Eating disorders are characterized by unhealthy, obsessive, extreme, and self-destructive relationships with food that can harm a person’s mental and physical health in severe ways. Eating disorders quite often develop due to a desire for a certain body image, weight, and shape that affects a person’s self-esteem mentally and emotionally.
Over 20 million women are victims of eating disorders that commonly involve self-abusive eating habits such as starvation, binge-eating, purging, and over-exercising. Such extreme behaviors can negatively impact one’s physical health, leading to nutritional deficiency, and consequently, a host of systemic diseases.
People with eating disorders such as Anorexia or Bulimia Nervosa tend to pay attention to the readings on the scale and packages, and their appearance in the mirror. They quite often avoid eating food with others and usually eat food either alone or after counting the calories of their meals. Due to malnutrition, these people fail to focus and suffer from a lack of concentration, dizziness, and extreme mood swings.
Types of Eating Disorders with Symptoms
Classified into 6 common subtypes as per the DSM-5, eating disorders commonly stem during adolescence or mid-teens, but can also occur during adulthood. Eating disorders like Anorexia Nervosa and Bulimia Nervosa are commonly known to the public, but there are 4 types that are as prevalent and worthy of recognition.
Anorexia Nervosa typically manifests in adolescence and is associated with a perceived misconception regarding one’s weight. People with anorexia are typically underweight, yet perceive themselves to be excessively overweight, which inadvertently leads to restrictive eating behaviors.
More commonly found in women, anorexia nervosa often causes the patient to hyperfixate on their calorie intake, body weight, and body contours. Apart from reducing daily calories, patients with anorexia often indulge in purging behaviors, dietary aids, or laxatives to overcome their guilt of eating food. Anorexia Nervosa can lead to starvation, causing interference in day-to-day activities due to lack of energy and malnutrition.
Bulimia Nervosa is associated with recurrent bouts of binge-eating and purging behaviors that harm a person’s mental and physical health brutally. Bulimia and Anorexia Nervosa are quite often confused due to their overlapping symptoms, as in the case of their binge-eating and purging episodes.
But, three distinctive features of people with Bulimia Nervosa are that one, they often lose control over the sight of food that they normally perceive as unhealthy. Secondly, due to a lack of control over their diet, they consume more calories than desired, which leads them to discomfort and intense guilt. Thirdly, unlike those with Anorexia, people with Bulimia aim to maintain a healthy weight but are often fearful and less confident about gaining a few pounds.
Such binge-eating episodes consequently result in shame and self-hatred for distorting one’s body image. In order to compensate for the binge-eating guilt trip, people with bulimia nervosa resort to purgatory behaviors such as self-induced vomiting leading to swelling of salivary (parotid) glands, excessive use of laxatives, diuretics, extreme exercise regimens, and/or fasting.
Patients with binge eating disorder often lose control over the sight of food and consume excessive amounts of calories despite feeling guilty and distressed. Unlike Bulimia Nervosa, those with the binge-eating disorder might feel shame and disgust for eating large amounts of food but do not resort to purgatory behaviors to compensate for their lack of control. Binge-eating disorders are usually at risk of being overweight or obese; both of which can lead to obesity, diabetes, and heart diseases.
Associated with primarily nutritional deficiencies, iron in particular, Pica is an eating disorder where people have intense and compulsive cravings of non-food substances. Some of the most common non-foods include earth or soil, clay, chalk, paint, and ice. Other non-food items might include wool, cloth, hair, soap, paper, and even detergent or cornstarch.
Most commonly due to iron deficiency or anemia, pica is quite common in children, adolescents, and pregnant women. Similar to any other eating disorder, Pica should be treated immediately as it can ultimately result in malnutrition or death in the case of harmful substances. Pica is not a culturally, morally, or religiously acceptable eating behavior, and thus, should not be overlooked in any case.
Rumination Eating Disorder is a recently introduced term used to describe people who often indulge in regurgitating behaviors. Rumination Syndrome is also called Mercyism, in which a patient regurgitates and swallowed the food in order to rechew and re-swallow or spit it out.
Rumination typically occurs shortly after completing a meal when the food is still in its first stages of digestion and has not been mixed with stomach acid. There are no purgatory behaviors involved to get rid of the food after being swallowed. Another distinctive hallmark of rumination eating disorder is the fact that it has no association with an organic cause.
Rumination Eating Disorder
Regurgitation is a reflex, but in rumination eating syndrome, it is either self-inflicted intentionally or unintentionally due to recurrent practice. Rumination syndrome arises typically in children, but can also occur in infants aged 3 to 12 months.
Regurgitation behaviors also occur in gastro-intestinal reflux disease or pyloric stenosis, but in rumination eating disorder, there is no organic cause involved. Regurgitation in rumination disorder most commonly leads to indigestion due to repeated regurgitation of food, chapped lips, bad breath or mouth odor, tooth cavities and decay, and belching. It can also result in weight loss as people with rumination tend to avoid eating food in public.
Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID was exclusively reserved as a diagnostic feeding disorder in infants as well as children younger than 7 years of age. However, with the recent updates in DSM-5, ARFID is now considered an eating disorder that can affect other age groups but is predominantly prevalent among children.
In ARFID, children tend to develop negatively conditioned responses towards selective food substances. People with ARFID find certain food items either distasteful or sensory displeasing. Such responses can either be due to a preference for certain kinds of foods or in unsaid cases, due to a past traumatic event.
Due to deliberate avoidance to specific food items, children with ARFID can develop nutritional deficiencies leading to malnutrition. They are ideally seen to avoid food in public and are often dependent on supplement intake in order to make up for the nutritional loss.
Causes and Risks
Almost all eating disorders have one root cause in common – stress caused by culturally derogatory portrayal of beauty standards. The overbearing urge to retain a specific body shape in order to be desirable and socially acceptable causes severe distress, guilt, shame, and mistreatment for one’s body.
People with eating disorders, especially children and infants, are also associated with mental disabilities and increased morbidity, or in severe cases, mortality. Eating Disorders can also occur in personality traits associated with impulsivity such as in Borderline Personality Disorder, as well as in people with core perfectionism or neuroticism.
Eating disorders often accompany over 12% of cases of Body Dysmorphic Disorder where patients, especially teens and adolescents, develop hyperfixations towards their weight and image of certain body parts.
Managing and treating an eating disorder primarily depends on the identification and resolution of its root cause. Cognitive Behavioural Therapy (CBT) is a form of psychological treatment that allows you to reassess and restructure your thoughts in a way that is helpful for your mind and body.
Many view Anorexia as a dangerous lifestyle instead of considering it dangerous and a debilitating food disorder. By challenging cultural norms and irrelevant body standards via therapy, you can acquire reassurance and techniques for maintaining body positivity and health. Reassurance and therapy can also help you develop a healthy relationship with food, and eventually, confidence in your body and food choices.
– Disclaimer –
This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.
About The AuthorDr. Syra Hanif M.D.
Board Certified Primary Care Physician
Dr. Syra Hanif is a board-certified Primary Care Physician (PCP) dedicated to providing compassionate, patient-centered healthcare.Read More