Eating Disorders Explained

 What is an Eating Disorder? To start off, let’s get our definitions straight. An eating disorder is a disturbance between someone’s eating behavior and their related thoughts and emotions. People with eating disorders typically become preoccupied with food and their body weight.

What is an Eating Disorder Not? Having an eating disorder is NOT a lifestyle choice. In fact, it’s considered a complex medical and psychiatric illness. Health professionals consider eating disorders to be a bio-psycho-social disease. This means that the genetic, biological, environmental, and social elements in one's life all play a role.

What is Normal Eating? Non-disordered, or “normal,” eating is when a person is able to mindfully consume food when they are hungry, and stop when they are full. Additionally, they’re able to incorporate variety into their diet. Overall, a normal relationship with food would entail that there isn’t unnecessary stress or emotion tied to food or eating in general.

Eating Disorder Vs. Disordered Eating Have you heard the term ‘disordered eating?’ Sometimes it refers to people who are overly-conscious of the foods they eat or who partake in eating habits that could be deemed ‘not normal.’ These habits could include: fasting, leaving out certain food groups, dieting, counting calories, or eating when bored. Societal standards and pressures, as well as our fascination and obsession with weight-loss and exercise, can lead people to alter and manipulate their food intake. For some people, these limitations or regulations ‘work’ and don't interfere with their lives. They’re able to get all their nutrients, regularly consume food that they enjoy, and there’s no desire to change. For others, this behavior leads to a full-on eating disorder.

How To Know the Difference From a clinical perspective, anyone who has a non-normalized relationship with food could benefit from some introspective thinking and reflection about why they make the choices they do when it comes to creating their diet and eating habits. Many people partake in disordered eating habits but don’t suffer any major health consequences—after all, everybody is built differently. That being said, if you’re not sure what type of help or resources are needed for a specific situation, you should keep three things in mind: behavior, obsession, and functionality.

How to Spot an Eating Disorder Behavior Obsession Functionality Behavior: An individual suffering from an eating disorder will likely portray abnormal behaviors in relation to the food they eat, their own body image, or their mood. This differs for everyone, and we’ll discuss it in more detail later on.

Obsession: The level of obsession involved with food can distinguish an eating disorder from disordered eating. For those living with an eating disorder, thoughts of food are generally all-consuming, and can impair focus, the ability to stay present, and even sleep.

Functionality: The last factor to consider is how a person’s functionality is affected by their eating habits. Are they missing out on events in order to exercise? Are they skipping dinners out because they fear eating in front of people? In other words, are their food-related choices resulting in a lack of typical lifestyle function?

Addressing Some Misconceptions It’s a common misconception that eating disorders only affect women. This is not true. While it is more common for women between the ages of 12-35 to develop eating disorders, they can affect any gender at any age. Another misconception is that eating disorders only result in weight loss, or can only exist in extremely thin people—this is also untrue. In fact, there are three main types of eating disorders, anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Anorexia Nervosa Anorexia nervosa is diagnosed when a patient weighs at least 15% less than the normal healthy weight expected for their height. People living with this disorder typically refuse to eat a healthy amount of food, are highly restrictive of their food intake, and exercise obsessively.

Signs to Look Out For People with anorexia feel that they can never be thin enough and continue to see themselves as “fat” despite extreme weight loss. They may weigh themselves repeatedly, show symptoms of low self-esteem, and are outwardly and openly critical of themselves and their bodies.

