Eating disorders are a topic close to my heart. I have a long and painful history with disordered eating. I want to share my story with a focus on helping others to feel less alone as I did and still do.
I will detail my story in the next post because I think it is important to first share some facts about eating disorders. (From Healthline, https://www.healthline.com/nutrition/common-eating-disorders.) Eating disorders have, throughout history, been primarily associated with adolescents and young adults. This is no longer true. Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. (https://www.nimh.nih.gov/health/topics/eating-disorders/)
Note: the original source of much of this information comes from the healthline article cited above).
Eating disorders are about more than food. They are complex mental health conditions that often require medical and/or psychological intervention to alter their course. These disorders are described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In the United States alone, an estimated 20 million women and 10 million men have or have had an eating disorder at some point in their life .(https://www.nationaleatingdisorders.org/what-are-eating-disorders)
What are eating disorders? Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop. They are marked by an obsession with food or body image. Most people can drink responsibly. However, that is not possible for an alcoholic. Food addicts have a similar experience.
In severe cases, eating disorders can cause serious health consequences and may result in death if left untreated. Many are familiar with the Karen Carpenter story.
Those with eating disorders can have a variety of symptoms. However, most include the severe restriction of food, food binges, or purging behaviors like vomiting or over-exercising. What causes them?
There are many causes including genetics, brain biology, personality traits, and cultural ideals but research continues.
5-10 percent of individuals with anorexia die within 10 years after being diagnosed, and 18-20 percent of individuals with anorexia will die within 20 years of being diagnosed.
The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of all causes of death in females 15-24 years of age.
Without treatment, up to 20 percent of individuals with a severe eating disorder will die, and with treatment, the mortality rate drastically falls to 2-3 percent.
Among those who struggle with anorexia, 1 in 5 deaths are by suicide.
According to the National Center on Addiction and Substance Abuse, up to 50% of individuals with eating disorders abused alcohol or illicit drugs, a rate five times higher than the general population. https://centerfordiscovery.com/blog/statistics-on-eating-disorders/. The thing that separates food addicts from other substance abusers is the dependence of the body on nutritional support provided by food. Food is also considered very important in most cultures. It is impossible for food addicts to completely walk away from their drug of choice if they want to survive.
Many people will not recover from their eating disorder without intervention.. Help comes in many forms but the affected individual must be open to it. Some sources of help include:
Eating Disorder Inpatient or Outpatient Facilities
12 step program called Overeaters Anonymous (includes anorexia)
Other Support groups
Nutritionists who specialize in eating issues
Most Common Eating Disorders
Anorexia nervosa is likely the most well-known eating disorder. It was identified and named by Sir William Withey Gull in 1873. People with anorexia generally view themselves as overweight, even if they’re dangerously underweight. They tend to constantly monitor their weight, avoid eating certain types of foods, and severely restrict their calories. Common symptoms of anorexia nervosa include:
being considerably underweight compared with people of similar age and height
very restricted eating patterns
an intense fear of gaining weight or persistent behaviors to avoid gaining weight despite being underweight
a relentless pursuit of thinness and unwillingness to maintain a healthy weight
a heavy influence of body weight or perceived body shape on self-esteem
a distorted body image, including denial of being seriously underweight
Obsessive-compulsive behaviors such as preoccupation with food thoughts, obsessive recipe collection and food hoarding
difficulty eating in public
exhibiting a strong desire to control the environment, limiting the ability to be spontaneous.
Anorexia is officially categorized into two subtypes — the restricting type and the binge eating and purging type. Individuals with the restricting type lose weight solely through dieting, fasting, or excessive exercise. Individuals with the binge eating and purging type may binge on large amounts of food or eat very little. In both cases, after they eat, they purge using activities like vomiting, taking laxatives or diuretics, or exercising excessively.
Anorexia can be very damaging to the body. Over time, individuals living with it may experience the thinning of their bones, infertility, brittle hair and nails, and the growth of a layer of fine hair all over their body (https://www.nimh.nih.gov/health/topics/eating-disorders.) In severe cases, anorexia can result in heart, brain, or multi-organ failure and death. Bulimia nervosa is another well-known eating disorder. People with bulimia frequently eat unusually large amounts of food in a specific period of time. Each binge eating episode usually continues until the person becomes painfully full. During a binge, the person usually feels that they cannot stop eating or control how much they are eating. Binges can happen with any type of food but most commonly occur with foods the individual would normally avoid.
Individuals with bulimia then attempt to purge to compensate for the calories consumed and relieve gut discomfort. Common purging behaviors include forced vomiting, fasting, laxatives, diuretics, enemas, and excessive exercise.
