An Eating Disorder is a mental disorder that is characterised by abnormal eating habits, and generally, an unhealthy relationship with food. Eating disorders can cause intense mental suffering, and lead to physical health problems.
There are several different types of eating disorders – each with their own set of symptoms. The disorders generally involve eating habits, obsessions with body shape, and unhealthy attitudes towards food.
It is common for someone with an eating disorder to have a comorbid mental health condition. The causes of these disorders aren’t very clear.
Treatment is available, and in many cases, a full recovery is possible. While eating disorders are normally associated with teenage girls, it is possible for adults (both male and female) to be affected.
Types of Eating Disorders
There are several different types of Eating Disorders. It is useful for patients to know what the exact eating disorder is that they suffer from. This allows treatment to be tailored to their needs.
Anorexia Nervosa: This condition involves an individual attempting to keep their weight as low as possible – normally by not eating enough food, or excessively exercising. The person may have intense self-esteem issues, distorted body image, and will commonly have a strong fear of obesity. As a result of trying to keep their weight as low as possible, they may develop ill health. Feelings of depression and anxiety are common.
Bulimia Nervosa: Bulimia is characterised by recurrent episodes of an individual losing control over food intake. At first, a person will eat a high amount of food in a short amount of time (binging), before being deliberately sick, or using laxatives to get rid of what they have eaten (purging). To ensure that they don’t gain weight, they may starve themselves between binges. Feelings of depression and anxiety are common. This behaviour puts an individual at risk of poor health.
Binge-Eating Disorder: A Binge-Eating Disorder involves an individual regularly losing control of their eating – normally evidenced by episodes of significant consumption of food until an individual feels uncomfortably full. In the aftermath of these episodes, feelings of guilt and low mood are common. These episodes are not accompanied by purging – where a person tries to make themselves sick. During the episode however, a person will often feel that they cannot stop themselves from eating. These activities puts an individual at risk of developing poor health.
Other Specified Feeding or Eating Disorder: This condition is the most commonly diagnosed eating disorder. This is diagnosed when the symptoms of an individual don’t fit into those of other eating disorders. For instance, someone in this category may starve themselves, like someone with anorexia nervosa would, only to be in the normal range of weight, as opposed to being underweight. This condition is no less serious than other eating disorders.
Pica: Pica refers to the condition where an individual persistently eats non-food material. Typical materials eaten include chalk, ice, metal, or sponges. This can cause serious health issues, including impairment in physical development if conducted during childhood or puberty. Pica is often associated with other mental health conditions.
Rumination Disorder: This condition is characterised by an individual repeatedly regurgitating their food after eating. After regurgitating their food, they may swallow the food again, or spit out the food. There is no physical health problem that causes an individual to do this. Rumination Disorder often runs alongside other mental health conditions. This is not the same as rumination.
Avoidant/Restrictive Food Intake Disorder: Avoidant/Restrictive Food Intake Disorder involves an individual feeling the need to avoid food (avoidance), or certain foods (restrictive). The idea of eating can lead to feelings of anxiety. This pattern of food intake will lead to significant weight loss, poor functioning and nutritional deficiency. But unlike Anorexia nervosa and Bulimia nervosa, someone with this condition will not be concerned about their weight or body image. This disorder often runs alongside another mental health condition.
As seen, there are many different types of eating disorders. While there is some overlapping characteristics in these conditions, they are all distinct conditions.
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Symptoms of Eating Disorders
While the symptoms of each different eating disorder vary, in general, possible signs that someone may have an eating disorder include:
- Weakness and fatigue
- Weight loss
- Often going to the bathroom after eating
- Tooth decay
- Sensitivity to the cold
- Secrecy around food
- Health problems
- Men: Reduction in waking erections or low sex drive
- Interrupted periods in women
As well as these basic symptoms, the individual will also exhibit the specific symptoms of the eating disorder they are diagnosed with. For instance, someone with Binge-Eating Disorder will regularly lose control of eating habits – binge-eating on occasion. While someone with Anorexia Nervosa conversely will often starve themselves to try and avoid putting on weight.
These symptoms will typically lead to an individual being at risk of developing health ailments. Those with eating disorders are more at risk of obesity or being dangerously underweight.
It is common for their behaviour to peculiar too. For example, someone may start to act strangely around food, or try to avoid it wherever possible.
Due to possible low mood, they may not engage in activities they once found enjoyable. They will commonly exhibit signs of Depression or Anxiety.
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Causes of Eating Disorders
Eating Disorders are complex conditions, it isn’t entirely known what causes them. However, it appears certain factors are involved in the onset of a condition, with certain risk factors also being evident. It appears that eating disorders can be triggered by a multitude of factors, such as:
- Genetics: Around 50% of eating disorders can be attributed to genetics . Having a parent who once had an eating disorder is a risk factor. Also, any family history of mental illness appears to be a risk factor.
- Abuse: Eating disorders sometimes due to the practice of comfort eating – where someone eats as a way of coping with intense emotional pain. This means that any form of abuse – such as physical, sexual or emotional, can lead to an eating disorder developing.
- Childhood Events: Any form of trauma during childhood could cause an eating disorder. Eating disorders often appear during early teenage years – a stage where several big life changes take place, making people vulnerable.
