eating disorders

WHAT IS AN EATING DISORDER?

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact your health, your emotions and your ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

Most eating disorders involve focusing too much on your weight, body shape and food, leading to dangerous eating behaviors. These behaviors can significantly impact your body's ability to get appropriate nutrition. Eating disorders can harm the heart, digestive system, bones, and teeth and mouth, and lead to other diseases.

Eating disorders often develop in the teen and young adult years, although they can develop at other ages. With treatment, you can return to healthier eating habits and sometimes reverse serious complications caused by the eating disorder.

WHAT ARE THE Symptoms?

Symptoms vary, depending on the type of eating disorder. Anorexia nervosa, bulimia nervosa and binge-eating disorder are the most common eating disorders. Other eating disorders include rumination disorder and avoidant/restrictive food intake disorder.

Anorexia nervosa

Anorexia nervosa — often simply called anorexia — is a potentially life-threatening eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. People with anorexia use extreme efforts to control their weight and shape, which often significantly interferes with their health and life activities. Efforts to reduce their weight, even when underweight, can cause severe health problems, sometimes to the point of deadly self-starvation.

Bulimia nervosa

Bulimia nervosa — commonly called bulimia — is a serious, potentially life-threatening eating disorder. When someone has bulimia, they have episodes of bingeing and purging that involve feeling a lack of control over what they eat. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging. Because of guilt, shame and an intense fear of weight gain from overeating, people may force vomiting or may exercise too much or use other methods to get rid of the calories.

Binge-eating disorder

When someone has a binge-eating disorder, they regularly eat too much food (binge) and feel a lack of control over their eating. The person may eat quickly or eat more food than intended, even when they're not hungry, and they may continue eating even long after you're uncomfortably full. After a binge, they may feel guilty, disgusted or ashamed by your behavior and the amount of food eaten. But they don't try to compensate for this behavior with excessive exercise or purging, as someone with bulimia or anorexia might. Embarrassment can lead to eating alone to hide the bingeing.

Rumination disorder

Rumination disorder is repeatedly and persistently regurgitating food after eating, but it's not due to a medical condition or another eating disorder such as anorexia, bulimia or binge-eating disorder. Food is brought back up into the mouth without nausea or gagging, and regurgitation may not be intentional. The disorder may result in malnutrition if the food is spit out or if the person eats significantly less to prevent the behavior. The occurrence of rumination disorder may be more common in infancy or in people who have an intellectual disability.

Avoidant/restrictive food intake disorder

This disorder is characterized by failing to meet the minimum daily nutrition requirements because a person doesn't have an interest in eating; they avoid food with certain sensory characteristics, such as color, texture, smell or taste; or they're concerned about the consequences of eating, such as fear of choking. Food is not avoided because of fear of gaining weight. The disorder can result in significant weight loss or failure to gain weight in childhood, as well as nutritional deficiencies that can cause health problems.

Causes

The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes, such as..

GENETICS AND BIOLOGY

Certain people may have genes that increase their risk of developing eating disorders. Biological factors, such as changes in brain chemicals, may play a role in eating disorders.

PSYCHOLOGICAL AND EMOTIONAL HEALTH

People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behavior and troubled relationships.

WARNING SIGNS

Unfortunately, many people with eating disorders may not think they need treatment. Even if your loved one isn't ready to acknowledge having an issue with food, you can open the door by expressing concern and a desire to listen.

Be alert for eating patterns and beliefs that may signal unhealthy behavior, as well as peer pressure that may trigger eating disorders. Red flags that may indicate an eating disorder include...

Skipping meals or making excuses for not eating
Adopting an overly restrictive vegetarian diet
Excessive focus on healthy eating
Making own meals rather than eating what the family eats
Withdrawing from normal social activities
Persistent worry or complaining about being fat and talk of losing weight
Frequent checking in the mirror for perceived flaws
Repeatedly eating large amounts of sweets or high-fat foods
Use of dietary supplements, laxatives or herbal products for weight loss
Excessive exercise
Calluses on the knuckles from inducing vomiting
Problems with loss of tooth enamel that may be a sign of repeated vomiting
Leaving during meals to use the toilet
Eating much more food in a meal or snack than is considered normal
Expressing depression, disgust, shame or guilt about eating habits
Eating in secret

Prevention

Although there's no sure way to prevent eating disorders, here are some strategies to help your loved one develop healthy-eating behaviors:

Avoid dieting around them. This may influence the relationships they develop with food. Talk to them about the pitfalls of dieting and encourage eating a balanced diet in reasonable portions.
Talk to your loved one. For example, there are numerous websites that promote dangerous ideas, such as viewing anorexia as a lifestyle choice rather than an eating disorder. It's crucial to correct any misperceptions like this and to talk the them about it.
Cultivate and reinforce a healthy body image, whatever their shape or size. Talk to your loved one about self-image and offer reassurance that body shapes can vary. Avoid criticizing your own body in front of them. Messages of acceptance and respect can help build healthy self-esteem and resilience that will carry through the rocky periods.
Enlist the help of a doctor. Doctors may be able to identify early indicators of an eating disorder. They can ask questions about their eating habits and satisfaction with their appearance during routine medical appointments, for instance. These visits should include checks of height and weight percentiles and body mass index, which can alert any significant changes.