Eating Disorders: Facts and Treatment Options

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According to the National Association of Anorexia and Associated Disorders (ANAD), an eating disorder is defined as an unhealthy relationship or preoccupation with food or weight that interferes with several facets of an individual’s life. Although eating disorders may begin as a result of body dissatisfaction or low self-esteem, individuals who suffer from eating disorders often use behaviors involving food as a means to cope with uncomfortable emotions, or to provide a sense of control when life circumstances become overwhelming.

The most commonly diagnosed eating disorders are Anorexia Nervosa and Bulimia Nervosa. The primary characteristics of Anorexia include fear of weight gain and an inability to maintain a healthy body weight. Some who suffer from Anorexia achieve weight loss through food restriction, but others may frequently binge and purge while sustaining a below average body weight. Individuals who suffer from Bulimia Nervosa also battle binge-purge behaviors and often report a fear of gaining weight, but may preserve an average body weight despite engaging in eating disorder behaviors. Although the term purge is often used in reference to self-induced vomiting, the act of purging as it relates to eating disorders is considered to be any behavior used as a compensatory strategy for food intake. Individuals who suffer from an eating disorder may utilize laxatives, diuretics, excessive exercise, and diet supplements to control hunger or void food consumption to achieve weight loss (American Psychiatric Association 2000).

Research suggests that an estimated 15% of adolescent and young adult females qualify for a clinical or sub-clinical diagnosis of anorexia nervosa. Further research has established that approximately one-third of individuals who receive eating disorder treatment will continue exhibiting symptoms of an eating disorder up to five years post-intervention (Polivy & Herman, 2002). Perhaps most alarming is the fact that 10% of individuals diagnosed with anorexia nervosa will die within 10 years from the onset of the disorder (Arcelus, Mitchell, Wales, & Nielsen, 2011). Among the list of potentially fatal health hazards associated specifically with Anorexia are increased risk of heart disease/failure, osteoporosis, muscle loss, dehydration, and kidney or liver damage. Similarly, Bulimia is associated with electrolyte imbalance, dehydration, and tooth decay, inflammation of the esophagus /possible ruptured esophagus, and a damaged digestive system (National Eating Disorder Association, n.d., McCormick, 2014)

While eating disorders are most commonly linked to women, specifically between the ages of 10 and 25-years-old, studies suggest that as many as 10 million men in the United States will suffer from a clinically significant eating disorder within their lifetime. In addition, 37% of young men may silently use unhealthy weight control measures as a means to cope with difficult feelings and body dissatisfaction (National Eating Disorder Association, n.d.; McCormick, 2014).

Needless to say, these findings highlight the severity of eating disorders and overall body dissatisfaction. In fact, anorexia nervosa continues to be the most lethal of all mental health conditions. Therefore, heightened awareness of the signs and symptoms associated with disordered eating is imperative for increasing early eating disorder intervention and diminishing the overall prevalence of this deadly illness.

Due to heightened media coverage of thinness and shame associated with weight gain or obesity, a large percentage of Americans are constantly trying to shed pounds. Although it is not uncommon to know someone who is frequently dieting or trying to lose weight, there are several signs that may indicate susceptibility to the development of an eating disorder, specifically in young females. Some such warnings may include remarkably low self-esteem, preoccupation with food/weight, changes in eating habits/atypical eating rituals (i.e. taking exceptionally small bites), spending an increased amount of time in front of mirrors, social isolation or avoidance, rapid weight loss, excessive exercise, and frequent bathroom visits following meals. It is also important to note that lack of proper nutrition may lead to difficulty with sustained attention and concentration. A combination of any of the above listed changes in behavior or appearance and significantly increased irritability or mood swings is cause for further investigation (National Eating Disorder Association, n.d.; McCormick, 2014).

If you or someone you know is struggling with disordered eating, there are options for help. First and foremost, it is important to receive a thorough evaluation by a medical professional to rule out any life threatening medical conditions that may have been triggered by poor nutrition. Next, it is important to develop a comprehensive treatment team with the ability to treat both the physical and emotional aspects of disordered eating. Registered dieticians, psychotherapists, and psychiatrists are all integral parts of eating disorder treatment.

Perhaps you are one who does not particularly struggle with disordered eating, but often find yourself consumed with poor body image (as so many do). Here are a few tips for increasing self-esteem and decreasing focus on appearance:

  1. Identify your inner strengths and values. Are you a loyal friend, caring, or intelligent?
  2. Make note of the internal assets of others. Rather than complimenting outfits or smiles, practice praising character.
  3. Practice accepting your natural shape and size without judgment. What would your body look like if you weren’t dieting? Can you accept that size even if it’s not your current ideal?
  4. Remember that physical appearance is only one, small part of who we are. There are many other aspects of ourselves that we can be confident about! Take a minute to think about what yours might be and choose to focus on those specific attributes when you are feeling particularly consumed with poor body image.

Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with Anorexia Nervosa and other eating disorders. Archives of General Psychiatry, 68(7), 724-731.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC

McCormick, K. A. (2014). Disordered eating prevention: A clinical application for parents of preadolescent girls (Unpublished doctoral dissertation). Azusa Pacific University, Azusa, CA

Polivy, J., & Herman, C. P. (2002). Causes of eating disorders. Annual Review of Psychology, 53, 187 213.

National Association of Anorexia and Associated Disorders (2014). Retrieved from http://www.anad.org/

National Eating Disorder Association (n.d.). Retrieved from http://www.nationaleatingdisorders.org/get-facts-eating-disorders

—Aimee Foster, PsyD is ‎Treatment Coordinator – Adult PHP at Loma Linda Behavioral Medicine Center, Loma Linda, California.