Hi friends! Today’s post is a rather serious. As you can tell from the title “Eating Disorders, Defined,” I want to chat about eating disorders. I am going to follow this post up with a post about why we need to stop normalizing disordered eating behaviors, but I thought this was a good intro post to lay out the definitions of eating disorders to refer back to.
I hope you learn a little bit more about what eating disorders are, and why they are serious. I remember one of my favorite child/adolescent mental health professors in undergrad always telling us to strive to “understand, rather than judge,” and I hope this post encourages you to do the same.
Whether you are struggling silently, out loud, or just reading for general information, know that there is hope.
Read on for for more!
Disclaimer: As always, this is general information. Please never replace individualized clinical care with generalized health information you read online. If you or someone you know suffers from an eating disorder, please see the National Eating Disorders Association website or text ‘NEDA’ to 741741 for 24/7 crisis support.
Eating Disorders, Defined:
First let’s get something really clear: eating disorders are serious, often debilitating and potentially deadly psychological illnesses; they are not ‘phases’ or something someone can just ‘snap out of.’ And something I cannot stress enough: they are rarely about vanity. For those of you who like to get technical, I’ve thought I’d provide some current definitions below.
Eating disorders come in many shapes and sizes. Eating disorders are serious and sometimes deadly mental illnesses in which the individual is functionally impaired due to severe disturbances in their eating behaviors and food-related thoughts.
Often times, eating disorders are characterized by an immense preoccupation with food and the body, and the preoccupation often impacts to emotional well-being of the individual.
What causes eating disorders?
There is no one single cause of eating disorders. Likely, eating disorders emerge as a complex result of genetic, social, environmental, and/or psychosocial variables that lead to an individual to have a preoccupation with food and body.
What are important things to know about eating disorders?
As mentioned above, eating disorders are serious, debilitating diseases, and can be life-threatening.
Eating disorders have a higher death rate compared to any other mental illnesses; every 62 minutes someone dies from a direct result of an eating disorder.
At least 30 million Americans suffer from an eating disorder (according to ANAD). There are likely more who have not been diagnosed.
Eating disorders are found most commonly in adolescents and young adults but may present at other ages. Both males and females are impacted by eating disorders.
Eating disorders are not diseases of vanity. They can severely and significantly impair an individuals social, functional, and occupational and emotional well-being.
Weight loss may be a sign or symptom of some eating disorders, but individuals of different weights may have eating disorders.
Those with eating disorders often take immense measures to hide their disorder and may become socially isolated.
Early detection is crucial. If you or someone you know suffers from an eating disorder, seek help. Treatment is available, and there is always hope.
Anorexia is one of the most well known eating disorders. By definition, anorexia nervosa is characterized by extremely restricted eating, extreme thinness, a relentless pursuit of thinness and unwillingness to maintain a normal weight, and a distorted body image.
Left untreated, anorexia can lead to thinning of the bones, lethargy, anemia, brittle hair and nails, yellowish and dry skin, fine hair growth over the body, constipation, brain damage, multi-organ failure, infertility, and death. In fact, anorexia is known to be the most deadly of all psychological illnesses, claiming more lives than depression and suicide.
Bulimia nervosa involves recurrent and frequent episodes of eating unusually large amounts of food, followed by purging of the food, and can take many forms. A person may physically purge food by vomiting, or they may compensate in other ways, by over-exercising, taking laxatives, or following food consumption with restriction for a long period of time.
Bulimia can lead to electrolyte imbalances, acid reflex, GI problems, internal bleeding, organ damage, dehydration, inflammation of the throat, and, if purging via vomiting, tooth decay.
Sometimes, bulimia is paired with anorexia, and may manifest as a cycle of binging followed by restricting. Individuals Bulimia Nervosa may be of any weight.
Binge Eating Disorder (BED):
Binge eating disorder (BED) occurs when a person loses control of their eating.
