Some people think that eating disorders are merely fads or lifestyle choices, but they are not. They affect patients physically, socially, and psychologically, thus can be classified as mental disorders.
In the US, approximately 20 million women and 10 million men were diagnosed with an eating disorder at least once in their lives (1). Generally, they are commonly seen in young women aged 13-17 years old (2). Eating disorders can have serious, life-threatening consequences. Luckily, there are treatments that can help!
This article will discuss 6 of the most common types of eating disorders, their causes, symptoms, and treatment options.
What Are Eating Disorders?
Eating disorders include a wide range of conditions expressed through unhealthy eating behaviors. They usually stem from an obsession with weight, body shape, and food, which results in serious health conditions. In severe cases, eating disorders may even cause death.
Patients with eating disorders present with a variety of symptoms. However, many would restrict food intake, binge, vomit, or over-exercise. As mentioned earlier, although eating disorders can affect both men and women at any life stage, they are most often seen in young women. In fact, 13% of youth may experience at least one eating disorder at 20 years old (3).
What May Cause An Eating Disorder?
Eating disorders are serious but treatable mental illnesses that can affect people of every age, sex, gender, race, ethnicity, and socioeconomic group. No one knows exactly what causes eating disorders, but it is generally believed they are the result of biological, psychological, and sociocultural factors.
Biological Causes
Studies have shown a genetic link amongst family members with eating disorders. It’s not uncommon to see eating disorders span generations. Twin and adoption studies proved that eating disorders may be hereditary. Even after separation and adoption by different families, if one twin develops an eating disorder, the other has a 50% chance of developing one too (4).
While there are clear links within families, it’s important to note that eating disorders are often accompanied by other mental health comorbidities, such as depression, anxiety, and other mood disorders as well as drug or alcohol abuse. Eating disorder treatment centers should address these co-occurring disorders while an individual is receiving care.
Recently, experts have said that differences in biology and brain structure also play a role in the development of eating disorders. The levels of dopamine and serotonin, which are brain messengers, may have an effect too (5, 6).
Personality Traits such as impulsivity, perfectionism, and neuroticism are associated with a greater risk of developing an eating disorder (4).
Environmental Causes
The environment can certainly play a role in the development of eating disorders, too.
- Traumatic experiences
- Feelings of pressure to look a certain way
- Sports performance requirements
- Expectations about grades in school
- Family dynamics
The above are all examples of how a sufferer’s environment can fuel eating disorder symptoms. Many times, a patient’s drive for perfectionism to achieve his or her own personal standard of excellence contributes greatly to the eating disorder.
Cultural Causes
Cultural preferences and exposure to media promoting weight loss and thinness may also cause eating disorders (4). Every day, we are besieged with messages about beauty, unrealistic body images and fad diets. Patients with eating disorders are abnormally preoccupied with food, oftentimes labeling certain foods as “good” or “bad.”
In cultures that were not exposed to Western ideals of thinness, some eating disorders are non-existent (7).
General Signs and Symptoms of Eating Disorders
If you or people around you are worried that you have an unhealthy relationship with food that’s affecting your eating habits, you could have an eating disorder.
Symptoms of eating disorders include:
- Spending a lot of time worrying about your weight and body shape
- Avoiding socializing when you think food will be involved
- Eating very little food
- Deliberately making yourself sick or taking laxatives after you eat
- Exercising too much
- Having very strict habits or routines around food
- Changes in your mood
You may also notice physical signs, including:
- Feeling cold, tired or dizzy
- Problems with your digestion
- Your weight is very high or very low for someone of your age and height
- Not getting your period for women and girls
6 Common Eating Disorders You Should Know
1. Anorexia Nervosa
This is perhaps the most popular eating disorder. It usually starts during adolescence or early adulthood and affects more women than men (8). Anorexic patients see themselves as overweight, even if they are no longer in good health. They constantly monitor their weight and restrict eating specific types of foods, especially those that are high in calories.
Anorexic patients would normally present with the following symptoms (9):
- Severely underweight compared to other people of the same height and age
- Follows a very strict eating pattern
- Fears and avoids gaining weight, despite being undersized
- In denial of being severely underweight
- There are persistent efforts to stay thin
- Body and weight dissatisfaction reflects low self-esteem
Obsessive-compulsive symptoms are also present. Many anorexic patients are preoccupied with thoughts about food. Some even hoard and collect recipes. These patients have difficulty eating in public and desire to control the environment, making them unspontaneous.
