More About Eating Disorders

Eating disorders are chronic conditions consisting of severely disrupted eating behaviours.

The most common of the eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge-eating disorder. Although there are other types too, we will discuss these three here.

Remember, everyone’s experience with an eating disorder can be different, and the symptoms can vary in intensity and frequency.

What Are the Signs & Symptoms of Anorexia Nervosa as Eating Disorder?

Notably low body weight caused by restrictive eating behaviours

This is a symptom of Anorexia Nervosa because individuals with this disorder often have an intense fear of gaining weight, which leads them to restrict their food intake.

They may avoid eating altogether, eat very small portions, or cut out certain foods. This can result in a significant weight loss and an abnormally low body weight.

This symptom can be recognised by a thin appearance, extreme weight loss, or not making expected developmental weight gains.

Extreme fear of gaining weight or becoming fat

This fear is a central feature of Anorexia Nervosa.

Individuals with this disorder often have a distorted perception of their bodies, perceiving themselves as overweight even when they are underweight. They may equate thinness with self-worth and have an intense fear of gaining weight or becoming fat.

This symptom can be recognised by behaviours such as avoiding eating, exercising excessively, or using methods to purge after eating.

Body image disturbance and preoccupation

Body image is severely distorted in individuals with Anorexia Nervosa, so they tend to perceive themselves as fat even when they are emaciated.

They often have a distorted perception of their bodies, thinking they’re fat even when they’re underweight.

This symptom can be recognised by behaviours such as avoiding removing baggy clothing to hide severe weight loss or making comments around feeling ‘fat’ or ‘overweight’, even when there has been a significant drop in weight.

Persistent behaviour that interferes with gaining weight such as over-exercising

Individuals with Anorexia Nervosa may use drastic measures around food restriction and exercise to prevent weight gain.

They may try to lose weight by exercising excessively.

This symptom can be recognised by behaviours such as exercising excessively, showing signs of irritability/anxiety when they are not able to exercise, or avoiding weight gain by vomiting, laxative misuse, or using appetite suppressants.

What Are the Signs & Symptoms of Bulimia Nervosa as Eating Disorder?

Avoiding weight gain by vomiting, laxative misuse, or using appetite suppressants

To prevent weight gain after a binge, individuals with Bulimia Nervosa may use different methods such as self-induced vomiting, misuse of laxatives, or use of appetite suppressants.

This symptom can be recognised by behaviours such as frequent trips to the bathroom after meals, or the presence of packages of laxatives or appetite suppressants.

Recurrent binge-eating episodes

Eating excessive quantities in a short period of time is a symptom of Bulimia Nervosa because individuals with this disorder often have an intense fear of gaining weight, which leads them to engage in a cycle of binge eating (consuming large amounts of food in a short period) followed by compensatory behaviours.

This symptom can be recognised by a pattern of eating unusually large amounts of food in a specific amount of time, such as over a two-hour period.

A sense of lack of control over what or how much is eaten

Individuals with Bulimia Nervosa often feel a loss of control during their binge eating episodes.

They may feel like they can’t stop eating or can’t control what or how much they’re eating.

This symptom can be recognised by behaviours such as eating until uncomfortably full or eating when not physically hungry.

Alternating periods of starvation or over-exercising

Individuals with Bulimia Nervosa may try to compensate for their binges by fasting, restricting calories, or exercising excessively.

This symptom can be recognised by behaviours such as desperation to exercise even when it gets in the way of other activities, or creation of schedules or rituals that allow for binging and purging.

Using appetite suppressants, thyroid, or diuretic medications

Some individuals with Bulimia Nervosa may misuse medications such as appetite suppressants, thyroid medications, or diuretics in an attempt to control their weight.

This symptom can be recognised by the presence of these medications without a medical need for them.

Body image disturbance and preoccupation

Individuals with Bulimia Nervosa often have a distorted body image and place an excessive emphasis on body shape or weight in their self-evaluation. This can lead to the person’s sense of self-esteem and self-worth being wholly defined by the way they look.

This symptom can be recognised by behaviours such as being preoccupied with body shape and weight, living in fear of gaining weight, or spending a lot of time thinking about food and how to control it.

What Are the Signs & Symptoms of Binge-eating Disorder?

Recurrent binge-eating episodes

This is a symptom of Binge Eating Disorder (BED) because individuals with this disorder frequently consume unusually large amounts of food and feel unable to stop eating.

This symptom can be recognised by a pattern of eating unusually large amounts of food in a specific amount of time.

A sense of lack of control over what or how much is eaten

Individuals with BED often feel a loss of control during their binge eating episodes. They may feel like they can’t stop eating or can’t control what or how much they’re eating.

This symptom can be recognised by behaviours such as eating until uncomfortably full or eating when not physically hungry.

Eating more rapidly than normal

People with BED often eat more rapidly than normal during binge episodes.

This symptom can be recognised by observing the speed at which the individual consumes food during a binge episode.

Eating until uncomfortably full

Individuals with BED often eat until they feel uncomfortably full.

This symptom can be recognised by the individual continuing to eat even when they express that they are full or uncomfortable.

Eating when not physically hungry

People with BED may consume large amounts of food even when they are not feeling hungry.

This symptom can be recognised by the individual eating large quantities of food outside of normal mealtimes or when they express that they are not hungry.

