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Eating Disorder Types and Symptoms

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In this article we will focus on the three types of eating disorders. We will look at the many other factors related to eating disorders - including their symptoms - and the impact it has on the individual, families and society. In subsequent articles we will look at other issues related to many Americans" relationship to food, body image and self esteem. Topics will include disordered eating, obesity and body confidence.

eating-disorder-kills-statisticWarning: An individual can be vulnerable to not just commonly known eating disorders but "disordered eating" as well. "Disordered eating" is something that many people living in America today can relate to, not just individuals clinically diagnosed with an eating disorder like Anorexia or Bulimia. The main thing differentiating disordered eating from an eating disorder is the level of severity and frequency of behaviors. The thinking and beliefs around food and body image can look very similar but they don’t go to the extreme behavior as the individual with an eating disorder. Someone can have a negative body image and low self-esteem without ever meeting the criteria for an eating disorder. Check back for our upcoming articles covering the subject of Disordered Eating.


EATING DISORDER TYPES AND SYMPTOMS

Eating disorders include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for both females and males.

 

anorexia-collage-of-words

ANOREXIA NERVOSA

Someone with anorexia nervosa is usually engaged with practicing unhealthy behaviors such as: restricting calories, only eating specific foods or skipping meals frequently. They have an intense fear of gaining weight or becoming fat.

Symptoms
• Inadequate food intake leading to a weight that is clearly too low.
• Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain.
• Self-esteem overly related to body image. • Inability to appreciate the severity of the situation.
• Binge-Eating/Purging Type involves binge eating and/or purging behaviors during the last three months.
• Restricting Type does not involve binge eating or purging.

Warning Signs of Anorexia NervosaScreen Shot 2015-09-01 at 8.54.31 PM

• Dramatic weight loss.
• Preoccupation with weight, food, calories, fat grams, and dieting.
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
• Frequent comments about feeling “fat” or overweight despite weight loss.
• Anxiety about gaining weight or being “fat.”
• Denial of hunger.
• Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate).
• Consistent excuses to avoid mealtimes or situations involving food.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in.
• Withdrawal from usual friends and activities.

Health Consequences of Anorexia Nervosa
Anorexia Nervosa involves self-starvation; the body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy.
This “slowing down” can have serious medical consequences:

• Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing.  The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
• Reduction of bone density (osteoporosis), which results in dry, brittle bones.
• Muscle loss and weakness.
• Severe dehydration, which can result in kidney failure.
• Fainting, fatigue, and overall weakness.
• Dry hair and skin, hair loss is common.
• Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

Anorexia Nervosa Statistics
• Approximately 90-95% of anorexia nervosa sufferers are girls and women.
• Between 0.5–1% of American women suffer from anorexia nervosa.
• Anorexia nervosa is one of the most common psychiatric diagnoses in young women.
• Between 5-20% of individuals struggling with anorexia nervosa will die.  The probabilities of death increases within that range depending on the length of the condition.
• Anorexia nervosa has one of the highest death rates of any mental health condition.
• Anorexia nervosa typically appears in early to mid-adolescence.

 

BULIMIA NERVOSA

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.

SymptomsBulimia with credit • Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting.
• A feeling of being out of control during the binge-eating episodes.
• Self-esteem overly related to body image.

Warning Signs of Bulimia Nervos

The chance for recovery increases the earlier bulimia nervosa is detected. Therefore, it is important to be aware of some of the warning signs of bulimia nervosa. Signs such as:
• Evidence of binge eating, including disappearance of large amounts of food in short periods of time or finding wrappers and containers indicating the consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the compulsive need to “burn off” calories taken in.
• Unusual swelling of the cheeks or jaw area.
• Calluses on the back of the hands and knuckles from self-induced vomiting.
• Discoloration or staining of the teeth.
• Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
• Continued exercise despite injury; overuse injuries.

man with eating disorder purgingHealth Consequences of Bulimia Nervosa
Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Tooth decay and staining from stomach acids released during frequent vomiting.
• Chronic irregular bowel movements and constipation as a result of laxative abuse.
• Gastric rupture is an uncommon but possible side effect of binge eating.

Bulimia Nervosa Statistics
• Bulimia nervosa affects 1-2% of adolescent and young adult women.
• Approximately 80% of bulimia nervosa patients are female.
• People struggling with bulimia nervosa usually appear to be of average body weight.
• Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.
• Bulimia nervosa is frequently associated with symptoms of depression and changes in social adjustment.

 

binge-eating-disorder-word-collage

BINGE EATING DISORDER


Binge eating disorder is an eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. Binge eating disorder is a severe, life-threatening and treatable eating disorder. Common aspects of BED include functional impairment, suicide risk and a high frequency of co-occurring psychiatric disorders.

Symptoms and Diagnostic Criteria
The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder:
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
• A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

B. The binge eating episodes are associated with three (or more) of the following:
• Eating much more rapidly than normal.
• Eating until feeling uncomfortably full.
• Eating large amounts of food when not feeling physically hungry.
• Eating alone because of feeling embarrassed by how much one is eating.
• Feeling disgusted with oneself, depressed, or very guilty afterward.

