Eating disorders, such as anorexia, bulimia and binge-eating disorder, seriously impact health. Learn about symptoms and treatments.
Eating disorders are serious conditions related to persistent eating behaviors that negatively impact your health, your emotions and your ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.
Most eating disorders involve focusing too much on your weight, body shape and food, leading to dangerous eating behaviors. These behaviors can significantly impact your body's ability to get appropriate nutrition. Eating disorders can harm the heart, digestive system, bones, and teeth and mouth, and lead to other diseases.
Eating disorders often develop in the teen and young adult years, although they can develop at other ages. With treatment, you can return to healthier eating habits and sometimes reverse serious complications caused by the eating disorder.
Symptoms vary, depending on the type of eating disorder. Anorexia nervosa, bulimia nervosa and binge-eating disorder are the most common eating disorders. Other eating disorders include rumination disorder and avoidant/restrictive food intake disorder.
Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is a potentially life-threatening eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. People with anorexia use extreme efforts to control their weight and shape, which often significantly interferes with their health and life activities.
When you have anorexia, you excessively limit calories or use other methods to lose weight, such as excessive exercise, using laxatives or diet aids, or vomiting after eating. Efforts to reduce your weight, even when underweight, can cause severe health problems, sometimes to the point of deadly self-starvation.
Bulimia (boo-LEE-me-uh) nervosa — commonly called bulimia — is a serious, potentially life-threatening eating disorder. When you have bulimia, you have episodes of bingeing and purging that involve feeling a lack of control over your eating. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging.
During these episodes, you typically eat a large amount of food in a short time, and then try to rid yourself of the extra calories in an unhealthy way. Because of guilt, shame and an intense fear of weight gain from overeating, you may force vomiting or you may exercise too much or use other methods, such as laxatives, to get rid of the calories.
If you have bulimia, you're probably preoccupied with your weight and body shape, and may judge yourself severely and harshly for your self-perceived flaws. You may be at a normal weight or even a bit overweight.
When you have binge-eating disorder, you regularly eat too much food (binge) and feel a lack of control over your eating. You may eat quickly or eat more food than intended, even when you're not hungry, and you may continue eating even long after you're uncomfortably full.
After a binge, you may feel guilty, disgusted or ashamed by your behavior and the amount of food eaten. But you don't try to compensate for this behavior with excessive exercise or purging, as someone with bulimia or anorexia might. Embarrassment can lead to eating alone to hide your bingeing.
A new round of bingeing usually occurs at least once a week. You may be normal weight, overweight or obese.
Rumination disorder is repeatedly and persistently regurgitating food after eating, but it's not due to a medical condition or another eating disorder such as anorexia, bulimia or binge-eating disorder. Food is brought back up into the mouth without nausea or gagging, and regurgitation may not be intentional. Sometimes regurgitated food is rechewed and reswallowed or spit out.
The disorder may result in malnutrition if the food is spit out or if the person eats significantly less to prevent the behavior. The occurrence of rumination disorder may be more common in infancy or in people who have an intellectual disability.
This disorder is characterized by failing to meet your minimum daily nutrition requirements because you don't have an interest in eating; you avoid food with certain sensory characteristics, such as color, texture, smell or taste; or you're concerned about the consequences of eating, such as fear of choking. Food is not avoided because of fear of gaining weight.
The disorder can result in significant weight loss or failure to gain weight in childhood, as well as nutritional deficiencies that can cause health problems.
An eating disorder can be difficult to manage or overcome by yourself. Eating disorders can virtually take over your life. If you're experiencing any of these problems, or if you think you may have an eating disorder, seek medical help.
Unfortunately, many people with eating disorders may not think they need treatment. If you're worried about a loved one, urge him or her to talk to a doctor. Even if your loved one isn't ready to acknowledge having an issue with food, you can open the door by expressing concern and a desire to listen.
