The term “eating disorder” elicits drastically different ideas about what the term means.
Some individuals think first about people who are extremely skinny and starve themselves to maintain a low weight. Others think of individuals who eat excessive amounts of food and are overweight or obese. Still others think about people who engage in unhealthy behaviors, such as self-induced vomiting, to maintain a certain weight.
“We currently live in a nation where there is great alarm about the increasing rates of obesity and associated health problems,” said Kristin Goodheart, psychotherapist with Prairie View. “Yet, there is also great concern about those who lose too much weight and become so thin that they risk starving themselves to death.”
It can be difficult to understand how such seemingly different issues can fall under the same category, Goodheart said, but the unifying characteristic is that people with eating disorders have dysfunctional, unhealthy relationships with food and with their bodies. Consequently, these dysfunctional relationships create significant distress and prevent people with eating disorders from living fulfilling lives.
Currently, diagnostic criteria have been developed for two specific eating disorders, anorexia nervosa and nulimia nervosa. Criteria for a third eating disorder, binge-eating disorder, will be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, due for publication later this year.
Any other clinically significant eating concern is currently included in a broad category labeled, “Eating Disorder Not Otherwise Specified.”
Signs of concern
Anorexia nervosa is associated with having an extremely low weight and an intense fear of gaining weight. People with this disorder often avoid certain types of foods and eat a very restrictive, low-calorie diet.
“They might weigh themselves frequently and are often preoccupied with calorie counting or with the nutrient composition of various foods,” Goodheart said.
Although they restrict their food intake, they might be very interested in activities related to food, such as baking, collecting recipes, reading food blogs or watching cooking shows. These individuals often have perfectionistic tendencies, are high achieving, think in a rigid way, and have a distorted body image.
The majority of people diagnosed with anorexia nervosa are women, and onset typically occurs during early to middle adolescence.
Bulimia nervosa is characterized by episodes of excessive calorie consumption or binge eating followed by some form of compensatory behavior, such as self-induced vomiting, laxative abuse, extreme fasting, excessive exercise, or a combination of these behaviors.
“People with bulimia nervosa often feel out of control when they are binge eating, and they can experience a lot of shame connected to the binge eating and purging behaviors,” Goodheart said.
People with bulimia nervosa are often of “normal” weight or are overweight, and have poor body image and low self-esteem. Additionally, people with this disorder are often secretive about their binge eating and purging behaviors, and can disguise their distress by giving others the impression that they are healthy and happy.
Therefore, a person with bulimia nervosa could engage in these unhealthy behaviors for years without anyone else knowing, according to Goodheart.
The majority of people diagnosed with bulimia nervosa are women, and onset typically occurs during late adolescence or early adulthood.
The onset of this disorder and other eating disorders, Goodheart said, can be triggered by a significant life change, such as moving away from home and beginning college.
“Eating Disorders Not Otherwise Specified” is a broad category that encompasses any type of eating disturbance that does not meet full criteria for anorexia nervosa or bulimia nervosa. A person who has some, but not all, symptoms of the two disorders—or both—would be diagnosed with an unspecified eating disorder.
About 60 to 70 percent of all clinically diagnosed eating disorders are classified as unspecified eating disorders.
Currently, “Binge Eating Disorder” is classified as an unspecified eating disorder. But researchers have been conducting studies over the past decade to determine appropriate diagnostic criteria for this disorder. These criteria will be included in the next edition of the “Diagnostic and Statistical Manual of Mental Disorders.”
Proposed criteria for binge-eating disorder include frequent episodes of excessive food consumption or binge eating, as one would see in bulimia nervosa, but without engaging in a subsequent compensatory behavior, such as self-induced vomiting, laxative abuse, or excessive exercise.
The episodes of binge eating cause significant distress and interfere with a person’s ability to function. People with binge-eating disorder are typically of “normal” weight or are overweight or obese, and they often experience body dissatisfaction and weight and shape concerns similar to those with anorexia nervosa and bulimia nervosa.
Numerous physiological and psychological consequences are associated with eating disorders, and sometimes these disorders can result in death.
“Sudden changes in diet, appetite, weight, or exercise regimen could be indicative of an eating disorder,” Goodheart said. “Additionally, eating disorders often co-occur with other psychological disorders, including depression, anxiety, substance abuse, bipolar disorder and personality disorders.
“Therefore, any unexplainable change in mood, sleep patterns, or academic, athletic, or work performance could be indicative of an eating disorder.”
Other possible warning signs include irritability, increased secrecy, withdrawal from friends and family, and loss of interest in enjoyable activities.
Addressing an eating disorder requires more than just behavioral changes, as there are often underlying emotional issues connected to the eating disorder symptoms. Both psychological and medical interventions are needed to treat these disorders, and highest recovery rates are associated with early intervention.
It is important to share information with a physician or mental health professional as soon as possible if symptoms of an eating disorder occur,” Goodheart said.
Prairie View is a faith-based, private behavioral and mental health services provider, offering a complete range of behavioral and psychiatric services for children, adolescents, adults and older adults, as well as consultation services to businesses and organizations. In addition to the main campus in Newton, Prairie View has outpatient locations in Hillsboro, Hutchinson, McPherson and Wichita. For more information, call 316-284-6400 or 1-800-362-0180.