different recovery rates, and up to 60% of people with an eating disorder may eventually recover.
Eating disorder treatment types
Eating disorder treatment can be a complex process. Instead of a singular treatment, people may benefit from receiving multiple types of treatment at once. Eating disorder treatments may include the following:
- Education and training
- Family therapy
- Individual therapy
- Group therapy
- Peer support or support groups
- Dietary programs or dietitian sessions
- Exercise programs or personal training
- Medication
- Virtual reality or other digital simulation programs
Eating disorder therapy
People with an eating disorder or disordered eating habits may want to pursue therapy. Remote therapy could be a uniquely appealing option because of the comfort it may provide. With remote therapy, a person doesn't have to go in public or travel anywhere to meet with a therapist. Instead, they can meet with a therapist virtually using a digital device and wi-fi, connecting through video chats, phone calls, or online chat. BetterHelp is a platform that can connect people with remote therapists, often within 48 hours.
Research on therapy for different types of eating disorders
Multiple types of therapy for eating disorders exist. The type of therapy a person pursues may depend on the type of eating disorder they have. Authors of a systematic meta-review of meta-analyses on eating disorder treatments concluded that family-based therapy is the most evidence-based treatment for anorexia nervosa, and cognitive behavioral therapy (CBT) is the most evidence-based treatment for bulimia nervosa. Other types of therapy were also found to benefit people with these and other eating disorders.
In addition, research increasingly supports the use of online therapy for eating disorder treatment. According to a 2023 study, online therapy may effectively treat individuals with eating disorders and reduce symptoms of co-occurring conditions like depression.
Takeaway
How can you start eating disorders education?
Teachers and other professionals who work with children can play an important role in educating young people about eating disorders, which may help prevent them. Educating students about how to build healthy habits, modeling healthy habits, teaching media literacy, promoting healthy self-esteem and coping mechanisms for anxiety, and creating a safe space for students to ask questions, report bullying, and ask for help can all be part of this.
What are schools doing to help people with eating disorders?
Some schools provide training for teachers and/or students with the aim of preventing eating disorders. Examples of programs some schools have implemented include media literacy training to combat media-based body ideals, robust systems to prevent and address weight-based bullying, and healthy school lunches along with education related to positive eating patterns and other self-care habits. Some schools also have a registered dietitian on staff to help plan school lunches, educate the student population on nutrition and eating disorder prevention, provide support for any child struggling with disordered eating, and help families find resources.
How can you help people with disordered eating habits and fear of gaining weight?
Eating disorder symptoms typically will not resolve without professional treatment. Treating eating disorders typically involves some form of talk therapy along with nutrition education. Intervention to address medical complications (such as abdominal pain, dangerous weight gain or loss, malnutrition, and others) may also be necessary. Eating disorder research suggests that early intervention may improve long-term outcomes, so gently but firmly encouraging someone showing disordered eating habits to seek professional help can often be the best way to help them.
How do eating disorders affect education?
Eating disorders are mental illnesses that can affect both physical and mental health and are potentially life-threatening. This means they can deeply impact the life of a student and their peers as well. In addition, as non-profit organization NEDA (the National Eating Disorders Association) points out, teachers have a unique role to play in eating disorder prevention and intervention. Signs of eating disorders typically appear before age 18, and teachers and others who are around children every day are often the first to notice warning signs and therefore often the first to intervene. Providing training and resources to teachers on this topic can be critical to child health and positive educational outcomes.
How can teachers prevent eating disorders or connect students with eating disorder treatment and therapy?
Eating disorder symptoms usually appear before age 18, which means that elementary, middle, and high school teachers engage daily with high-risk populations. Educators are often the first to notice signs of disordered eating in a child or adolescent, so they're uniquely positioned to intervene. Contacting the child's family to share concerns—which is usually done through or with the support of the school psychologist or counselor—can sometimes be the required next step. Providing a safe space for students to share their feelings and ask for help can also be important, as can modeling healthy behaviors, taking weight-related bullying seriously, and maintaining a collection of local eating disorder resources to share as needed.
What approach would you use with a student who has an eating disorder?
Some schools have specific guidelines for how teachers should respond to a student who is showing signs of an eating disorder. In many cases, working with the school psychologist or nurse to connect with their parents is the next step. In addition, acting compassionately and non-judgmentally toward the student and being there for them can be helpful.
What is psychoeducation for eating disorders or eating disorders education?
Psychoeducation for eating disorders can be a component of treatment for this type of illness. It's often done by a therapist or another type of mental health care professional. It usually involves educating patients and/or their families on what eating disorders are, what they can look like, what their impact can be, and how to prevent or treat them.
What accommodations are available for students with anorexia and other types of eating disorders?
Legally, students with a serious illness like anorexia or another eating disorder can receive what's known as a 504 plan, which is a customized plan designed to support the student and their unique needs in a school setting. Speaking to your child's school psychologist, counselor, and/or teacher can be a first step in creating this type of plan.
How do you control eating disorders, according to research?
Research suggests that the most effective treatment for eating disorders currently available is usually a combination of medical care, nutrition support, and talk therapy. That said, each individual is different. It's generally recommended that you meet with a licensed mental health care professional if you are showing signs of an eating disorder so they can create a personalized treatment plan that suits your unique needs.
As an educator, if a student has an eating disorder, you should typically check if your school has specific guidelines for how to handle the situation. These usually involve consulting with the school psychologist to contact the individual's parents and develop a plan for any support or accommodations they may need at school.
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