Understanding Different Types Of Eating Disorders
Eating disorders are serious mental illnesses characterized by significant disturbances in eating behaviors. They often occur with other mental illnesses, most commonly anxiety disorders, mood disorders, obsessive-compulsive disorder, and substance use disorders. They can be grave conditions, significantly affecting a person’s mental and physical health.
There are different types of eating disorders, and while each has unique symptoms, they tend to involve an extreme focus on eating and food. Here are six common eating disorders, their symptoms, possible complications, and information about treatment.
Anorexia nervosa
Anorexia nervosa is an eating disorder that causes people to severely limit the amount of food they eat to avoid gaining weight. People with anorexia may feel that they are overweight even if they are underweight, and they may exercise in excess to lose or avoid gaining weight.
Behavioral changes that are associated with anorexia may include not eating at all or eating very little, not eating in front of others, taking diet pills or laxatives, exercising excessively, and talking about food and body weight frequently.
Because people with anorexia tend to restrict their food intake so severely, they can also experience a variety of physical symptoms resulting from not getting the right nutrients to maintain basic body function. Some of these symptoms may include brittle hair and nails, dizziness, irregular or missed periods, dry skin, muscle weakness, and the growth of fine hair called lanugo all over the body. They can also experience cognitive changes, like moodiness, confusion, and poor memory.
Complications of anorexia nervosa
Anorexia nervosa can have severe effects on someone’s physical health as the body is not getting the nutrients it needs to function properly. People with anorexia may experience heart problems, anemia, osteoporosis, and kidney failure, and without effective treatment, the condition can be fatal.
Anorexia has the highest mortality rate of any psychiatric disorder; approximately 5% of patients die within four years of diagnosis.
Bulimia nervosa
People with bulimia nervosa typically engage in binge eating, consuming large quantities of food in a short period. Then, they usually try to prevent gaining weight by purging, either by making themselves vomit or taking laxatives to speed up the movement of food through the body. During periods when they are not binging and purging, people with bulimia may eat very little or exercise excessively to avoid gaining weight.
People with bulimia may appear to be of average weight, and they usually binge and purge sercretly, which can make it difficult to tell if someone has the disorder. Some behavioral changes that may indicate someone has bulimia include going to the bathroom immediately after eating to purge, exercising excessively, stating they hate the way they look, and not wanting to participate in activities they once enjoyed.
Complications of bulimia nervosa
Bulimia can prevent the body from getting the nutrients it needs and, over time, can cause significant damage to the body. Purging can cause tooth decay, broken blood vessels in the eyes, acid reflux, ulcers, or severe dehydration, while binge eating can cause stomach damage. Bulimia can also lead to electrolyte imbalances that can cause heart problems.
Binge eating disorder
Binge eating disorder typically leads a person to eat large quantities of food in a short time and feel like they cannot control how much they are eating. To be diagnosed with this disorder, someone must binge eat at least once a week for three months. People with binge eating disorder may be ashamed of or upset by their binging, and they are likely to binge secretly. Binge eating disorder is different from bulimia because preventing weight gain by purging or exercising excessively is generally not a regular part of this disorder.
Complications of binge eating disorder
Binge eating disorder can lead to weight gain and problems associated with obesity, like heart disease and type 2 diabetes. They may also be at risk of high cholesterol, high blood pressure, and gall bladder disease.
Avoidant/restrictive food intake disorder (ARFID)
People with this disorder may lose interest in eating or fear that they will choke or vomit when they do eat. They may also be selective about certain textures, colors, tastes, and smells. People with ARFID may identify a few things that they feel are safe to eat, and they may have rituals around how they eat. The list of foods that people with ARFID are willing to eat can get shorter over time.
It may be important to note that ARFID is not the same as picky eating. Picky eating usually only leads to avoidance of a few foods, and it is not typically significant enough to affect growth and development or cause complications due to a lack of nutrients.
Complications of avoidant/restrictive food intake disorder
ARFID can result in malnutrition, which can cause weight loss, lethargy, irregular periods, dizziness, weakness, and lanugo. Other possible complications include dehydration, anemia, low blood pressure, and delayed puberty.
Pica
According to the DSM-5 Pica is a disorder in which people eat “nonnutritive, non-food substances over a period of at least one month.” People with pica may ingest a variety of items, including ice, dirt, paper, chalk, eggshells, and coffee grounds.
Pica can be seen in people of all ages, including children. It’s also somewhat common in people with intellectual disabilities, and some women can experience pica during pregnancy. Pica is usually short-term and often resolves spontaneously in children and pregnant women, but it can last for years in people with intellectual disabilities.
Complications of pica
Long-term pica can have many complications, including toxicity, bowel obstruction, and bezoars, which are masses made of undigested materials that form in the GI tract. Complications generally depend on what someone with pica ingested. For example, ingested clay or earth could lead to lead poisoning or parasitic infections. Pica during pregnancy can also lead to significant fetal complications if what is being ingested leads to toxicity.
Other specified feeding and eating disorders
This category of eating disorders refers to disordered eating behaviors that do not fit into other categories, likely because the behavior or frequency of the behavior does not meet the threshold for another diagnosis. For example, for a diagnosis of bulimia, the DSM-5 criteria state that the person must binge-eat and engage in purging and other behaviors aimed at weight loss “on average, at least once a week for 3 months.” Someone who binges and purges one every two or three weeks or has only engaged in the behavior for two months may not meet this criteria, although they are still showing signs of disordered eating.
