Though widely believed to be rooted in poor body image, desire for thinness, and obsession with food, eating disorders are symptoms of deeper issues often rooted in low self worth, self criticism, insecurity, identity confusion, fear of rejection, fear of abandonment, difficulties managing emotions, loneliness, boredom, unhealthy relationships, sexuality concerns, trauma, and abuse. They are often co occurring in individuals who struggle with generalized anxiety disorder, social anxiety disorder, major depressive disorder, bipolar disorder, obsessive compulsive disorder, body dysmorphia, addiction, post-traumatic stress disorder and personality disorders.
Eating Disorder FAQs:
Eating disorders can take many forms such as anorexia, bulimia, binge eating disorder, and a newly coined term (though not official diagnoses), orthorexia. Other components of disordered eating that can have a pervasive negative effect on mental, physical, and emotional well being include compulsive over exercising, compulsive dieting, laxative abuse, and body image disturbances.
Do I have an eating disorder?
If you answer “yes” to 3 of more, please seek professional help for an eating disorder assessment.
- Do I have an intense fear of becoming fat?
- Do I constantly think about weight or feeling fat?
- Do I spend excessive time thinking about food and critiquing food choices?
- Does my weight determine my self-worth?
- Do I find extreme pleasure in times of eating alone?
- Do I regularly eat when not physically hungry (emotional eating)?
- Do I feel extreme guilt or shame after eating?
- Do I label food as “good foods” and “bad foods?”
- Do I eat large amounts of food in a short period of time (less than 2 hours)?
- Do I feel out of control when I’m eating?
- Do I feel satisfaction and in control due to restricting my food intake?
- Do I have to know calories, carbs, or fat grams in the majority of food I consume?
- Do I feel self-conscience or embarrassed about eating in front of others?
- Do I often sneak food?
- Do I find myself lying about my eating habits to others?
- Do I exercise for the purpose of getting rid of calories consumed?
- Do I think I am fat when others think I do not need to lose weight?
- Do I skip meals as a way to lose or control weight?
- Have a tried self-induced vomiting?
- Have I used laxatives and/or diuretics as a means of getting rid of calories?
- Do I feel controlled by food?
- Do I have long gaps between eating to the point I feel extreme physical hunger?
- Do I eat in a certain pattern (ritual)?
- Do I feel guilty about eating?
- Do I feel a “high” for restricting my food intake?
Anorexia Nervosa: Warning Signs, Physical Consequences, and Risk Factors
Anorexia Nervosa is an eating disorder characterized by obsessive preoccupation with weight and an intense fear of weight gain. A person with anorexia typically how a low self image and fixates on physical appearance. The individual may not acknowledge that they are losing weight and continue behaviors even when they are considered underweight for their height and age making this a potentially fatal disorder.
By understanding the signs and symptoms of this disorder, as well as the consequences, you can better help a loved one who is suffering from this disorder.
- Losing a significant amount of weight
- Continuing to diet although thin
- Feeling fat, even after losing weight
- Fearing weight gain
- Losing monthly menstrual periods (may still have period if on birth control)
- Preoccupation with food, calories, and nutrition
- Exercising compulsively
- Bingeing and purging
If you see these signs in a loved one it is important to either approach that individual or tell a trusted professional about your concerns. If an eating disorder is allowed to continue untreated, there are numerous physical and mental complications that can result from the long-term malnutrition; some of which are permanent.
- Hair loss
- Gaunt, hollow facial features
- Shrunken breasts
- Dry skin
- Sharply protruding bones
- Cold and blue hands and feet
- Delayed puberty: pre-adolescent females fail to menstruate and develop breasts at a normal age; in males, testosterone levels might remain low, leading to impotence.
- Menstruation: hormone levels drop, alerting the body to become irregular or stops completely- can result in temporary or permanent infertility.
- Premature bone loss: susceptibility to stress fractures and osteoporosis.
- Mood changes: impatience, irritability, depression, suicidal tendencies
- Insomnia, constipation, sensitivity to cold, kidney failure, abnormally low heart rate and blood pressure.