- Trauma: Any trauma, like being bullied for the way a person looks, can cause eating disorders to appear.
- Other Mental Health Conditions: Eating disorders often run comorbidly with other mental health conditions. Depression and Anxiety may lead to an individual changing their opinion about food – putting them at risk. There is also an overlap between Obsessive-Compulsive Disorder and eating disorders. An overlap also exists with Body Dysmorphic Disorder.
- Workplace: If someone who works in a fashion-oriented environment, where there is a pressure to be slim, they may feel under pressure to be thin.
- Society: Unfortunately, society places an emphasis on people having “perfect bodies”. Social media may cause unrealistic expectations of body types – leading to people making drastic changes to try and look similar.
- Personality Traits: Some personality traits like low self-esteem or self-loathing can leave someone vulnerable to developing an eating disorder. Feelings of worthlessness can lead to someone thinking negatively about themselves – with the idea that being thinner may improve their feelings. Being a perfectionist, obsessive behaviour and being self-critical are all other traits that can be damaging.
There is often no clear cause of an Eating Disorder. It is possible that a range of the above factors contribute to the onset of a condition.
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Diagnosis of Eating Disorders
Eating Disorders cannot be diagnosed through a laboratory test, though medical examinations can help assist in a diagnosis.
The first step is to see a doctor. A doctor will ask the individual a range of questions based around their symptoms. If they believe an eating disorder may be present, they will refer the individual to an eating disorder specialist.
The specialist will conduct a thorough assessment of symptoms, and aim to make a diagnosis. They may use some form of questionnaire to aid their diagnosis.
The exact criteria needed for a diagnosis differs between the various eating disorders. You can read in more detail about this at the link below [construction].
Sometimes, if someone has an eating disorder that doesn’t fit into any specific category, they can be diagnosed with Other Specified Eating or Feeding Disorder.
Seeking help for an eating disorder is important. Eating disorders don’t tend to clear up on their own, and can lead to intense emotional pain, as well as debilitating physical ailments.
Any underlying mental health condition will also be able to be diagnosed at this stage. The earlier help is sought, the sooner recovery will be possible.
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Treatment of Eating Disorders
Eating disorders are difficult conditions to live with. However, treatment is available. With the right treatment, and support from those around them, an individual has a very good chance of making a full recovery.
Treatment will involve talking therapy, and if needed – medication. The exact form of talking therapy that is used will vary between the different eating disorders.
- Talking Therapy: There are a wide range of possible talking therapies that can be used to treat eating disorders. Certain therapies are effective in certain disorders. Cognitive-Behavioural Therapy is a popular therapy type.
Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.
Maudsley Anorexia Treatment: Also known as MANTRA, this is a relatively new treatment type, developed by senior clinicians at the Maudsley Hospital in London. This model of treatment attempts to change the factors that contribute to the condition in the individual. Harmful personality traits can be addressed, with certain goals made for the future. Various behavioural experiments can be made, which can result in changes in eating behaviours. So far, this form of treatment has proved very helpful for many.
Hypnotherapy: Hypnotherapy is a form of therapy that uses hypnosis in an attempt to treat a condition. Hypnotherapy normally involves an individual being in a deeply relaxed state. The therapy also uses focused attention and concentration to induce a heightened state of awareness. This allows the patient to focus on specific thoughts or factors. Hypnotherapy will commonly involve suggestion therapy, which allows a person to be more inclined to changing behaviours (including pain management). It can also be used to explore causes of a condition or symptom. This may include events that have been hidden in an individual’s unconscious memory.
- Medication: Low mood, anxiety or other symptoms of mental illness are often present alongside an Eating Disorder. If this is the case, medication may be offered. However, if someone is very underweight, as is common in eating disorders, lower doses should be prescribed – due to the fact drugs will be absorbed quicker into the bloodstream.
Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.
- Other: In the event that someone with an eating disorder is severely ill, it may be necessary for an individual to access treatment in a Hospital. This rarely happens, although it is a possibility. Treatment in a Hospital will also include regular therapy. If it is believed that an individual will be at risk to themselves without hospitalisation, they may be sectioned under the Mental Health Act.
Eating Disorders can be dangerous conditions, but treatment is available. Treatment should lead to an individual recovering, and attaining a better, and more healthy life.
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Living with Eating Disorders
Eating Disorders have the potential to cause both physical and mental pain. Day-to-day life can be a significant struggle for those with eating disorders.
If left untreated, there is every chance the conditions will exacerbate, and cause yet more suffering. This is why accessing treatment is so important.
Treatment can certainly help, and in the majority of cases, will provide an individual with the support and help needed to make positive change.
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Eating Disorders can cause many issues. There is a heightened risk of physical problems, such as heart problems and weight gain or loss.
It does seem that there are a range of areas that affect the prognosis of the individual. These areas include whether or not a comorbid mental health condition is present, if certain personality traits are exhibited, past substance abuse history and whether or not their symptoms appeared at first in adolescence or adulthood.
The prognosis is okay for eating disorders, though several areas are present that can either worsen, or improve, this determination.
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 Trace, S. E., Baker, J. H., Penas-Lledó, E., & Bulik, C. M. (2013). The genetics of eating disorders. Annual Review of Clinical Psychology. 9: p589–620.