C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Society under-recognizes the seriousness of binging or attempts to avoid it or get relief from the systemic problems of it by using humor in mainstream social media.

Society under-recognizes the seriousness of binging or attempts to avoid it or get relief from the systemic problems of it by using humor in mainstream social media.

Characteristics of Binge Eating Disorder:
In addition to the diagnostic criteria for binge eating disorder, individuals with Binge Eating Disorder may display some of the behavioral, emotional and physical characteristics below. Not every person suffering from Binge Eating Disorder will display all of the associated characteristics, and not every person displaying these characteristics is suffering from Binge Eating Disorder, but these can be used as a reference point to understand Binge Eating Disorder predispositions and behaviors.

Behavioral Characteristics:
• Evidence of binge eating, including the disappearance of nbso online casino reviews large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food.
• Secretive food behaviors, including eating secretly (e.g., eating alone or in the car, hiding wrappers) and stealing, hiding, or hoarding food.
• Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting; and developing food rituals (e.g., eating only a particular food or food group [e.g., condiments], excessive chewing, not allowing foods to touch).
• Can involve extreme restriction and rigidity with food and periodic dieting and/or fasting.
• Has periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling uncomfortably full, but does not purge.
• Creating lifestyle schedules or rituals to make time for binge sessions.

Emotional and Mental Characteristics:
• Experiencing feelings of anger, anxiety, worthlessness, or shame preceding binges. Initiating the binge is a means of relieving tension or numbing negative feelings.
• Co-occurring conditions such as depression may be present. Those with BED may also experience social isolation, moodiness, and irritability.
• Feeling disgust about one’s body size. Those with BED may have been teased about their body while growing up.
• Avoiding conflict; trying to “keep the peace.”
• Certain thought patterns and personality types are associated with binge eating disorder. These include:
• Rigid and inflexible “all or nothing” thinking
• A strong need to be in control
• Difficulty expressing feelings and needs
• Perfectionistic tendencies
• Working hard to please others

Physical Characteristics:
• Body weight varies from normal to mild, moderate, or severe obesity.
• Weight gain may or may not be associated with Binge Eating Disorder. It is important to note that while there is a correlation between Binge Eating Disorder and weight gain, not everyone who is overweight binges or has Binge Eating Disorder.

bingeWarning Signs of Binge Eating Disorder
There are a number of tell tale signs to look for when determining if one’s condition is Binge Eating Disorder (BED), including:
• Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting.
• A feeling of being out of control during the binge eating episodes.
• Feelings of strong shame or guilt regarding the binge eating.
• Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.

Health Consequences of Binge Eating Disorder
The DSM-5, released in May 2013, lists binge eating disorder as a diagnosable eating disorder. Binge eating disorder had previously been listed as a subcategory of Eating Disorder Not Otherwise Specified (EDNOS) in the DSM-IV, released in 1994. Full recognition of BED as an eating disorder diagnosis is significant, as some insurance companies will not cover an individual’s eating disorder treatment without a DSM diagnosis.

Physical and Psychological Effects of Binge Eating Disorder:
Binge eating disorder has strong associations with depression, anxiety, guilt and shame. Those suffering from Binge Eating Disorder may also experience comorbid conditions (two mental disorders occurring together), either due to the effects of the disorder or due to another root cause. Comorbid conditions can be both physical and/or psychological.

Physical Effects:
• Most obese people do not have binge eating disorder. However, of individuals with Binge Eating Disorder, up to two-thirds are obese; people who struggle with binge eating disorder tend to be of normal or heavier-than-average weight.
• The health risks of Binge Eating Disorder are most commonly those associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:
• High blood pressure
• High cholesterol levels
• Heart disease
• Type II diabetes
• Gallbladder disease
• Fatigue
• Joint pain
• Sleep apnea

Psychological Effects:
• People struggling with binge eating disorder often express distress, shame and guilt over their eating behaviors.
• People with binge eating disorder report a lower quality of life than those without binge eating disorder.
• Binge eating disorder is often associated with symptoms of depression.
• Compared with normal weight or obese control groups, people with Binge Eating Disorder have higher levels of anxiety and both current and lifetime major depression.

Social Stigma of Binge Eating Disorder:
Many people suffering from binge eating disorder report that it is a stigmatized and frequently misunderstood disease. Greater public awareness that BED is a real diagnosis—and should not be conflated with occasional overeating—is needed in order to ensure that every person suffering from BED has the opportunity to access resources, treatment, and support for recovery.

Binge Eating Disorder Statistics
• Binge eating disorder is the most common eating disorder in the United States; it is estimated to affect 1-5% of the general population. BED affects 3.5% of women, 2% of men, 1 and up to 1.6% of adolescents.
• Binge eating disorder affects women slightly more often than men—estimates indicate that about 60% of people struggling with binge eating disorder are female and 40% are male.
• In women, binge eating disorder is most common in early adulthood. In men, binge eating disorder is more common in midlife.
• Binge eating disorder affects people of all demographics across cultures.