Symptoms may appear very similar to those of the binge eating or purging subtypes of anorexia nervosa. However, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight. Common symptoms of bulimia nervosa include : (see previous reference):
recurrent episodes of binge eating with a feeling of lack of control
recurrent episodes of inappropriate purging behaviors to prevent weight gain
a self-esteem overly influenced by body shape and weight
a fear of gaining weight, despite having a normal weight
Side effects of bulimia may include an inflamed and sore throat, swollen salivary glands, worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration, voice alteration, and hormonal disturbances (https://www.nimh.nih.gov/health/topics/eating-disorders/).
In severe cases, bulimia can also create an imbalance in levels of electrolytes, such as sodium, potassium, and calcium. This can cause a stroke or heart attack. Binge eating disorder is believed to be one of the most common eating disorders.(https://www.ncbi.nl m.nih.gov/pmc/articles/PMC3409365/) Individuals with this disorder have symptoms similar to those of bulimia or the binge eating subtype of anorexia. For instance, they typically eat unusually large amounts of food in relatively short periods of time and feel a lack of control during binges. People with binge eating disorder do not restrict calories or use purging behaviors, such as vomiting or excessive exercise, to compensate for their binges. Common symptoms of binge eating disorder include:
eating large amounts of foods rapidly, in secret and until uncomfortably full, despite not feeling hungry
feeling a lack of control during episodes of binge eating
feelings of distress, such as shame, disgust, or guilt, when thinking about the binge eating behavior
no use of purging behaviors, such as calorie restriction, vomiting, excessive exercise, or laxative or diuretic use, to compensate for the binging
People with binge eating disorder often have overweight or obesity. This may increase their risk of medical complications linked to excess weight, such as heart disease, stroke, and type 2 diabetes. (https://www.ncbi.nlm.nih.gov/books/NBK278973/)
Pica is an eating disorder that involves eating things that are not considered food. Individuals with pica crave non-food substances, such as ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent, or cornstarch. Pica can occur at any age.
Individuals with pica may be at an increased risk of poisoning, infections, gut injuries, and nutritional deficiencies. Depending on the substances ingested, pica may be fatal. However, to be considered pica, the eating of non-food substances must not be a normal part of someone’s culture or religion. In addition, it must not be considered a socially acceptable practice by a person’s peers. Rumination disorder is a newly recognized eating disorder exhibited by a person who regurgitates food they have previously chewed and swallowed, re-chews it, and then either re-swallows it or spits it out. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061016/)
Rumination typically occurs within the first 30 minutes after a meal. This disorder can develop during infancy, childhood, or adulthood. In infants, it tends to develop between 3–12 months of age and often disappears on its own. Children and adults with the condition usually require therapy to resolve it. If not resolved in infants, rumination disorder can result in weight loss and severe malnutrition that can be fatal. Adults with this disorder may restrict the amount of food they eat, especially in public. Avoidant/restrictive food intake disorder (ARFID) replaces what was known as a “feeding disorder of infancy and early childhood." Although ARFID generally develops during infancy or early childhood, it can persist into adulthood. What’s more, it’s equally common among men and women.
Individuals with this disorder experience disturbed eating either due to a lack of interest in eating or distaste for certain smells, tastes, colors, textures, or temperatures.
(https://www.healthline.com/nutrition/common-eating-disorders#avoidant) Common symptoms of ARFID include:
avoidance or restriction of food intake that prevents the person from eating sufficient calories or nutrients
eating habits that interfere with normal social functions, such as eating with others
weight loss or poor development for age and height
nutrient deficiencies or dependence on supplements or tube feeding
Other specified feeding or eating disorder (OSFED) is a catch all bucket for any other eating disorder not classified above. One disorder of note is orthorexia. Although increasingly mentioned in the media and scientific studies, orthorexia has yet to be recognized as a separate eating disorder by the current DSM. Individuals with orthorexia tend to have an obsessive focus on healthy eating, to an extent that disrupts their daily lives. For instance, the affected person may eliminate entire food groups, fearing they’re unhealthy. This can lead to malnutrition, severe weight loss, difficulty eating outside the home, and emotional distress. Individuals with orthorexia rarely focus on losing weight. Instead, their self-worth, identity, or satisfaction is dependent upon how well they comply with their self-imposed diet rules. https://scholarworks.iu.edu/conferences/index.php/iuurc/iuurc21/paper/view/217https://scholarworks.iu.edu/conferences/index.php/iuurc/iuurc21/paper/view/217.
I hope you will continue to connect with me and read my next post where I will document my personal journey of life with an eating disorder. I welcome your feedback