Eating Disorder Overview and Information
There are three types of eating disorders that can occur in teenagers, college students, or adults: anorexia nervosa, bulimia nervosa, and binge eating disorder. All three have in common an intense concern with food and weight that prevents individuals who have these disorders from being able to live a full and enjoyable life.
Even though individuals with eating disorders focus on food and weight, the disorders themselves are actually not about food. Instead they are complex disorders that have roots in the biology, psychology, social, and cultural experiences of each person.
When you begin dieting and losing weight, it may initially be experienced as a good thing. People make positive comments about you and you may feel more in control and more entergized. However, if you excessively restrict the amount of food you eat, your body may begin to experience starvation. Excessive restriction affects your brain, muscles, and internal organs and can also increase moodiness and anxiety while decreasing concentration.
Eventually, people who care about you may start telling you that while losing a little weight may have been good, you are now looking too thin or even emaciated. If you cannot stop restricting the amount of food that you eat, even when it may not be good for your body, exercising significantly more than your body can manage with the food fuel you allow it, or ignoring people who truly care about your best interests, you have developed anorexia. At this point, you may have found that your life has shrunk to a rigid routine involving a singular focus on avoiding any foods you consider "bad" and any social occasions that involve eating. You may find yourself choosing to give up friendships or relationships or avoiding previously pleasurable activities so that your routine will not be disrupted. You may notice that you have few feelings about anything besides an intense desire to be thin, and nothing else is intersting or seems to matter anymore.
If you are an athlete, you may have started losing weight because you believed it would make you faster or lighter and better at your sport. However, as anorexia progresses, you may discover that you no longer have the energy to participate, concentrate on the best strategy to win, or be effective even when you do participate. If this is the case, it may be time to be honest with your coach or trainer so that you can get the help you need to recover.
Some other possible symptoms of anorexia:
- Feeling cold all the time
- Wearing clothes that are too large or multiple layers of clothes to hide thinness
- Obsessive thoughts about food and/or weight
- Developing unusual habits or "rules" for eating food
- Intense fear of gaining any weight or becoming fat
- Denying hunger and refusing to eat enough to provide sufficient "fuel" for the body
- Pretending to eat in front of others or telling others it has been eaten when it has not
- Perceiving one's body as large even though others say how small or emaciated it is
- Frequent fatigue
- Loss of menstrual cycle
- Loss of muscle mass
- Dizziness or fainting
- Brittle or thinning hair, deteriorating fingernails, dry skin
- Loss of ability to concentrate
- Moods become flat; life is no longer exciting or interesting beyond weight concerns
- Irritability, especially if food rituals or beliefs are challenged
- Inability to maintain the body weight needed by one's body for healthy living
There can also be a number of other serious medical consequences of anorexia as it progresses. Among them are:
- Heart damage
- Kidney or liver damage
Another method for dealing with the desire to lose or maintain a lower weight may involve "purging," or getting rid of food in some way after it has been taken into your body.
At first, it may seem to be an almost free way to eat and enjoy yourself and manage your weight at the same time. However, after using these purging activities for awhile, you find yourself feeling trapped. You may alternate between restricting and purging, or, you may just "binge" (eating what other people would consider an abnormally large amount of food in a short period of time) and purge.
Over time, you also may find yourself using your eating disorder behaviors to deal with stress or any emotion that is uncomfortable. Your positive feelings about yourself may come to rely almost completely on whether you feel good about the shape of your body and your weight. You may also find the number of binge/purge cycles in your week increasing to the point that they begin to interfere with the rest of your life. If these are happening often enough, you may have difficulty concentrating or you may feel dizzy much of the time or even pass out. You may find yourself taking in larger and larger amounts of food because it feels like it takes that much to fill you up. If you do get rid of the food in some way, you may also find yourself feeling bad about yourself and out of control. Your moods may become more unmanageable and you may become prone to depression.