Anorexia can be classified into two subtypes. Patients with the restricting type lose weight by dieting, fasting, and exercising excessively. Those with binge-eating and purging subtype may either eat a lot of food or consume very little. After eating though, they vomit, drink laxatives or diuretics, and workout extremely (9).
Anorexia can be damaging to the body. Over time, patients will experience infertility and thinning of bones. They will grow brittle nails and fine hair all over their body (10). In severe cases, anorexia may cause brain, heart, or multi-organ failure and death.
2. Bulimia Nervosa
This yet another famous eating disorder. It affects the same group of people as anorexia (8). Bulimic patients usually eat large amounts of food within a short period of time. Binge eating episodes continues until they become uncomfortably full. It commonly happens with foods that they would normally avoid. Soon after, they’ll purge by fasting, vomiting, taking diuretics, enemas, and laxatives, or exercising to relieve gut discomfort and compensate for the excess calories consumed.
Symptoms are quite similar to the binge-eating or purging subtype of anorexia nervosa. However, bulimic patients have normal weight. Other symptoms to watch out for with bulimia nervosa include (9):
- Repeated episodes of binge eating
- Repeated episodes of purging to prevent weight gain
- Weight and body shape greatly affects self-esteem
- There is a fear of being overweight, despite being healthy and fit
Bulimic patients are at risk of developing a sore throat, swollen salivary glands, tooth decay, damaged tooth enamel, acid reflux, gut irritation, severe dehydration, and hormonal imbalances (10). In severe cases, bulimia may also cause electrolyte imbalance, which may lead to a heart attack or stroke.
3. Binge Eating Disorder (BED)
BED was categorized as an eating disorder just recently and it has become very common in the US (11). While this may occur later on in life, it is more common among adolescents and young adults. Patients with BED have similar symptoms to bulimic patients and the anorexic, with the binge-eating subtype.
Patients with BED eat large amounts of foods within a short period of time and lack self-control during binges. But unlike the two previous disorders, people with BED do not cut back on calories or purge after.
Common symptoms of BED include (9):
- Eating excessive amounts of foods very fast, secretly, and until uncomfortably ill, even when not hungry
- Lack of self-control during binges
- Feeling depressed, ashamed, and guilty when thinking about the binge-eating behavior
- No purging behaviors like vomiting, too much exercise, calorie restriction, and the use of diuretic and laxative
Also, patients with BED are usually overweight or obese, which increases their risks of medical complications like type 2 DM, heart disease, and stroke (12).
4. Rumination Disorder
This is yet another newly recognized eating disorder. Patients regurgitate food that they have taken, re-chew it and then either throw or re-swallow it (13). Rumination normally happens within the first 30 minutes after a meal. Unlike reflux, this occurs voluntarily (14).
This condition can affect infants, children, and adults. In infants, they develop between 3-12 months and usually disappear on their own. If not resolved, this may cause weight loss and severe malnutrition, which are fatal. Kids and adults would normally require therapy.
Adults with rumination disorder tend to limit their food intake, especially in public, which causes them to become underweight (9, 14).
5. Pica
DSM classified Pica as an eating disorder. This is quite unique from others. Patients crave non-food substances. They ask for ice, soil, soap, chalk, wool, paper, cloth, pebbles, dirt, cornstarch, or detergent (9).
While anyone can be affected, pica is more commonly seen in kids, pregnant women, and patients with mental disabilities (15). Patients with pica are more prone to infections, gut injuries, nutrition deficiencies, and poisoning. Depending on what was ingested, this can be fatal.
To establish a diagnosis, the eating of non-food substances must not be part of a religion or culture or tradition.
6. Avoidant or Restrictive Food Intake Disorder (ARFID)
ARFID is the new name for “feeding disorder of infancy and early childhood,” which was previously reserved for kids aged 7 years old and below. Although ARFID is common in infants and children, it can persist into adulthood. More so, it equally affects men and women.
Patients with ARFID experience problems eating either because they lack interest or dislike specific tastes, smells, temperatures, colors, or textures.