Eating Disorder Treatment
Effective evidence-based treatments are available for eating disorders, including specific forms of cognitive behavioral therapy (CBT), interpersonal therapy (IPT), dialectical behavioral therapy (DBT), and pharmacotherapy. All treatments should be evaluated in the matrix of risks, benefits, and alternatives. Decisions regarding treatments should be made after consulting with a trained medical professional and eating disorder specialist.

 

References
Hudson, J.I., Hiripi, E., Pope, H.G. et al. (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol.Psychiatry, 61, 348–358.

The American Psychiatric Association’s Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013

Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry. 2011;68(7):714–723

 

RELATED ARTICLES



<h2><strong>Resources to learn more about Eating Disorder.</strong></h2>
Please share with us and our readers any resources you have found to be useful in our comments section below.


<span style=”color: #ff0000;”><strong><a style=”color: #ff0000;” href=”http://www.nationaleatingdisorders.org/” target=”_blank”>National Eating Disorder Association (NEDA)</a></strong></span>
National Eating Disorder Association (NEDA) supports individuals and families affected by eating disorders, and serves as a catalyst for prevention, cures and access to quality care. NEDA envisions a world without eating disorders.

<a href=”http://www.aedweb.org/” target=”_blank”><strong>Academy for Eating Disorders (AED)</strong></a>
A multidisciplinary professional organization that focuses on Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and related disorders. Also sponsors a newsletter and a conference.

<a href=”http://www.eatright.org/”><strong>Academy of Nutrition and Dietetics</strong></a>
Formerly the American Dietetic Association, offers information about eating disorders, including an extensive nutrition reading list and a professional directory that allows visitors to search for Dietitians  specializing in eating disorders

<a href=”http://rehab-international.org/blog/anatomy-of-an-eating-disorder-infographic” target=”_blank”><strong>Anatomy of an Eating Disorder
</strong></a>Presentation of facts about eating disorders by Rehab International in an infographic.

<a href=”http://www.bingeeatingbulimia.com/” target=”_blank”><strong>Binge Eating and Bulimia: The latest psychological research</strong></a>
A research blog updated weekly describing new articles on binge eating and bulimia that are published in leading scientific journals.

<a href=”http://www.edreferral.com/” target=”_blank”><strong>Eating Disorder Referral and Information Center</strong></a>
Provides information, treatment resources, and client and provider e-mail message lists for all forms of eating disorders.

<a href=”http://feast-ed.org/feast.html”><strong>F.E.A.S.T</strong></a><strong>.</strong>
F.E.A.S.T. is an organization of and for parents and caregivers to help loved ones recover from eating disorders by providing information and mutual support, promoting evidence-based treatment, and advocating for research and education to reduce the suffering associated with eating disorders.

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About the Author

The Antioch University Community Psych Eating Disorder Team includes: Ori Shansi Agam, Lisa Blume, Lauren Emmel, Michele Simon, Suzy Unger, Sergio Ocampo. They are working together to provide materials that look at the problems, solutions and program of actions people can take individually and on a group level to make a difference in a community dealing with Eating Disorders.





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    How big of a problem is Disordered Eating?

     31.8% of the American population suffers from obesity. (Social Progress Index, 2015)

    • Eating disorders have the highest mortality rate of any mental illness.

     The United States populace ranks as the 14th most obese population in the world (14th out of 133 nations)  (Social Progress Index, 2015)

    • The estimated annual health care costs of obesity-related illnesses are a staggering $190.2 billion or nearly 21% of annual medical spending in the United States. (Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. Journal of Health Economics. 31(1):219-230. 2012.)

    images-19

     

    Media, Perception, Dieting:

    • 95% of all dieters will regain their lost weight within 5 years.

    • 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders.

    • The body type portrayed in advertising as the ideal is possessed naturally by only 5% of American females.

    • 47% of girls in 5th-12th grade reported wanting to lose weight because of magazine pictures.

    • 69% of girls in 5th-12th grade reported that magazine pictures influenced their idea of a perfect body shape.

    • 42% of 1st-3rd grade girls want to be thinner (Collins, 1991).

    • 81% of 10 year olds are afraid of being fat. (Mellin et al., 1991).

    > Good Sources:
    Collins, M.E. (1991). Body figure perceptions and preferences among pre-adolescent children. International Journal of Eating Disorders, 199-208.

    Mellin, L., McNutt, S., Hu, Y., Schreiber, G.B., Crawford, P., & Obarzanek, E. (1991). A longitudinal study of the dietary practices of black and white girls 9 and 10 years old at enrollment: The NHLBI growth and health study. Journal of Adolescent Health, 23-37.

    Come back to see our article update on the status of disordered eating in America. It’s horrendous. But the solutions that are forming bring hope!


    The Antioch University Community Psych Eating Disorder Team
    Antioch University