Complications of other specified feeding and eating disorders
Complications of this eating disorder can depend on the behaviors the person is exhibiting. The complications can resemble any of the complications listed above, including malnutrition, weight loss, or obesity.
How are eating disorders treated?
It is possible to get eating disorders treated successfully. Early detection and an appropriate treatment plan can help someone with an eating disorder make a full recovery. Treatment for eating disorders generally includes psychotherapy, nutritional support and education, medications, and medical care and interventions when necessary.
Because eating disorders can have significant effects on the body, restoring physical health can be an important part of treatment. Depending on the person’s physical health, in-patient monitoring or long-term residential programs may be required to ensure that they are gaining weight appropriately and that any physical health complications are being treated effectively.
Eating disorders can be complex to treat, which is why therapy can play such a significant role in recovery. People with eating disorders may have underlying mental disorders, such as anxiety, depression, or substance use, that contribute to their symptoms. Talk therapy can help them learn how to manage the thoughts and emotions that contribute to their behaviors while also addressing these underlying mental disorders.
Online therapy can be a convenient and flexible way to get help. With an online counseling platform, you can work with a licensed, professional counselor from the comfort of your home. You can change therapists at any time for no fee until you find one who is the right fit for you. Also, you can communicate in a way that’s comfortable for you, whether via audio, video, or live chat.
Research has found that online therapy for eating disorders is effective. One study that looked at the long-term effectiveness of online cognitive behavioral therapy found that this treatment had “large effect sizes for the reduction of ED psychopathology and body dissatisfaction” and determined that it has “long-term sustainability of treatment effects up to 1-year post-treatment.”
Takeaway
What are the most common eating disorders in adolescence?
Common eating disorders in adolescents include:
- Anorexia nervosa. This eating disorder features an intense fear that the individual will gain weight, alongside a strong weight distorted body image. In order to lose weight or prevent weight gain, the individual may follow extremely restrictive eating habits and an excessive exercise regimen. Their eating behavior can lead to dangerously low body weight, and life threatening medical complications.
- Bulimia nervosa. Bulimia nervosa is also rooted in distorted body image, and those with this disorder may also exercise excessively, with other symptoms including eating large quantities of food coupled with purging behaviors, such as forced vomiting or laxative abuse. Those with bulimia may have low body weight, but often can be of normal weight as well.
- Other Specified Feeding or Eating Disorder (OSFED). Other specified feeding and eating disorders refers to other mental disorders that involve disordered eating, but do not fall directly into the criteria for any of the others. OSFED is the most common eating disorder found in the United States.
What are common examples of disordered eating?
Some common disordered eating patterns include excessive tracking of foods eaten, obsessing over the nutritional value of foods, avoiding certain foods, abuse of supplements or laxatives, fasting or skipping meals, emotional eating, and frequent cleanses or detox.
How to identify disordered eating?
Disordered eating can be recognized through common physical signs such as significant weight loss or extreme weight fluctuations, changes in bowel habits, gastrointestinal pain or distress, dizziness, weakness, fatigue, or damage to tooth enamel.
Emotional signs of disordered eating may include a hyper focus on weight or body mass index, performing food rituals, avoiding social activities because of food, an extremely restricted list of “safe” or preferred foods, or being preoccupied with body size or shape, or a specific part of the body.
What triggers disordered eating?
Disordered eating is often triggered by trauma and stress. Biological and genetic factors are often involved as well, but over time ingrained disordered eating can take hold during times of high stress, and may even lead to a separate eating disorder (for example, orthorexia may become severe and lead to developing anorexia).
How to fix eating disorders?
Treating eating disorders can be complicated, as these are complex disorders. Proper medical care for treating eating disorders often requires a team effort. Typically, this team will include a primary care provider, along with an eating disorder specialist, to oversee the medical side, with blood tests and care to treat serious illnesses that may occur due to lack of nutrition. A mental health professional may work on compensatory behaviors, healing self-image and self-esteem issues, and reinforcing healthy eating habits. Nutrition counseling is often overseen by a licensed dietician, who will educate on healthy eating, and create a refeeding plan. Very often, because patients can be younger, family-based treatment is pursued, and family members are educated on how to support their loved one.
What is the psychology of eating disorders like binge eating?
Binge eating is complicated like all eating disorders, experts believe that binging behaviors have their roots in trauma, and are propagated by guilt and restriction.
Why are eating disorders so hard to treat?
Eating disorders are difficult to treat because they can be both complex and severe. People who experience eating disorders may become very adept at hiding behaviors, and are often very reluctant to admit to needing help. These behaviors often begin in adolescence or young adulthood and can lead to serious harm if not caught early.
What is the main cause of eating disorders like anorexia nervosa or binge eating disorder?
Science has not pinpointed an exact cause of disordered eating, rather research suggests that a number of factors can contribute including genetics. If a close family member has had an eating disorder, you may be at higher risk for developing one. Other risk factors include having another mental illness like anxiety, depression, or rumination disorder, high stress, trauma, or having been bullied about weight in childhood.
What are the mental and social effects of eating disorders?
Eating disorders are not only triggered by mental health challenges, but can also affect mental health in a negative way. Lack of nutrition and reinforced negative thought patterns can continue to exacerbate symptoms and create a cycle of poor mental and physical health. A fear of discovery can lead to social isolation, which in turn can lead to greater stress, anxiety, or depressive symptoms.
Can you tell if someone has an eating disorder by watching their food intake?
Not always. Many people who have an eating disorder become very good at hiding what or how much they eat. They may be able to hide signs of their disorder from even close loved ones for a long time.
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