Generally, eating disorders involve self-critical, negative thoughts and feelings about body weight and food, and eating habits that disrupt normal body function and daily activities. Eating disorders are one of the most complex of all DSM-IV diagnoses and lead to unmanageability in life every bit as severe as drug addiction and alcoholism.
The two main types of eating disorders are anorexia nervosa and bulimia nervosa. A third category is “eating disorders not otherwise specified (EDNOS),” which includes several variations of eating disorders. Most of these disorders are similar to anorexia or bulimia but with slightly different characteristics. Binge-eating disorder, which has received increasing research and media attention in recent years, is one type of EDNOS.
What are Eating Disorders?
An eating disorder is marked by extremes. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.
Individuals suffering from eating disorders may say things like:
“I am so depressed and afraid all the time. I’ve destroyed my self-respect and I know I’m abusing my body, but I don’t know what else to do. I’m feeling so alone and helpless. You don’t know how hard it was for me to make this call. Do you think I could have an eating disorder?”
Family members of eating disorder sufferers may say:
“She’s absolutely obsessed with her weight. She’s bingeing now at least twice a day. I can’t keep any food in the house. I put something in the refrigerator, and it’s gone.”
“She says that the only time she feels better is when she’s eating. She eats and eats and then throws up. Do you think she has an eating disorder?”
“I know she’s lost a lot of weight. She wears baggy clothes but the other day I saw here changing in her room, and all I saw were bones. I’m so scared. She doesn’t have an eating disorder does she?”
Eating Disorder Statistics
During the past thirty years, the incidence of eating disorders has increased dramatically in the United States. Eating disorders affect a significant number of Americans, an estimated 7 million every year. These disorders include anorexia nervosa, bulimia nervosa, binge-eating disorders and several other variations. Although these disorders are more common in adolescent girls or young women, approximately 6 million girls and adult women struggle with eating disorders and approximately 1 million boys and men will struggle with eating disorders this year.
Anorexia nervosa, bulimia nervosa, and binge eating disorder are prevalent and often chronic in our current culture. One-half of one percent to 3.7% of females will suffer from anorexia nervosa in their lifetime; 1.1% – 4.2% of females will suffer from bulimia nervosa in their lifetime; 2% – 5% of the American population will experience binge eating disorder (I’m sure these numbers are much higher); 10%-25% of all those battling anorexia will die as a direct result of the eating disorder; up to 19% of college-aged women in America are bulimic; and 10% – 15% of all persons with eating disorders are male. Eating disorders have one of the highest mortality rates of any psychiatric diagnosis; in fact, it is the highest cause of death among adolescent females with bulimia nervosa coming in second.
Eating disorders can be viewed on a continuum from normal to pathological, and the numbers of people, men as well as women, with clinical eating disorders, disordered eating, and body dissatisfaction is growing. Statistics show that 42% of all first through third-grade girls want to be thinner and that 81% of 10-year-olds are afraid of being fat. To me, this is still an unfathomable number. Ninety-one percent of women recently surveyed on a college campus had attempted to control their weight through dieting. 20-25% of all dieters progress to partial or full-clinical eating disorders. Yes, dieting is one of the causes of eating disorders.
Because of the secretiveness and shame associated with eating disorders, many cases are probably not reported. Also, many individuals struggle with body dissatisfaction and dysfunctional disordered eating attitudes and behaviors. For example, 80% of American women are dissatisfied with their appearance that is indicative of a cultural condition.
Insurance and Eating Disorders
Many insurance companies and providers view eating disorders as being long-term conditions that are chronic and require long-term treatment. This is one of the reasons insurance companies are frequently reluctant to pay for inpatient or residential treatment because they don’t believe that these individuals will get better!
Sufferers of Eating Disorders
Sufferers become obsessed with food and their body weight as well. An eating disorder is marked by severe disturbances in eating behavior, such as extreme overeating or extreme reduction of food intake. Eating disorders do not discriminate between gender, class, race, or even age. Eating disorders have been diagnosed in children as young as three and in adults as old as ninety. Researchers have discovered more and more anorexia nervosa in the elderly and that now the majority of deaths from anorexia nervosa occur in people over age 65. Eating disorders frequently occur with other mental disorders such as depression, substance abuse, and anxiety disorders.
