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Eating Disorders

Eating Disorders include anorexia nervosa, bulimia nervosa and binge eating. Patients experience extreme preoccupation with weight and a distorted sense of self-image, believing they are overweight, even when they are dangerously thin. They are obsessed with control over food and eating, and with their resulting body image, and weight gain. They exhibit abnormal eating behaviors and disturbances, often eating in private or purging after eating. Behaviors vary, depending on the disorder from which the patient is suffering. The three most common eating disorders are:

Anorexia Nervosa patients practice what amounts to self-starvation, and do not maintain even a normal body weight. Anorexia can be life threatening, in severe cases.

Bulimia Nervosa with cycles of binge eating, Followed by purging food to avoid weight gain. Bulimics often maintain a normal weight.

Binge Eating is characterized by frequent episodes of overeating but is not followed by purging.

For more detailed information on these three disorders, see the title article on the disorder. Other eating disorders include purging without binging, chewing then spitting out without purging, and combinations of anorexia, bulimia, or binge eating. Less well-known disorders include compulsive exercising, body dysmorphic and muscle dysmorphic disorders, orthorexia nervosa, night eating and nocturnal sleep related disorders, rumination, Gourmand and Prader-Willi syndromes, and Pica. Eating disorders can occur with other psychiatric disorders like anxiety, panic disorder, obsessive compulsive disorder, and alcohol or drug abuse. There is some research to suggest that heredity may contribute to eating disorders, but there may be patients diagnosed with no family history of an eating disorder. Occupation may also predispose a person to an eating disorder. Gymnasts, runners, dancers, and those with similar occupations or hobbies may be more vulnerable. Cultural pressures that glorify "thinness" and place value on obtaining the "perfect body" Narrow definitions of beauty that include only women and men of specific body weights and shapes Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths

What are the symptoms?

The symptoms of eating disorder(s) will vary depending on the disorder the patient suffers. There are primary symptoms, exhibited by the patient as part of the disorder and secondary symptoms (medical problems caused by the disorder, or secondary symptoms that may contribute to the disorder).

Primary symptoms for the three most common eating disorders include

Anorexia: body weight significantly below normal for height, body type, age, activity. Fear of weight gain, feels fat in spite of extreme weight loss, absence of menstrual cycles in women

Bulimia: Repeated binging and purging Feels out of control during binging, eats beyond being comfortably full, purges after binge using self-induced vomiting, laxatives, diet pills or diuretics excessive exercise, fasting

Binge Eating (Compulsive Overeating): uncontrolled, impulsive, or continuous eating beyond feeling comfortably full, fasts or repetitive dieting, shame or self-hatred after, body weight varies from normal to obese

Secondary Symptoms

Anorexia: slow heart rate, low blood pressure, increased chance of heart failure, brain damage, brittle hair and nails, dry or yellow skin, sometimes covered with soft hair, anemia, swollen joints, reduced muscle mass, dizziness, brittle bones, anxiety, depression

Bulimia: Worn outer layer of the teeth caused by stomach acids during vomiting, inflamed or damaged esophagus or stomach, enlarged glands near cheeks, irregular heartbeat, heart failure, chemical imbalance ulcers, pancreatitis, constipation, anxiety, depression

Binge Eating (Compulsive Overeating): high blood pressure, high cholesterol, fatigue, joint pain, type II diabetes, gallbladder and heart disease, depression, anxiety

How is it diagnosed and treated?

A medical assessment, blood tests and urinalysis are required to rule out other physical and mental disorders. Diagnostic criteria vary depending on the specific disorder the patient suffers. For detailed information on each of these disorders, see the titled article for that disorder.

Anorexia: at least 15 percent below normal weight for height, age; activity, women miss at least 3 consecutive menstrual cycles, fear of gaining weight; believes she/he is overweight though she/he is dangerously thin

Bulimia: At least 2 binge/purge cycles per week, for at least 3 mo; lack of control over eating behavior; obsessed with body shape and weight

Binge Eating (Compulsive Overeating): At least 2 binge-eating episodes per week, for 6 mo; lack of control over eating behavior

Treatment(s) will vary depending on the disorder. See titled articles for specific disorders for more detail.

Treatments can include:

Anorexia: Hospitalization in extreme cases, psychotherapy, behavioral therapy, group therapy, self-help groups, medication if appropriate for medical or coincident mental disorders

Bulimia: Behavioral therapy, psychotherapy, family therapy, medication if appropriate for medical or coincident mental disorders

Binge Eating (Compulsive Overeating): Behavioral therapy, psychotherapy, family therapy, medication if appropriate for medical or coincident mental disorders

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