Understanding Eating Disorders

Eating disorders are real, treatable medical illnesses. They frequently coexist with other illnesses such as depression, substance abuse, or anxiety disorders. Eating disorders, including Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder, can affect both genders. These disorders frequently appear during the teen years or young adulthood, but also may develop during childhood or later in life.

What Are Eating Disorders?

Anorexia Nervosa has the highest death rate of any mental disorder which is caused by starvation, metabolic collapse, or suicide. It involves three primary characteristics: (1) eating less, (2) being afraid of gaining weight, and (3) having a distorted body image. Individuals with Anorexia Nervosa generally weigh themselves often, portion food carefully, and eat small quantities of certain foods. Some also engage in binge eating, followed by extreme dieting, excessive exercise, self-induced vomiting, and abuse of laxatives, diuretics, and enemas.

Bulimia Nervosa involves recurrent and frequent episodes of eating unusually large amounts of food, accompanied by feelings of lack of control and behaviors to compensate for overeating. Bulimic behavior is typically done secretly because it is often accompanied by feelings of disgust or shame. The binge-eating and purging cycle can happen anywhere from several times a week to many times a day; however, individuals with Bulimia tend to maintain a normal or healthy weight, with some even slightly overweight.

Binge-Eating Disorder is the most common eating disorder in the United States. People with Binge-Eating Disorder generally lose control over their eating. There are no compensatory behaviors like purging, excessive exercise, or fasting. Individuals with Binge-Eating Disorder are generally overweight or obese. They may feel embarrassed or ashamed and will attempt to hide their eating from family and friends, which can generally lead to more binge eating.

What are the Signs and Symptoms?
	Anorexia Nervosa	Bulimia Nervosa	Binge-Eating Disorder
Observable Signs and Symptoms	Extremely low body weight Severe food restriction Relentless pursuit of thinness Unwillingness to maintain a normal or healthy weight Intense fear of weight gain Distorted body image and self-esteem Denial of seriousness of low body weight	Repeated binge eating Feelings of loss of control Forced vomiting Consuming laxatives, diuretics, or diet pills Abuse of laxatives Fasting Heavy exercise Excessive worry about body shape and size	Repeated binge eating with a lack of control over eating Eating alone due to embarrassment Eating large amounts of food when not physically hungry Eating more rapidly than normal Eating until uncomfortably full Restricted food intake Feelings of dissatisfaction in life Feelings of disgust, sadness, or guilt

Health Complications	Lethargy Iron deficiency Low body temperature Dry and yellowish skin Growth of fine hair all over the body Brittle hair and nails Lack of menstruation for females Infertility Muscle wasting Low blood pressure Severe constipation Thinning of bones Slower heart rate or rhythm problems Dehydration Fainting Brain damage and/or multi-organ failure	Chronically inflamed and sore throat Swollen salivary glands in the neck and jaw area Worn tooth enamel and decaying teeth Gastrointestinal problems and intestinal distress Dehydration Electrolyte imbalance Swelling of hands and feet Rupture of esophagus Gum disease Irregular menstrual cycle for females Fatigue Headaches	Weight gain Obesity or weight cycling Bloating Dehydration Stress High blood pressure and cholesterol Possible diabetes

How are Eating Disorders Treated?

Eating disorders are treatable and recovery is absolutely possible. The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or psychological counseling, coupled with careful attention to medical and nutritional needs. Treatment is tailored to the individual and may include individual, group, or family therapy, medical care and monitoring, nutritional counseling, and the use of medications.

How Can I Talk to My Loved One if I am Concerned?

Pick a good time. Choose a time when you can speak to them in private without distractions or constraints. It’s also important to have the conversation when emotions are calm. Explain why you’re concerned. Be careful to avoid lecturing or criticism. Refer to situations and behaviors you’ve noticed and why they worry you. Your goal at this point is to not offer solutions, but to express your concern, how much you love them, and your desire to help.

Be prepared for denial and resistance. Be calm, focused, and respectful. Remember that this conversation will likely feel threatening to your loved one. Don’t take it personally.

Be patient and supportive. Don’t give up if they try to shut you down. It could take some time before your loved one is willing to open up and admit to having a problem. Keep the lines of communication open. Make it clear that you believe in them, care for them, and you’ll be there when they’re ready to talk.