Eating Disorder Recovery
Finding a way out
What are eating disorders?
Eating disorders are illnesses characterised by irregular eating habits and severe distress or concern about body weight or shape. These generally stem from an obsession with food, body weight or body shape and often result in serious health consequences. In some cases, eating disorders even result in death.
Individuals with eating disorders can have a variety of symptoms. However, most include the severe restriction of food, food binges, inappropriate purging behaviors like vomiting or over-exercising, and an over-emphasis on healthy eating and physical appearance.
Although eating disorders can affect people of any gender at any life stage, they’re most often initially reported in adolescents and young women.
Types of eating disorders
Anorexia nervosa is likely the most well-known eating disorder. It generally develops during adolescence or young adulthood and tends to affect more women than men. People with anorexia generally view themselves as overweight, even if they’re dangerously underweight. They tend to constantly monitor their weight, avoid eating certain types of foods and severely restrict their calories.
Common symptoms of anorexia nervosa include:
- Being considerably underweight compared to people of similar age and height.
- Very restricted eating patterns.
- An intense fear of gaining weight or persistent behaviors to avoid gaining weight, despite being underweight.
- A relentless pursuit of thinness and unwillingness to maintain a healthy weight.
- A heavy influence of body weight or perceived body shape on self-esteem.
- A distorted body image, including denial of being seriously underweight.
- Obsessive-compulsive symptoms are also often present. For instance, many people with anorexia are preoccupied with constant thoughts about food, and some may even obsessively collect recipes or hoard foods.
- Such individuals may also have difficulty eating in public and have a strong desire to control their environment, limiting their ability to be spontaneous.
Anorexia is officially categorized into two subtypes — the restricting type and the binge-eating and purging type. Individuals with the restricting type lose weight solely through dieting, fasting or excessive exercise. Individuals with the binge-eating and purging type may binge on large amounts of food or eat very little. In both cases, after they eat, they purge using activities including vomiting, taking laxatives or diuretics or exercising excessively.
Anorexia can be very damaging to the body. Over time, individuals living with it may experience the thinning of their bones, infertility, brittle hair and nails and the growth of a layer of fine hair all over their body. In severe cases, anorexia can result in heart, brain or multi-organ failure and death.
Bulimia nervosa is another well-known eating disorder. Just like anorexia, bulimia tends to develop during adolescence and early adulthood and appears to be less common among men than women.
People with bulimia frequently eat unusually large amounts of food in a relatively short period. Each binge-eating episode usually continues until the person becomes painfully full. Moreover, during a binge, the person usually feels that they cannot stop eating or control how much they are eating. Binges can happen with any type of food, but most commonly occur with foods the individual would normally avoid. Individuals with bulimia then attempt to purge to compensate for the calories consumed and relieve gut discomfort. Common purging behaviors include forced vomiting, fasting, laxatives, diuretics, enemas and excessive exercise.
Symptoms may appear very similar to the binge-eating or purging subtypes of anorexia nervosa. However, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight.
Common symptoms of bulimia nervosa include:
- Recurrent episodes of binge eating, with a feeling of lack of control
- Recurrent episodes of inappropriate purging behaviors to prevent weight gain
- A self-esteem overly influenced by body shape and weight
- A fear of gaining weight, despite having a normal weight
Side effects of bulimia may include an inflamed and sore throat, swollen salivary glands, worn tooth enamel, tooth decay, acid reflux, irritation of the gut, severe dehydration and hormonal disturbances. In severe cases, bulimia can also create an imbalance in body levels of electrolytes such as sodium, potassium and calcium. This can cause a stroke or heart attack.
Binge Eating Disorder
Binge eating was only officially recognized as an eating disorder relatively recently. However, it is currently believed to be one of the most common eating disorders. Binge eating disorder typically begins during adolescence and early adulthood, although it can also develop later on.
Individuals with this disorder have similar symptoms to those with bulimia or the binge-eating subtype of anorexia. For instance, they typically eat unusually large amounts of food in relatively short periods of time and usually feel a lack of control during binges. However, contrary to the two previous disorders, people with binge eating disorder do not restrict calories or use purging behaviors such as vomiting or excessive exercise to compensate for their binges.
Common symptoms of binge eating disorder include:
- Eating large amounts of foods rapidly, in secret and until uncomfortably full, despite not feeling hungry.
- Feeling a lack of control during episodes of binge eating.
- Feelings of distress, such as shame, disgust or guilt, when thinking about the binge-eating behavior.
- No use of purging behaviors, such as calorie restriction, vomiting, excessive exercise or laxative or diuretic use, to compensate for the binging.
