National Eating Disorders Awareness Week is in February

Around 30 million Americans struggle with eating disorders, making it the second deadliest mental health disorder (following opioid overdoses). National eating disorders week is in February, making it a great time to spread more awareness. If you or someone you know is struggling with an eating disorder, please seek immediate care. The National Eating Disorders Awareness (NEDA) hotline can be reached at (800)-931-2237.

Types of Eating Disorders

Eating disorders are multifaceted and more than a black-and-white diagnosis. However, eating disorders are separated into different categories and/or classifications diagnosed by a healthcare provider based on certain criteria. This article will focus on four common types of eating disorders and some of the important factors of each one.

Anorexia

One type of eating disorder is known as anorexia nervosa, which is an eating disorder typically characterized by weight loss, difficulty maintaining weight, and/or distortion in body image. People with anorexia may:

• Restrict overall caloric intake
• Over-exercise
• Engage in purging behavior such as vomiting and/or taking laxatives
• Binge eat

No eating disorder presents outwardly the same, meaning it is impossible to diagnose someone with an eating disorder, including anorexia, just based on how they look. People of both genders, all ages, and all sizes suffer from anorexia.

To be diagnosed with anorexia, according to the Diagnostic Statistic Manual 5 (DSM-5), an individual may:

• Restrict caloric intake, leading to a very reduced body weight based on an individual’s parameters
• Have an intense fear of gaining weight
• Have disturbances in the way that their body is, allowing this to affect their self-evaluation, and/or have denial of their low body weight.

Anorexia is a serious health condition that warrants immediate, consistent, and thorough treatment by a team of qualified healthcare professionals.

Bulimia Nervosa

Another type of eating disorder is known as bulimia nervosa, which is an eating disorder typically characterized by cycles of bingeing followed by compensatory purging behaviors.

To be diagnosed with bulimia, according to the DSM-5, an individual may:

• Have repeated episodes of binge eating, or eating a large amount of food that is not typical of what someone else would eat in a similar period (someone who is binge eating may often feel out of control during the episode)
• Have repeated episodes of compensatory behavior to prevent weight gain
• Experience repeated cycles, at least once a week for 3 months

Bulimia is a serious health condition that warrants immediate, consistent, and thorough treatment by a team of qualified healthcare professionals.

Binge Eating Disorder

Another type of eating disorder is known as binge eating disorder (BED), which is an eating disorder typically characterized by cycles of bingeing without using compensatory purging behaviors.

To be diagnosed with BED, according to the DSM-5, an individual may:

• Have repeated episodes of binge eating (someone who is binge eating may often feel out of control during the episode)
• Experience binge eating episodes often associated with eating more than normal, feeling uncomfortably full, eating large amounts of food while not hungry, eating alone out of embarrassment, and feeling significant guilt and/or disgust after bingeing
• Experience repeated cycles at least once a week for 3 months.

BED is a serious health condition that warrants immediate, consistent, and thorough treatment by a team of qualified healthcare professionals.

Orthorexia

The last type of eating disorder we will cover is known as orthorexia, which is a newer eating disorder typically characterized by an obsession with “healthy” eating.

While there is no formal diagnostic criterion for orthorexia, an individual may:

• Be compulsively obsessed with checking nutrition facts
• Be very concerned about the health of ingredients
• Cut out many food groups
• Refuse to eat foods that are not “healthy”
• Have an obsessive interest in following like-people on social media platforms

Orthorexia is a serious health condition that warrants immediate, consistent, and thorough treatment by a team of qualified healthcare professionals.

Causes of Eating Disorders

Because eating disorders are often a symptom of other underlying issues and/or concerns, individuals develop eating disorders for various reasons. When an individual begins to either deprive themselves of food, over-consume food as a coping mechanism, or a combination of deprivation and excess, the food is often the symptom of a larger, underlying problem or concern.

Some of the most common causes of eating disorders include:

• Family history: Having a relative with an eating disorder may increase your likelihood of developing one.
• Mental health conditions: Having other mental health conditions such as anxiety, depression, or addiction issues can increase your risk of having an eating disorder. In addition, undergoing largely traumatic events can increase your risk.
• History of dieting: Having a history of dieting behaviors can increase your likelihood of developing an eating disorder.
• Certain personality traits: Having certain personality traits, such as perfectionism and/or inflexibility may increase your propensity for developing an eating disorder.
• Weight stigma: Being overly influenced by weight stigma, whether that’s coming from social media, family, or cultural sources, can contribute to your propensity for developing an eating disorder.

