Eating Disorders: What You Need to Know

By Meghan O’Dell

Millions of people, both female and male, are afflicted by eating disorders, which can range from binging and purging to avoiding food and exercising compulsively. Eating disorders are long-term illnesses that can often lead to death, and they also often co-occur with other disorders such as depression, substance abuse, and anxiety. But the good news is that eating disorders are very treatable, and the sooner you can admit you have a problem and get help, the better your chances for successful recovery.

Eating disorders can affect anyone, regardless of gender or age. A 2003 study showed that more than 90 percent of those who are affected by eating disorders are females between the ages of 12 and 25, but there are increasing numbers of older women, men, and even young boys who are suffering from these diseases. Eating disorders are all-consuming, affecting almost every part of a person’s life, from physical appearance and emotional well-being to relationships, school, and work.

Anorexia nervosa and bulimia nervosa are the most common eating disorders; together, they affect an estimated 5-7 percent of females in the United States. The third most common type is binge-eating disorder, which involves compulsive bouts of overeating, regardless of whether the person feels hungry.

Anorexia nervosa
Anorexia nervosa occurs when a person deliberately avoids food due to an intense fear of gaining weight, even when he or she is dramatically underweight. People with anorexia usually avoid meals altogether or eat very small portions; they also often weigh their food, obsessively count calories, and exercise compulsively. Clinicians define anorexia nervosa as having an abnormally low body weight (at least 15 percent below normal weight), missing three consecutive menstrual cycles (in females of child-bearing age), and having an unnatural preoccupation with body weight and shape.

Anorexia nervosa often occurs during adolescence, and it is about ten times more likely to occur in females than males. People with anorexia often have very low self-esteem and are perfectionists by nature; when they fail to meet the unrealistically high standards they set for themselves, they turn to their bodies, believing that food and weight loss are the only things they can control.

Some risk factors for developing anorexia include having depression, anxiety, or obsessive-compulsive disorder; having low self-esteem; being a perfectionist; being teased by others about your body; being sexually abused as a child; and inheriting certain genes (having a female with anorexia in your immediate family increases your chances of developing it).

Anorexia can slow the heart rate and lower blood pressure, increasing the risk of heart failure. Using drugs to stimulate vomiting, bowel movements, or urination also increases this risk. Starvation can also lead to heart failure and brain damage. Severe cases of anorexia can lead to brittle bones that break easily. The mortality rate of anorexia is about 6 percent-higher than any other psychiatric disorder-with about 3 percent of deaths caused by suicide.

The first goal of treatment for anorexia is to get back to a healthy weight, which usually requires hospitalization. Once a person’s physical condition is stable, the patient should receive individual and family therapy, where he or she will undergo behavioral treatment, learning how to maintain healthy eating habits and improved body image. The patient may also be prescribed antidepressants to help elevate mood. Zinc has also been found to help with treatment, as adequate zinc intake can result in increased appetite and thus weight gain.

Bulimia nervosa
This eating disorder is characterized by recurrent binge eating, followed by a behavior that is mean to compensate for the overeating, such as self-induced vomiting (purging); fasting; using laxatives, diuretics, and enemas; and excessive exercising. There are two types of bulimia: purging (vomiting and/or abusing laxatives, diuretics, etc.) and non-purging (dietary fasting or excessive exercising).

Like people with anorexia, people with bulimia have an intense fear of gaining weight. Clinicians diagnose bulimia when a person eats an amount of food that is much larger than most people would eat, followed by recurrent behavior to prevent weight gain. These symptoms occur at least twice a week over a minimum of three months.

The onset of bulimia is often during adolescence (between ages 13 and 20); however, bulimia can be hard to detect as bulimics tend to be of average weight. People with bulimia are also more likely to be suffering from another disorder like depression or anxiety. They also have twice the risk of abusing a substance than non-bulimics.

There are many negative medical problems than can arise with bulimia, including damage to the teeth, esophagus, and stomach (due to excessive vomiting); dehydration; enlarged glands in the neck; irregular heartbeat; heart failure; and death from chemical imbalances and the loss of important minerals like potassium. Inflammation of the pancreas, long-term constipation, and peptic ulcers are also common adverse effects.

Behavioral therapy has been effective in changing eating patterns and body image in people with bulimia, as has psychotherapy. Individual and family therapy are recommended, as well. There has also been research involving anti-addiction medications such as naltrexone and topiramate, which can block cravings for certain drugs, alcohol, and food. Residential rehab programs are also extremely effective.

Binge-eating disorder
People with binge-eating disorder (BED) eat an unusually large amount of food, often until they are physically uncomfortable and on the verge of vomiting. Eating occurs regardless of whether the person is hungry, and often as a result of being bored or depressed. Binge eaters usually eat alone during binging episodes to avoid being discovered, and they also often feel shameful or guilty after binge eating. A person with BED engages in binging episodes at least twice a week for at least six months and lacks control over his or her eating behaviors.

Binge-eating symptoms are also present in those with bulimia nervosa, but binge eaters do not purge, fast, or exercise compulsively after binge sessions. Binge eaters are also typically overweight or obese, though some people are of normal weight. BED is also similar to compulsive overeating, but those with BED do not have a compulsion to overeat and don’t spend a great deal of time thinking about food.

About two percent of adults in the US have BED, and it is twice as common in women as in men. The causes of BED are still unknown, but as many as half of all people suffering from it have been depressed at some point. Binge eating can be triggered by emotions such as happiness, anger, sadness, or boredom, but some people binge regardless of their mood.

Binge eating can cause high blood pressure and cholesterol levels, and can lead to morbid obesity, Type II diabetes, gallbladder disease, heart disease, and certain types of cancer. People can also become ill due to lack of proper nutrition, as binging usually involves food that is high in sugar and salt and low in healthier nutrients. In addition, people with BED are usually ashamed of their problem and can become very depressed.

Research is under way to find the most beneficial treatments for controlling BED, but Cognitive Behavioral Therapy can teach people how to change their unhealthy eating habits, and 12-step programs like Overeaters Anonymous can be very helpful.

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