You may find yourself thinking constantly about where to find food and what to do with it once you have eaten it. Eventually, this secret life may interfere with your relationships, your feelings of competence, and your self-esteem. Since binging and purging is typically done secretly, no one may know how you are managing your food or the degree to which you are losing control over your life.
However, as large amounts of food disappear out of the refrigerator at home or from roommates' rooms, you may begin to hear complaints. There may also be complaints about how you have chosen to purge your food if the results are seen by others or affect their sense of cleanliness or neatness.
Sometimes you may find yourself impulsively involved in other actions that are not good for you, such as drinking, using drugs, getting into and out of a number of relationships without thinking of the consequences (sexual or otherwise), or even shoplifting food or purging supplies.
If you have Bulimia, you are more likely to be of normal weight or a bit overweight. It is also possible that you started at a higher weight, but are now in a more normal weight range.
There are two types of bulimia: purging (vomiting or use of diuretics, laxatives, or others to make up for a binge) and nonpurging (methods such as overexercising or fasting). Although binging is typically thought of as ingesting a large amount of food, some individuals purge after eating just a small amount of food.
Other symptoms of Bulimia Nervosa may include:
- Frequent weight fluctuation
- Swollen cheeks due to effect on salivary glands of vomiting; puffy face, red eyes
- Scars on the backs of hands from purging
- Stomach pain, bloating
- Acid reflux
- Low potassium or other electrolyte imbalance from purging; can result in dizziness, passing out (can be life-threatening)
- Irregular heartbeat
- Purging more automatic (i.e. happens without thought or intent) over time
- Irregular menstrual cycles
- Tooth decay or erosion of tooth enamel, mouth or throat sores
- Increase of depression and/or anxiety
- Feelings of shame about overeating and/or purging
- Increasing secretiveness about eating, may not eat with others
- May hide food or take it without permission; food may start disappearing
- Talks frequently about dieting, exercise, appearance; very negative perception of body image
- May shoplift food, laxatives, diuretics, or other dieting or purging meds
- May make rounds of fast food restaurants
- May exercise much more than others of similar age or lifestyle (hours at a time)
- If an athlete, may exercise in addition to practice requirements
Binge Eating Disorder
Binge Eating Disorder (BED) is not simply overeating. Most obese individuals do not have BED and individuals with BED may be of normal weight, overweight, or obese.
If you "binge," you may find yourself taking in significantly larger amounts of food than others would in one period of time (usually defined as two hours). Once you start eating, you continue, often eating very quickly, until you are uncomfortably or even painfully full.
However, you do not use strategies to get rid of the food as in bulimia. In between binges, you may try to diet intensely to make up for the quantity of food taken in during the binges. In spite of this, you may not find yourself losing weight.
The longer it has gone on, the harder it has become to control. You may find yourself hoarding food. The amount of food you take in also may have increased over time. You may find yourself binging even when you are not hungry and eating may also have become a way to manage feelings such as stress, depression, or anxiety. You may also find yourself skipping school, missing work, or avoiding relationships in order to binge.
Over time, you may find yourself feeling embarrassed, disgusted, depressed, or guilty after binges. Since you are more likely to binge in private, others may not know how out of control your eating has become.
Other possible signs or symptoms of Binge Eating Disorder are:
- Eating an extreme amount of food in a short period of time, often rapidly without tasting or enjoying it
- Feeling unable to control the amount of food or how often a binge occurs, feeling unable to stop
- Eating until uncomfortably full or in pain
- Eating a lot of food, even when not hungry
- Eating secretly
- Eating alone to avoid the embarrassment of having others see the quantity of food taken in
- Avoiding social occasions that involve food
- Hoarding food
- Frequent weight changes
- Using binging to manage emotions such as depression or anxiety
Starvation has been studied and found to have certain symptoms, even if anorexia has not caused it:
- Obsessive thoughts about food
- Mood variability, especially depression
- Decreasing interest in living a meaningful life
- Decreased sexual interest