About Eating Disorders

A History of Eating DisordersANAD WEEK_th.jpg

Although the term "eating disorder" is easily recognized in contemporary society, eating disorders are not a recent development by any means. Eating disorders can be traced back hundreds of years as many ancient texts depict the eating disorders we see today. But, even as late as the 1970's the term eating disorder did not exist in the way that we recognize it today. Anorexia Nervosa was so rare that there were no more than 2000 reported cases in the entire United States.  Forty years later, eating disorders affect seven to ten million women, and approximately one million men in the US alone. The good news is that by raising awareness of eating disorders, more individuals are identified and have the opportunity to seek help. 

What is an Eating Disorder?
You may have heard the terms anorexia, bulimia or binge eating disorder, but what is an eating disorder, really? It is not simply a body weight, a percentage of fat, or a desire to be skinny. It is an improper relationship with food characterized by obsessive thoughts and habits causing psychological distress. No one knows the exact causes of eating disorders, but in general, eating disorder behaviors are used to cope with anxiety or strong emotions. People with eating disorders are very anxious about what they eat, are very worried about gaining weight or looking too heavy, and spend a great deal of time thinking about these concerns. Social isolation and low self-esteem are common in those with eating disorders.

Anorexia Nervosa (AN) is a serious, potentially life-threatening eating disorder characterized by self-starvation, a drive for thinness and excessive weight loss.

Bulimia Nervosa (BN) is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting, laxative abuse or over-exercise. 

Binge Eating Disorder (BED) is a type of eating disorder characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating. An individual suffering from BED engages in frequent episodes of uncontrolled eating characterized by feeling frenzied, out of control, and consuming food past the point of being comfortably full.

Eating Disorder-Not Otherwise Specified (NOS) is the category for people who do not meet the strict criteria for Anorexia, Bulimia Nervosa, or Binge Eating Disorder, but who have significant concerns about eating and body image. Most patients do not have pure forms of eating disorders, and symptoms may cross over from one disorder to another over time.

Common Co-Morbidity (CCM) Eating Disorders often co-exist with other psychological problems. Anxiety Disorders, Depression, Bipolar Depression, Obsessive Compulsive Disorder, Alcohol and Drug addictions, and Self-Injury are commonly found in people already struggling from eating disorders. When these problems co-exist they complicate the treatment and increase the risk.

Body Dysmorphic Disorder (BDD) is defined as an excessive preoccupation with a real or imagined defect in personal appearance. People with BDD have an irrational or distorted perception of how they look, and they are obsessed with certain characteristics of their appearance. They may exaggerate a perceived flaw out of proportion and have trouble controlling obsessive, negative thoughts about "flaws" in their appearance. People with BDD may consider themselves so unattractive that social anxiety may develop due to fear of rejection from others based on this "flaw".

Why are Eating Disorders Considered Mental Health Problems?
Eating disorders are associated with emotional problems in addition to poor eating behaviors. Some of those who have eating disorders have undergone extreme distress, trauma, or abuse, which may trigger disordered behavior. Eating disorder sufferers experience both emotional and behavioral symptoms. These disorders are also closely related to many other mental health issues such as: depression, low self-esteem, loss, problems at home or with peers, surgical or dental procedures, diabetes, physical and sexual abuse, and substance abuse.

Who do Eating Disorders Affect?
Eating disorders are serious and persistent problems that touch people across all ages and races, and affect both males and females. One misconception about eating disorders is that a person has to be underweight to have an eating disorder.  People in a great deal of emotional pain and at great medical risk can be underweight, average weight, or overweight. Twenty-five percent of college-aged women engage in bingeing and purging as a weight-management technique. Up to 24 million people of all ages and genders suffer from an eating disorder (anorexia, bulimia and binge eating disorder). In the United States a recent study in the Archives of General Psychiatry showed almost equal numbers of men and women who have Anorexia Nervosa in the United States.

Mortality Rates
Sadly, eating disorders have the highest death rate of any mental illness. Eating disorders increase an individual's death rate due to both medical complications and an increased suicide risk. The mortality rates reported on those who suffer from eating disorders can vary considerably between studies and sources. Part of the reason why there is a large variance in the reported number of deaths caused by eating disorders is because those who suffer from an eating disorder may ultimately die of heart failure, organ failure, malnutrition or suicide. Often, the medical complications of death are reported instead of the eating disorder that compromised a person's health.

Early Detection of Eating Disorders is Necessary to Increase the Likelihood of Successful Treatment.
Friends, relatives, teachers and health care providers all play an important role in helping an ill person begin and continue treatment. Only 35% of people that receive treatment for eating disorders receive treatment from specialists in the field of eating disorders, and only 1 in 10 men and women with eating disorders receive any treatment. Eating disorders carry complexities unmatched by almost any other disease. Eating disorders are not simply just a physical disease; eating disorders are also biological and psychological and are impacted by genetics, societal norms, and personal belief systems. To effectively treat an eating disorder, each of these elements must be addressed. Once these areas are addressed, the reality is that recovery is possible and does happen. Eating disorders can be treated and a healthy weight can be restored. The sooner these disorders are diagnosed and treated, the better the outcomes are likely to be.