Bulimia Nervosa: Warning Signs, Physical Consequences, and Risk Factors
Bulimia Nervosa involves frequent episodes of binge eating almost always followed by purging and intense feelings of shame or guilt. Usually the individual feels out of control and recognizes that their behavior is abnormal but cannot stop.
By understanding the danger signals of Bulimia Nervosa, you can help a loved one get the treatment they need.
Bingeing, or eating uncontrollably. Generally, a person binges if they eat more than what is typically normal in one sitting.
Purging can be done in multiple ways to feel one has made up for the extra food they have consumed.
Using the bathroom frequently after meals
Preoccupation with body weight
Depression or mood swings
Developing dental problems, swollen cheek glands, heartburn, and/or bloating.
Experiencing personal or family problems with alcohol or drugs
If you recognize these signs in a loved one and believe they need help it is important to either approach them about the problem or confide in a trusted professional. If left untreated, Bulimia Nervosa can have lasting physical damage.
Gastrointestinal problems: irritation of esophagus, stomach, salivary glands, and throat from persistent vomiting.
Dependency on laxatives due to weakening of intestinal muscles
Damaged or discolored teeth: gastric acids erode enamel
Lung irritation: Choking while vomiting cause food particles to lodge in lungs, causing inflammation.
Chronic loss of bodily fluids: depletes blood potassium, sodium and chloride levels, resulting in muscle spasms, weakness, irregular heartbeat, and kidney disease.
Binge Eating Disorder: Warning Signs, Physical Consequences, and Risk Factors
Compulsive eaters and overweight binge eaters also experience uncontrolled eating, sometimes kept secret. Both groups often experience depression and/or other psychological problems.
- Episodes of binge eating
- Eating when not physically hungry
- Frequent dieting
- Feeling unable to stop eating voluntarily
- Awareness that eating patterns are abnormal
- Weight fluctuations
- Depressed mood
- Social and professional successes and failures attributed to weight gain or loss
If you or a loved one have these warning signs it is important to seek the help of a trusted to professional for help in getting treatment. If left untreated, binge eating and over eating can have serious physical consequences.
- Weight related hypertension and/or fatigue
- Weight gain
- Increase in risk of diabetes, high blood pressure, and some forms of cancer (for obese individuals only)
What is Orthorexia?
Orthorexia is a term coined by Dr. Steve Bratman describing an obsessively healthy diet. This may include fixating on certain foods or ingredients as bad or impure. Those who struggle are not motivated by being thin but with eating what they believe to be healthy. Though it is an unrecognized diagnosis, it falls into the category of eating disorder NOS. Orthorexia, like other forms of eating disorders, leads to a decrease in quality of life due to time spent focused on food, obsession about food, and rigid rules about eating. Most who struggle with any kind of eating disorder do not think they have a problem. Only 1 in 10 who have an eating disorder receive treatment?
Who is at risk?
Those who are struggling with their identity, purpose, and self-worth are at risk. Most eating disorders begin between ages 12 to 25.
Family eating habits, such as not eating home cooked meals together or parents regularly on a diet have led many individuals to no longer know what is normal eating. Typically, those with more perfectionist personalities are at risk as they struggle to deal with stressors in life and begin feeling that many parts of life are out of their control. Frequently, they have friends who are focused on body image and are dieting or talking about methods for controlling their weight. This leads to feeling one has to pretend to be more put together than they are to others and/or difficulty showing emotions. Magazines, television and other media may cause anxiety and fear of how certain foods affect the body.
Others at risk are those who try to diet, get caught in an obsessive cycle which leads to extreme dieting practices.
How does it begin?
Any kind of eating disorder can start with one trying to have a healthier diet. The line gets crossed when it becomes an obsession; when a good day or bad day depends on what one ate or how much they exercised.
What does it exhibit?