Eating alone because of embarrassment

Individuals with BED often eat alone or in secret because they feel embarrassed about the amount of food they eat.

This symptom can be recognised by the individual avoiding eating in public or in the presence of others or finding evidence of large amounts of food being consumed in private.

Feelings of disgust, depression or guilt after eating

After a binge eating episode, individuals with BED often experience negative emotions such as disgust, depression, or guilt.

This symptom can be recognised by the individual expressing these emotions after eating, particularly after a binge episode.

Eating Disorders Causes and Pre-Dispositions

Eating disorders are complex conditions that arise from a combination of long-standing behavioural, emotional, psychological, interpersonal, and social factors.

Here are some of the main causes and predispositions:

Genetic Factors

Research shows that eating disorders have a genetic component, with studies suggesting that the risk of developing an eating disorder is 50-80% genetic.

People with a first-degree relative with an eating disorder have a 28% to 74% risk of being diagnosed with an eating disorder themselves.

Environmental Factors

Environmental influences play a significant role in the development of eating disorders.

These can include pressure at school, bullying or abuse, criticism for body shape or eating habits, difficult family relationships, and having a job or hobby where being thin is seen as ideal.

Psychological Factors

Eating disorders are connected to certain personality traits, such as perfectionism, obsessive-compulsive tendencies, and sensitivity to negative emotions.

Mental health challenges such as anxiety and depression are also risk factors.

Sociocultural Factors

Societal pressure to obtain a certain body type and societal beauty standards can contribute to the development of eating disorders.

The media can also play an important role in promoting unrealistic and unhealthy ideas of what men, women, and often teens should look like.

Risk Factors

Certain factors that may increase the risk of developing an eating disorder include being female, having a comorbid anxiety disorder, and having a family history of anxiety disorders, depression, or other psychiatric disorders.

Myths About Eating Disorders

Myth: Eating disorders only affect women

This myth likely arises from the fact that eating disorders are more commonly diagnosed in women.

Fact

 Eating disorders affect both sexes. One in 3 people who have an eating disorder are male.

Myth: Eating disorders only affect teenagers

There is a belief that teenagers — especially teenage girls — are the group most at risk of eating disorders.

Fact

 Eating disorders affect people of all ages. Although research indicates that the average age of onset for anorexia nervosa and bulimia nervosa is 18 years, these disorders can develop at any age, including in childhood.

Myth: Eating disorders are a way to get attention

This myth likely arises from a lack of understanding about the nature of eating disorders.

Fact

People develop eating disorders for a variety of reasons, but getting attention is not typically one of them. Some people develop eating disorders as a way of coping with something negative in their life, such as trauma, bullying, or bereavement.

Myth: People choose to have an eating disorder

This myth likely arises from a lack of understanding about the nature of eating disorders.

Fact

 Eating disorders are a medical illness, not a choice. It is biologically influenced medical conditions.

Early Warning Signs of Eating Disorder

Early warning signs of eating disorders can often be subtle and needs to be brought to the attention of professionals. Here are some early warning signs:

• Changes in Eating Behaviours that may include new practices with food or fad diets, including cutting out entire food groups.
• Both weight loss and weight gain could be potential signs of an eating disorder.
• Refusal to eat certain foods, progressing to restrictions against whole categories of food.
• Frequent comments about feeling “fat” or overweight despite weight loss.
• Maintaining an excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury.
• Extreme mood swings can be a sign of an eating disorder.
• Some people with eating disorders hoard food in strange places.
• Withdrawal from usual friends and activities, becoming more isolated, withdrawn, and secretive.

Negative Symptoms of Eating Disorders

Negative symptoms of eating disorders that refer to the absence or reduction of normal behaviours include the following:

• People with eating disorders may avoid social situations due to their anxiety or substance use. This can lead to a decrease in normal social interactions.
• The constant worry and fear associated with eating disorders can make it difficult to concentrate and can lead to a decrease in productivity at work or school.
• Individuals with eating disorders may avoid activities or situations that they fear will trigger their anxiety, such as going to the grocery store or attending social events.
• People with eating disorders often have trouble falling asleep or staying asleep.
• The constant worry and fear can make it difficult for individuals with eating disorders to enjoy activities that they used to find pleasurable.

How Eating Disorders Are Diagnosed

Eating disorders are diagnosed by medical healthcare providers or mental health professionals, including psychiatrists and psychologists.

Although there is no one laboratory test to screen for eating disorders, a healthcare provider can use a variety of physical and psychological evaluations as well as lab tests to determine a diagnosis:

During a physical exam, the doctor will check your height, weight, and vital signs. They may also listen to your lungs and heart, since eating disorders can cause high or low blood pressure and slow breathing or pulse rates.

The doctor may examine your abdomen, check your skin and hair for dryness, look for brittle nails, and ask about any other possible problems, like a sore throat or intestinal issues.

Eating disorders can damage the body and cause problems with vital organs. So, doctors may run lab tests, including a complete blood count, liver, kidney, and thyroid function tests, and urinalysis.

The doctor may also order an X-ray to look for broken bones, which can be a sign of bone loss from anorexia or bulimia. An electrocardiogram can check for heart irregularities.

A mental health professional will ask about your thoughts, feelings, and eating habits and behaviours. You also may be asked to answer a series of questions to help with the diagnosis.

Finally the doctor will make sure a person meets the diagnostic criteria for an eating disorder.