Be alert for eating patterns and beliefs that may signal unhealthy behavior, as well as peer pressure that may trigger eating disorders. Red flags that may indicate an eating disorder include:
If you're worried that your child may have an eating disorder, contact his or her doctor to discuss your concerns. If needed, you can get a referral to a qualified mental health professional with expertise in eating disorders, or if your insurance permits it, contact an expert directly.
The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes, such as:
Teenage girls and young women are more likely than teenage boys and young men to have anorexia or bulimia, but males can have eating disorders, too. Although eating disorders can occur across a broad age range, they often develop in the teens and early 20s.
Certain factors may increase the risk of developing an eating disorder, including:
Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications, such as:
Although there's no sure way to prevent eating disorders, here are some strategies to help your child develop healthy-eating behaviors:
If you notice a family member or friend who seems to show signs of an eating disorder, consider talking to that person about your concern for his or her well-being. Although you may not be able to prevent an eating disorder from developing, reaching out with compassion may encourage the person to seek treatment.
Eating disorders are diagnosed based on signs, symptoms and eating habits. If your doctor suspects you have an eating disorder, he or she will likely perform an exam and request tests to help pinpoint a diagnosis. You may see both your primary care provider and a mental health professional for a diagnosis.
Assessments and tests generally include:
Your mental health professional also may use the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Treatment of an eating disorder generally includes a team approach. The team typically includes primary care providers, mental health professionals and dietitians — all with experience in eating disorders.
Treatment depends on your specific type of eating disorder. But in general, it typically includes nutrition education, psychotherapy and medication. If your life is at risk, you may need immediate hospitalization.
No matter what your weight, the members of your team can work with you to design a plan to help you achieve healthy eating habits.
Psychotherapy, also called talk therapy, can help you learn how to replace unhealthy habits with healthy ones. This may include:
Medication can't cure an eating disorder. However, certain medications may help you control urges to binge or purge or to manage excessive preoccupations with food and diet. Drugs such as antidepressants and anti-anxiety medications may help with symptoms of depression or anxiety, which are frequently associated with eating disorders.
If you have serious health problems, such as anorexia that has resulted in severe malnutrition, your doctor may recommend hospitalization. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.
To improve your chances of success in overcoming your eating disorder, try to make these steps a part of your daily routine:
Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary or integrative medicine is a nonconventional approach used along with conventional medicine.
Usually, when people turn to alternative or complementary medicine it's to improve their health. But dietary supplements and herbal products designed to suppress the appetite or aid in weight loss may be unsafe and abused by people with eating disorders. Such products can have potentially dangerous interactions with other medications.
Weight-loss and other dietary supplements don't need approval by the Food and Drug Administration (FDA) to go on the market. The FDA maintains an online list of tainted weight-loss products, some of which can cause serious harm, such as irregular heartbeats, increased blood pressure, stroke and even death.
Talk with your doctor before trying any alternative or complementary medicine. Natural doesn't always mean safe. Your doctor can help you understand possible risks and benefits before you try a treatment.
Some complementary treatments and approaches may help reduce stress and anxiety, promote relaxation, and increase a sense of well-being in people with eating disorders. Examples include:
It's difficult to cope with an eating disorder when you're hit with mixed messages by the media, culture, and perhaps your own family or friends. Whether you or your loved one has an eating disorder, ask your doctor or mental health professional for advice on coping and emotional support.
Learning effective coping strategies and getting the support you need from family and friends are vital to successful treatment.
Here's some information to help you get ready for your appointment, and what you might expect from your doctor and a mental health professional.
You may want to ask a family member or friend to come with you. Someone who accompanies you may remember something that you missed or forgot. A family member may also be able to give your doctor a fuller picture of your home life.
Before your appointment, make a list of:
Ask a family member or friend to come with you, if possible. Someone who accompanies you may remember something that you missed or forgot. A family member may also be able to give your doctor a fuller picture of your home life.
Some questions you might want to ask your doctor or other health care provider include:
Don't hesitate to ask additional questions during your appointment.
Your doctor or mental health professional is likely to ask you a number of questions, such as:
Be ready to answer these questions to reserve time to go over any points you want to focus on.
May 5th, 2021