People with binge eating disorder are often overweight or obese. This may increase their risk of medical complications linked to excess weight, such as heart disease, stroke and type 2 diabetes.
Orthorexia has not yet been officially recognized as a separate eating disorder by the current DSM, but more and more individuals are suffering with it. Individuals with orthorexia tend to have an obsessive focus on healthy eating, to an extent that disrupts their daily lives.
For instance, the affected person may eliminate entire food groups, fearing they’re unhealthy. This can lead to malnutrition, severe weight loss, difficulty eating outside the home and emotional distress.
Individuals with orthorexia rarely focus on losing weight. Instead, their self-worth, identity or satisfaction is dependent on how well they comply with their self-imposed diet rules.
Individuals with this disorder often use purging behaviors, such as vomiting, laxatives, diuretics or excessive exercising, to control their weight or shape. However, they do not binge.
Night eating syndrome
Individuals with this syndrome frequently eat excessively, often after awakening from sleep.
Eating disorder not otherwise specified (EDNOS)
This includes any other possible conditions that have symptoms similar to those of an eating disorder but don’t fit into any of the categories above.
Pica is another entirely new condition only recently recognized as an eating disorder by the DSM. Individuals with pica crave non-food substances such as ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent or cornstarch. Pica can occur in adults, as well as children and adolescents. That said, this disorder is most frequently observed in children, pregnant women and individuals with mental disabilities.
Individuals with pica may be at an increased risk of poisoning, infections, gut injuries and nutrition deficiencies. Depending on the substances ingested, pica may be fatal.
However, to be considered pica, the eating of non-food substances must not be a normal part of someone’s culture or religion. In addition, it must not be considered a socially acceptable practice by a person’s peers.
Rumination disorder is another newly recognized eating disorder. It describes a condition in which a person regurgitates food they have previously chewed and swallowed, re-chews it and then either re-swallows it or spits it out. This rumination typically occurs within the first 30 minutes after a meal. Unlike medical conditions such as reflux, it is voluntary.
This disorder can develop during infancy, childhood or adulthood. In infants, it tends to develop between three and 12 months and often disappears on its own. Children and adults with the condition usually require therapy to resolve it. If not resolved in infants, rumination disorder can result in weight loss and severe malnutrition that can be fatal.
Adults with this disorder may restrict the amount of food they eat, especially in public. This may lead them to lose weight and become underweight.
Avoidant or Restrictive Food Intake Disorder
Avoidant or restrictive food intake disorder (ARFID) is a new name for an old disorder. It actually replaces what was known as a “feeding disorder of infancy and early childhood,” a diagnosis previously reserved for children under seven years old. Although ARFID generally develops during infancy or early childhood, it can persist into adulthood. What’s more, it is equally common in men and women. Individuals with this disorder experience disturbed eating either due to a lack of interest in eating or a distaste for certain smells, tastes, colors, textures or temperatures.
Common symptoms of ARFID include:
- Avoidance or restriction of food intake that prevents the person from eating sufficient calories or nutrients.
- Eating habits that interfere with normal social functions, such as eating with others.
- Weight loss or poor development for age and height.
- Nutrient deficiencies or dependence on supplements or tube feeding.
It’s important to note that ARFID goes beyond normal behaviors, such as picky eating in toddlers or a lower food intake in older adults. Moreover, it does not include the avoidance or restriction of foods due to lack of availability or religious or cultural practices.
Do I have an eating disorder?
Reflect on the following checklist. Should you answer yes to multiple symptoms over at least a three month period, you may be experiencing an Eating Disorder.
- Restriction of energy intake (food and drink) relative to physical requirements
- Engagement in purging behaviours (e.g. self-induced vomiting, excessive exercise)
- Intense fear of weight gain or of becoming fat
- Disturbance in the way one’s body weight and shape is perceived, placing over-importance on the influence of body weight or shape on self-evaluation, or persistently failing to recognise the seriousness of low body weight
- Eating an amount of food in a discrete time period that is definitely larger than what is normal for most individuals in a similar timeframe and circumstance, and feeling out of control whilst doing so
- Eating more rapidly than normal
- Eating until uncomfortably full
- Eating large amounts when not hungry
- Eating alone due to embarrassment over the amount one is eating
- Feeling disgusted, depressed or guilty after the eating episode
- Less than minimally expected body weight for age, gender, development stage and health status.
- Obsessive concern over the relationship between food choices and health concerns such as digestive problems or food allergies
- Feelings of guilt when deviating from strict diet guidelines
- Feelings of satisfaction, esteem or spiritual fulfillment from eating “healthy”
- Fear of eating away from home due to not being able to comply with diet or avoiding food prepared by others