There are three types of eating disorders: anorexia nervosa, bulimia nervosa, and EDNOS (eating disorders not otherwise specified) that include disorders that are similar to anorexia or bulimia but have slightly different characteristics. Binge Eating Disorder is one type of EDNOS.
Anorexia Nervosa is diagnosed when patients’ weigh at least 15 percent less than the normal healthy weight expected for their height. Individuals with anorexia nervosa refuse to eat enough, often exercise obsessively, and sometimes force themselves to vomit or use laxatives to lose weight.
Over time, the following symptoms may develop as the body goes into starvation:
- Menstrual periods cease
- Osteopenia or osteoporosis (thinning of the bones) through loss of calcium
- Hair/nails become brittle
- Skin dries and can take on a yellowish cast
- Mild anemia and muscles, including the heart muscle, waste away
- Severe constipation
- Drop in blood pressure, slowed breathing and pulse rates
- Internal body temperature falls, causing person to feel cold all the time
Individuals with bulimia nervosa can be slightly underweight, normal weight, overweight or even obese. Patients with bulimia nervosa binge eat frequently, and when they binge they may eat an astounding amounts of food in a short time, often eating thousands of calories that are high in sugars, carbohydrates, and fat. They can eat very rapidly, sometimes gulping down food without even tasting it. Their binges often end only when another person interrupts them, or they fall asleep, or they are in extraordinary pain because their stomachs have been stretched beyond normal capacity.
Feeling out of control while bingeing is a familiar feeling for binge eaters. After a binge, stomach pains and the fear of weight gain are common reasons that those with bulimia nervosa purge by throwing up, using laxatives or diuretics, and/or compulsively exercising. This cycle is usually repeated at least several times a week or, in serious cases, several times a day. I have spoken with many young women who literally purge everything they eat without bingeing but with eating small amounts of food (which they consider a binge.) Since they don’t become drastically thin, their behaviors may go unnoticed for quite a long by those closest to them.
Bulimia nervosa does have symptoms that ultimately can become fatal:
- Chronically inflamed and sore throat
- Salivary glands in the neck and below the jaw become swollen. Cheeks and face often become puffy, causing sufferers to develop a “chipmunk” looking face
- Tooth enamel wears off, teeth begin to decay from exposure to stomach acids
- Constant vomiting causes gastroesophageal reflux disorder
- Laxative abuse causes irritation, leading to intestinal problems
- Diuretics (water pills) cause kidney problems
- Severe dehydration from purging of fluids
Binge Eating Disorder
People with binge eating disorder have episodes of binge eating in which they consume very large quantities of food in a brief period and feel out of control during the binge. They do not try to get rid of the food by purging or using laxatives, diuretics, compulsive exercise or any other unsafe methods. Binge eating is chronic and can lead to serious health complications, particularly severe obesity, diabetes, hypertension and cardiovascular diseases. Binge eaters also feel ashamed and disgusted by their behavior. The binges can typically be done in secret.
Eating disorders are real, treatable medical illnesses with complex underlying psychological, sometimes genetic, and physiological causes. If you think you or someone you know has developed an eating disorder, please do not deny that there is a problem. The sooner a person gets treatment for an eating disorder the faster they can return to being their normal selves. Never forget that death may occur if an eating disorder is left untreated.
About the Author
Jeanne Rust, PhD is the Founder and CEO of Mirasol, a holistic, integrative, eating disorders treatment center located in Tucson, AZ. She was the first in the country to use holistic and complementary interventions for eating disorder treatment. She has been written up in various newspapers such as the Chicago Tribune, USA Today, the San Francisco Chronicle among them, as well as other print publications such as Time magazine in the United States and Flair magazine in Canada. You can access Mirasol’s listing in our treatment directory by clicking here: Mirasol Eating Disorder Treatment Center
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