Symptoms and Side Effects Over time, the following symptoms and health risks can develop as the body goes into starvation: - Dramatic weight loss and refusal to maintain an unhealthy body weight - Wearing baggy clothes or layers to hide body shape - A preoccupation with weight, exercise and/or calories - Food restriction and avoidance - Belief life will be better if weight is lost - Use of diet pills, laxatives and/or enemas - Isolation and fear of eating with others - Food rituals and secretive eating patterns - Disposing of food in strange places - Keeping a "food diary" or lists of calories and exercise - Hair loss, sunken eyes, pale skin - Dizziness and headaches - Feeling cold - Low blood pressure and heart rate - Loss of menstrual cycle or irregular menstrual periods - Constipation, stomach pain - Perfectionist personality - Loss of sexual desire - Mood swings, depression, anxiety and/or fatigue - Trouble sleeping

Bulimia Nervosa One of the most important things to note about bulimia is that people suffering from it can be slightly underweight, normal weight, overweight, or even obese. Patients with bulimia will binge-eat, then purge (by vomiting or using a laxative). When they binge, they may eat an astounding amount of food, usually rapidly and without even tasting it. These binges usually are only interrupted by another person, when they fall asleep, or if their stomach physically cannot handle any more food. During these binges, sufferers feel out of control, and control is ‘regained’ by purging. This cycle is repeated several times a week, or in some severe cases, several times a day.

Signs to Look Out For People living with bulimia almost always hide their binges. Since they don’t become drastically thin, their behaviors can go unnoticed and slide under the radar of loved ones around them. One giveaway is when an individual takes trips to the bathroom following meals, sometimes using running water to hide the sound of vomiting.

Symptoms and Side Effects In addition to the signs and symptoms listed above for anorexia, symptoms of bulimia can include: - Chronically inflamed and sore throat - Swollen salivary glands in the neck and jaw area - Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid - Acid reflux disorder and other gastrointestinal problems - Intestinal distress and irritation from laxative abuse - Severe dehydration from purging of fluids

- Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack. Over time, bulimia can lead to rare but potentially fatal complications including esophageal tears, gastric rupture, and cardiac arrhythmias.

Binge Eating Disorder The main difference between bulimia and binge eating is that people who partake in binge-eating behaviors do not try and get rid of the food by inducing vomiting, fasting, or laxative abuse. A patient diagnosed with binge eating has lost control over their eating. Binge eating disorder is the most common eating disorder in the United States.

Signs to Look Out For If you or someone you love is eating unusually large amounts of food in a specific amount of time (like within a 2-hour period), eating when they’re not hungry, eating quickly, eating alone, or frequently dieting without weight loss, they could be partaking in binge eating.

Symptoms and Side Effects Binge eating habits can result in health issues such as high blood pressure, high cholesterol, diabetes, kidney disease, bone loss, and other effects of obesity.

Connecting Behavior with Intention As humans, we need food to survive. We’re wired to love food and derive pleasure from eating, but sometimes, that relationship becomes abusive. When it comes to treating an eating disorder, the first step is to decipher WHY we behave the way we do when it comes to food-related behavior.

Tackling the Psychiatric Component By this point, I hope I’ve made it very clear that our relationship with food is closely tied to emotion, and often control (or lack of it). People with eating disorders can often have other mental health issues such as depression and/or anxiety and use food as a way to cope with the feelings that stem from those issues. That’s why it’s important for those living with eating disorders to opt-in to a treatment plan that includes some sort of individual, group, or family psychotherapy or counseling.

Nutrition Counseling In addition to mental health care, nutritional care is also of the utmost importance when treating an eating disorder. Because eating disorders create a morphed relationship with or fear of food, it usually takes a nutritionist’s expertise to correct misperceptions and help a patient create a well-rounded and healthy way of thinking about, preparing, and eating food.

Complementary Therapies Massage, mindfulness, chiropractic care, acupuncture, and energy medicine therapies are just a few of the options that an individual can add to their treatment plan in order to cope more effectively with emotions, triggers, and situations that might lead back to disordered eating behaviors.

Recovery is Possible I’ve seen many people recover from eating disorders and go on to live happy healthy lives. “When you say no to an eating disorder, you’re saying yes to something else—to a healthy choice, to another step leading you closer to freedom.”

Let the Journey Towards Healthier Eating Begin We’ve arrived at the end of this class, but your journey has just begun!

I hope that you have learned something valuable and you feel better equipped to take the next step toward helping yourself or someone you love with their eating disorder. Please feel free to reach out to me with any questions, thoughts or concerns. www.susanlopresti.com