Because so many different elements can contribute to your risk of developing an eating disorder, it is important to identify if you are at a higher risk of developing an eating disorder, knowing some of these common causes. If so, managing your mental health and being proactive to prioritize a healthy relationship with your body and with food is of utmost importance.

Symptoms of Eating Disorders

Each type of eating disorder may present with different symptoms, which may vary for each individual.

Anorexia

While symptoms will vary from person to person, some common symptoms of anorexia can include:

• Significant weight loss
• Wearing heavy clothes to hide the body, feel warm
• Over-preoccupation surrounding food, calories, etc.
• Omission of various types of foods, leading to lots of restrictions on diet
• Negative comments surrounding body
• Low energy levels
• Denying feelings of hunger
• Cooking meals for other people but does not eat them
• Making excuses to avoid mealtime
• Withdrawing from friends and family
• Loss of menstrual cycle post-puberty
• Fainting
• Having very fine hair
• Poor wound healing

Bulimia

While symptoms will vary from person to person, some common symptoms of bulimia can include:

• Behaviors to try to lose weight and/or diet
• Evidence of binge eating behaviors
• Evidence of purging behaviors
• Skipping meals
• Disappearance after eating, often to use the bathroom
• Hoarding food
• Discoloration of teeth
• Bloating
• Abnormal lab findings

BED

While symptoms will vary from person to person, some common symptoms of BED can include:

• Evidence of binge eating behaviors
• Hoarding food
• Scheduling times to binge
• Social or familial withdrawal
• Eating alone out of embarrassment
• Significant weight fluctuations
• Stomach cramping

Orthorexia

While symptoms will vary from person to person, some common symptoms of orthorexia can include:

• Worrying extensively about food quality and/or safeness
• Avoiding going out or eating foods prepared by other people
• Being overly critical of other’s food choices
• Being underweight or malnourished

Treatment of Eating Disorders

There are many different levels of care for eating disorders, depending on the severity of the condition and how at-risk you are. Some of these levels include:

• Outpatient care: This is the first, least-invasive type of treatment approach. This may be appropriate if you are medically stable and do not need daily monitoring. Additionally, outpatient care may be the best fit if you can function at a normal level from a psychiatric standpoint, engaging in day-to-day functioning without significant difficulty.
• Partial hospitalization: The next level of care would be partial hospitalization, in which you may be medically stable, but your eating disorder requires daily monitoring. In these cases, individuals can’t function in normal social or educational settings.
• Residential: This is the next level of care in which you are medically stable but is psychiatrically impaired in ways that do not respond to outpatient or hospital treatments.
• Inpatient: This is the highest level of care in which you are medically and psychiatrically unstable.

You may need to go from one level of care to another throughout your treatment journey. Or you may need less intervention and could stay at the outpatient level of care and receive adequate treatment.

Treatment for an eating disorder is a process, and change does not occur overnight. It requires time and a team of qualified healthcare practitioners, including a doctor, therapist, dietitian, and any other therapies deemed to fit.

The goal of treatment is to stabilize you and help you heal your relationship with yourself, with your ailments, and with food. This can include different therapeutic and/or medical interventions, including medications, therapy sessions, dietary monitoring and education, and consistent surveillance until you can function on your own without health-harming behaviors.

Overall, eating disorders are an incredibly serious group of medical conditions. It can be hard to seek treatment or to help a loved one to seek treatment. If you or someone you know is struggling with an eating disorder, seeking the help and guidance of qualified professionals can be a helpful starting point. It is never too early, too late, or unworthwhile.

Jordan Stachel holds a Master’s degree in Nutrition and Dietetics from The University of Southern California and is a Registered Dietitian Nutritionist. She has several years of experience helping clients reach their health goals through her clinical work within private practice. Jordan is most fulfilled when guiding others towards making stepwise, sustainable changes that add up to big results over time. Jordan works with a wide variety of individuals, ranging in age from children through the elderly, with an assortment of concerns and clinical conditions. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.

References:

1. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia
2. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bulimia
3. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed
4. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia
5. https://www.nationaleatingdisorders.org/help-support/contact-helpline
6. https://www.nationaleatingdisorders.org/risk-factors
7. https://www.nationaleatingdisorders.org/what-expect-treatment