Decreased in social interaction (thoughts about food intrude on relationships)
Cycling through emotional extremes
Obsessing about food
Self worth based on one’s eating practices
More pleasure out of eating “correctly” rather than enjoying the experience of eating
Feeling extreme guilt for eating foods that are not on one’s mental “healthy” food list
What or how one eats gives them a sense of achievement and control
Compulsive exercise is similar to any other addiction. It is when the individual experiences exercise as an essential need and compulsion. In addition, exercise becomes a must, instead of a choice.
Do You or a Loved One Have Any of These Warning Signs? If so, we encourage you to seek help.
- Ongoing preoccupation with exercise routine and schedule, which intercedes with one’s everyday life.
- Daily schedule is managed around one’s exercise plan.
- One plans time to exercise at the cost of anything. For example, one may sacrifice sleep, social events, school in order to exercise.
- One experiences anger, anxiety, or guilt if unable to exercise.
- It is not an option to alter or interrupt exercise routine.
- The primary drive is to control weight, shape, and/or body composition.
- Food choices are based on exercise. For example, one may exercise as punishment for eating “bad” foods, or to cancel out calories.
- One may exercise alone in order to avoid their routine being disturbed.
- Dishonesty about exercise.
- Exercise routine may not be disturbed regardless of circumstances such as, bad weather or unsafe surroundings.
- Exercise continues regardless of injury and sickness.
- For competitive athletes, exercise may be done secretively, fanatically, and above the requirements.
- Self-worth is related to exercise routine. For example, how much and/or how rigorously the routine is completed.
- For females: exercise induced amenorrhea and/or stress fractures.
Eberle G., Suzanne, MS, RD, How Much Exercise is Too Much? (2004). National Eating Disorders Association.
Kokora, Pat, RD. Compulsive Exercise and Eating Disorders. Eating Disorder Center of Denver.
Body image concerns
Signs of an Unhealthy Body Image:
- Desire to be thinner
- Comparing one’s body to others
- Disliking certain body parts
- Wearing clothes that are too large to hide body
- Weighing oneself frequently
- Seeing oneself as weighing more than what she actually is
- A strong focus on weight
- A desire to look like a certain celebrity or model
- Great increase in exercise
- Judging other people based on appearance and weight
Body Dysmorphic Disorder
Body Dysmorphic Disorder is a mental disorder characterized by a a preoccupation with a defect in the person’s physical appearance. The defect is either imagined, or, if a slight physical anomaly is present, the individual’s concern is markedly excessive. The preoccupation must cause significant distress or impairment in social, occupational, or other important areas of functioning. Last, the preoccupation cannot be better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa).
Complaints commonly involve imagined or slight flaws of the face or head such as hair thinning, acne, wrinkles, scars, vascular markings, paleness or redness of the complexion, swelling, facial asymmetry or disproportion, or excessive facial hair. Other common preoccupations include the shape, size, or some other aspect of the nose, eyes, eyelids, eyebrows, ears, mouth, lips, teeth, jaw, chin, cheeks, or head. However, any other body part may be the focus of concern (e.g., the genitals, breasts, buttocks, abdomen, arms, hands, feet, legs, hips, shoulders, spine, larger body regions, or overall body size).
The preoccupation may simultaneously focus on several body parts. Although the complaint is often specific (e.g., a “crooked” lip or a “bumpy” nose), it is sometimes vague (e.g., a “falling” face or “inadequately firm” eyes). Because of embarrassment over their concerns, some individuals with Body Dysmorphic Disorder avoid describing their “defects” in detail and may instead refer only to their general ugliness.
Most individuals with this disorder experience marked distress over their supposed deformity, often describing their preoccupations as “intensely painful,” “tormenting,” or “devastating.” Most find their preoccupations difficult to control, and they may make little or no attempt to resist them. As a result, they often spend hours a day thinking about their “defect,” to the point where these thoughts may dominate their lives. Significant impairment in many areas of functioning generally occurs. Feelings of self-consciousness about their “defect” may lead to avoidance of work or public situations.
Specific Symptoms of Body Dysmorphic Disorder
Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa or other eating disorders).