While it’s normal to eat past fullness sometimes, BED is characterized by eating unusually large amounts of food in short windows, often quickly, and beyond a point of physical discomfort. The individual feels out of control of their behavior.
Often times, foods eaten during binge episodes are high in fats and added sugars.
Unlike bulimia, binge episodes are not followed by episodes of purging. Those suffering from BED may eat alone to avoid embarrassment, and the disorder is often associated with distress, shame, and guilt.
BED may lead to increased risk of diabetes, high blood pressure, depression and social isolation.
Other Specified Feeding or Eating Disorders (OSFED)
“OSFED,” also known as “other specified feeding or eating disorders,” has replaced the “EDNOS” diagnosis in the most recent version of the DSM.
The diagnosis of EDNOS is a catch-all of sorts; the diagnosis is given when a person doesn’t hit all the precise diagnostic criteria of a specific ED, but is still in need of treatment.
While individuals with the OSFED diagnosis may not present as “textbook” eating disordered patients as those above, they often experience just as many functional impairments in their daily lives and are no less serious.
Examples of the OSFED diagnosis include: atypical anorexia, low-frequency BED, low frequency bulimia nervosa, purging disorder (recurrent purging in the absence of binges), and night eating syndrome (excessive eating at night not characterized by environmental factors which may explain the behavior).
For example, adults with “atypical” or “subclinical” anorexia may have just as many obtrusive eating disorder thoughts and behaviors as those with the alternative diagnosis and may have just as many medical complications.
The diagnosis of OSFED helps individuals get the help they need.
More recently, orthorexia has gained attention. Orthorexia nervosa is not currently a DSM-diagnosis. But, it is thought by some, that it may be one day. Orthorexia means ‘correct diet,’ and basically describes a person that has taken ‘healthy’ or ‘clean eating’ to an extreme so that it becomes functionally impairing.
There is a clear obsessive focus on ‘healthy’ eating, and is frequently associated with self-imposed dietary rules or restrictions, escalating dietary restrictions, and an exaggerated fear of food not part of a person’s ritualistic or ‘healthy’ eating pattern.
A lot of people experience some ED-thought patterns or behaviors without experiencing a full-blown eating disorder. I think learning about the different disorders and their signs and symptoms can help us all recognize them if we see or feel them in ourselves and others.
Pica is an eating disorder characterized by consumption of foods without nutritional value, including dirt, wool, string, ice, hair, paint, and more.
Iron-deficiency anemia is one of the most common causes of pica, as inadequate iron consumption may lead an individual to crave ice (this is a classic presentation in pregnancy, a period during which iron requirements are much higher).
Other mental illnesses may also lead to pica.
Rumination disorder involves regular regurgitation of food without making an effort to do so, and occurs in the absence of stress, disgust or distress.
Regurgitation of food must occur for at least one month and is unexplained by a medical condition or in the context of another eating disorder.
Unspecified Feeding or Eating Disorder
Unspecified Feeding or Eating Disorder (UFED) is characterized by presentation of an individual that does not have symptoms of any eating disorder mentioned above, but is still experiencing social, occupational, or other important characteristics.
Compulsive exercise is not classified as a DSM-V diagnosis, but impacts many individuals with and without clinically diagnosed eating disorders.
Compulsive exercise is characterized by excessive, rigid exercise regimens, despite poor weather, injury, illness or fatigue, and discomfort, irritability, anxiety or feelings of guilt/distress upon missing a workout.
Exercise is used inappropriately to purge meals, “earn” foods or the right to eat, and/or may be done in secret or hidden.
What is the difference between eating disorders and disordered eating?
I’m so glad you asked. I have a whole post about that, which I encourage you to read if you are curious.
Thank you for reading! I hope you learned something about what eating disorders are, and how they are defined.
And once again, if you or someone you know is suffering from an eating disorder, please see the National Eating Disorders Association website or text ‘NEDA’ to 741741 for 24/7 crisis support.
*The DSM is an official manual published by the American Psychiatric Association that defines criteria for diagnosing psychological illnesses.
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