Eating and feeding disorders are a category of mental illness that is related to food intake, relationships with food, and has many side effects that can roll over into other areas of mental and emotional functioning.
The major eating disorders according to the DSM-5 are anorexia nervosa, bulimia nervosa, pica, binge eating disorder, rumination disorder, and avoidant/restrictive food intake disorder. Great variability exists between these disorders. With some disorders centered on not receiving enough calories (bulimia and anorexia), and others ingesting an unhealthy amount (binge-eating disorder), or even more bizarre, eating non-food items like rocks, plastic, or metal (pica).
Eating disorders are a major problem today, and often misunderstood. With millions of people diagnosed with anorexia and bulimia living dangerously underweight that organ failure, suicide, irrevocable physical damage, and other serious mental health issues are all possible. Many of the issues going on for these people runs far deeper than just food intake. Many people with anorexia will also experience depression, anxiety, and other severe mental health issues and sadly early death.
On the flip side are people who have binge-eating disorder, where excessive amounts of food are being consumed. This also leads to serious physical issues like diabetes, hypertension, and also sadly early death. Roughly 1 in 3 Americans are obese. This is clearly a problem and is something that needs to be understood not only from a physical standpoint but also a mental perspective.
While there is often similarities in symptoms between disorders of the same category, while all of these disorders involve an individual’s relationship with food, the manifestation of symptoms is often complete opposites. With people with anorexia avoiding food at all costs and possibly taking in 0-500 calories daily from fruits and veggies, and a person with binge-eating disorder who is obese and taking in 5,000-20,000 calories from pizza and processed foods.
In the two examples above both people have unhealthy behaviors and relationships surrounding food, they would act, look, and feel very different. Every person is unique. How and why they have developed the symptoms and behaviors that they have is equally as unique. Remember, just like every disorder and person that they are special and different. While there will be similarities between people with similar diagnosis, treat people as individuals, because they are, severity will vary as well.
Symptoms of Eating Disorders
Symptoms for eating disorders can drastically vary from disorder to disorder. Here are a few:
- Abnormal relationship with food. We all need food, and there is a scientific balance of calories (input) vs. exercise (output). This equation unique to each person, finding a healthy balance is essential, often this will be off in one way or another for people with eating disorders.
- Emotional eating. Often seen in people with bulimia and binge-eating disorder, emotional eating is essentially allowing your feelings and emotions (like stress, anxiety, depression) to influence your eating. Some people will eat in great excess, others will minimize or cease eating.
- Other mental health issues. For people with an eating disorder there is often a high co-morbidity (meaning having multiple diagnosis) with depressive, bi-polar, anxiety, obsessive-compulsive disorder, and other mental health disorders. Sometimes the diagnosis can be essentially a chicken-or-egg type of situation, what came first the eating disorder or the depression? Regardless, both are very real and prevalent and probably influencing each other.
- Secretive eating or behaviors. For some people this is binging on mass quantities of food, for others it is hiding vomiting in the bathroom. For most people eating in front of people is not a problem because there is nothing to hide. People who are secretive about eating may be hiding negative behaviors.
- Major fluctuations in weight. People with abnormal eating behaviors will often experience great and frequent flux in their weight.
- Feeling controlled by food. On both ends of the spectrum, people will often feel like their relationship with food is out of their control. In one way or another food has control over everything they do in life and becomes very unhealthy.
- Body image issues. Not having an accurate view of self can also lead to issues with the way a person approaches food and eating. For some people they will have an insanely skewed and inaccurate view of their physical being.
- Do not recognize the severity of the situation. For some people with a diagnosis their physical health could be so deteriorated, yet they have no idea how bad it is, same with the mental side. Often denying a problem and brushing it aside only allows for it to continue and intensify.
Who can Develop Eating disorders?
Anyone can develop an eating disorder. It can happen for a variety of reasons. Some people are more likely to develop eating disorders than others.
- Family history of eating disorders or other mental illness. Having a family member with an eating disorder drastically increases the chances that one will be developed. This is likely biological and environmental, as we often share similar eating behaviors to those that we live with.