Patients with ARFID present with the following (9):
- Food restriction causes nutrient and calorie deficiencies
- Eating habits interfere with normal social functions like dining with others
- Weight loss
- Growth delay
- Nutrient deficiencies or dependence on tube feeding or supplements
You have to keep in mind that ARFID is not the same as picky eating in kids and lower food intake in the elderly.
Other Less Common Eating Disorders
Aside from the six eating disorders mentioned above, the less common ones are still worth knowing. They are generally grouped into 3 categories (9):
- Night Eating Syndrome: Patients frequently eat an excessive amount of food at night, often after waking up from sleep.
- Purging Disorder: Patients often purge by vomiting, over-exercising, or using laxatives or diuretics to control body weight. This differs from other eating disorders because patients do not binge.
- Eating Disorders Not Otherwise Specified (EDNOS): This includes any other conditions that present with symptoms of an eating disorder but do not fit into any of the groups listed above. Orthorexia is a good example. Patients tend to have an obsessive focus on healthy eating that is disrupting their everyday lives. They tend to avoid an entire food group, fearing they are not healthy. This causes malnutrition, weight loss, problems dining out, and emotional stress. They are not concerned about losing weight. They are merely focused on their identity and self-worth. Satisfaction only comes when they were able to comply with their self-imposed diet rules (16).
How To Get Treated?
Because of the severity and complexities of these conditions, a comprehensive and professional treatment team specializing in eating disorders is often fundamental in establishing healing and recovery.
Treatment plans are utilized in addressing the many concerns a man or woman may be facing in the restoration of their health and well-being and are often tailored to meet individual needs.
Treatment for an ED is usually comprised of one or more of the following and addressed with medical doctors, nutritionists, and therapists for complete care:
- Medical Care and Monitoring: The highest concern in the treatment of eating disorders is addressing any health issues that may have been a consequence of eating disordered behaviors.
- Nutrition: This would involve weight restoration and stabilization, guidance for normal eating, and the integration of an individualized meal plan.
- Therapy: Different forms of psychotherapy, such as individual, family, or group, can be helpful in addressing the underlying causes of eating disorders. Therapy is a fundamental piece of treatment because it affords an individual in recovery the opportunity to address and heal from traumatic life events and learn healthier coping skills and methods for expressing emotions, communicating and maintaining healthy relationships.
- Medications: Medications won’t treat eating disorders, but they work well as an adjunct to psychological therapies. Antidepressants are commonly prescribed for binging and purging behaviors (17).
Varying levels of treatment, ranging from outpatient support groups to inpatient treatment centers, are available and based on the severity of the eating disorder. In any case, recognizing and addressing the ED are crucial in being able to begin treatment.
Key Takeaway
The classifications above are meant to provide science-based information about the most common eating disorders and dispel the myths that a lot of people tell about them.
Eating disorders are mental conditions that can cause damaging physical and emotional health consequences when not taken seriously. These are not fads or something that a patient consciously chooses to take part in.
If you are suffering from an eating disorder or know someone who might have one, seek immediate help from a medical professional that specializes in eating disorders. Speak up, ask for help, and be treated!
References
(1) https://www.nationaleatingdisorders.org/what-are-eating-disorders
(2) https://www.nhs.uk/conditions/eating-disorders/
(3) https://www.ncbi.nlm.nih.gov/pubmed/23148784
(4) https://www.ncbi.nlm.nih.gov/pubmed/26095891
(5) https://www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00704-5/fulltext
(6) https://www.biologicalpsychiatryjournal.com/article/S0006-3223(13)00647-1/fulltext
(7) https://www.ncbi.nlm.nih.gov/pubmed/12956542
(8) https://www.ncbi.nlm.nih.gov/pubmed/26754944
(9) https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
(10) https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
(11) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409365/
(12) https://www.ncbi.nlm.nih.gov/books/NBK278973/
(13) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061016/
(14) https://rarediseases.info.nih.gov/diseases/7594/rumination-disorder
(15) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015153/
(16) https://scholarworks.iu.edu/conferences/index.php/iuurc/iuurc21/paper/view/217
(17) https://www.mayoclinic.org/diseases-conditions/eating-disorders/in-depth/eating-disorder-treatment/art-20046234