- Gender. Currently, there are almost 2 to 1 females to males diagnosed with eating disorders. Females having higher rates of anorexia and bulimia, and binge-eating disorder is much closer to equal division. Rates of males with eating disorders once were much farther behind, but have caught up.
- Athletes. In many sports, body weight can be seriously influenced by pressures from the self, coaches, teammates, etc. Wrestlers, boxers, swimmers, runners, and many other sports can have issues with eating disorders.
- Age. Adolescents, particularly females are at a high risk of developing disordered eating behaviors. Peer pressure, media, and evolving self-identity, as well as changes in the physical body are all contributing factors.
- Certain careers or interests. Dancing, modeling, fashion, and other jobs/activities interests could also influence the development of an eating disorder.
Impact of Eating Disorders
There are both long and short term side effects that can occur as a result of eating disorders, as well as mental and physical problems. The longer the disorder persists often the more severe the symptoms become.
- Inability to concentrate or focus
- Depression
- Anxiety
- Cessation of menstruation
- Weight fluctuation
- Organ failure and problems (heart, kidney, liver)
- Teeth problems (bulimia and pica)
- Hypertension, obesity, diabetes (binge-eating disorder)
- Inability to have children
- Obsessive compulsive disorder or other mental illness
- Strained social relationships
- Higher risk of suicide (Anorexia is the deadliest mental illness)
- Death
Causes of Eating Disorders
Like all mental illness, usually the causes are multi-faceted. With a variety of nature and nurture topics influencing the development of eating or feeding disorders.
- Media. Social media bullying and pressures, air-brushed models, images of the “perfect body/person” being forced down our throats, magazines telling us to be a certain way, websites judging people, etc. And so much more, the media influences, particularly adolescents and sells a notion of looking and being a certain way. All these and many more factors go into the media influencing eating disorders.
- Biology and chemistry. Like all mental illness, there is likely a biological and chemical component to the formation of eating disorders. Increased dopamine has been seen in many people with anorexia, and serotonin is a key component in multiple other eating disorders.
- Learned behaviors. Modeling the behaviors of others is not uncommon. Seeing other people have negative relationships with food that are off mimicked. This is especially true in families where a parent had issues with eating.
- Peer Pressure. The intentional and unintentional pressures that friends, family, and romantic partners can pose is significant. While some of it is direct and intentional, some of it is not, but pressure is there and can impact people’s behaviors.
Treatment Options for Eating Disorders
- Talk Therapy. Talking with a professional mental health counselor is without a doubt one of the most successful treatment methods. This allows a person to discuss and confront issues they may have. From a counseling standpoint, working with people who have eating disorders can be frustrating and requires great patience. A licensed professional can also help with other mental health problems that could be present. Some professionals specialize in just eating disorders.
- Improving one’s relationship with food. Changing behaviors and improving one’s relationship with food is paramount. Making necessary changes to the way people view food, quantities, types, frequency, etc. is necessary. This includes finding the diet that works well for the individual. This is much more difficult than people would expect.
- Unlearning negative behaviors. Behavioral modification is essential, changing the current dynamics with food is more challenging. Often, people will be unlearning years and decades of behaviors.
- Food logs. For both people who eat too much and too little, keeping a food log can help to improve eating behaviors. This is also helpful tool for counselors, family, and other members of a person’s support system.
- Other changes in life. Getting in a health routine with diet, exercise, and other behavioral life choices can have an influence on eating disorders. Finding a healthy balance is crucial.
- Nutritionists. Having an expert in the field of nutrition can be very helpful for people to form a healthy eating.
- Medication. In extreme instances, psychopharmaceutical medications, like anti-anxiety and anti-depression meds are used. This should be done as a last resort and in conjunction with talk therapy and other behavioral improvements.
Eating disorders can be difficult for the individual, family, friends, and other people in a person’s life. Getting help is important and necessary. Encourage loved ones to reach out and get the help that he or she needs. People can improve, get healthy, and live awesome and fulfilling lives. Support and encourage people to be the healthiest version of themselves. Read here for more facts about Eating Disorders