What are eating disorders?
Eating disorders are psychological disorders that affect how the person thinks and behaves with food. Most eating disorders are characterised by an excessive worry about weight, body shape, and food, causing risky food behaviours that prevent the body from getting the nutrients it needs. The person becomes obsessed with thinness and tries to follow specific cultural slim standards by modifying the way they eat, eating much more or less of what is recommended.
In some eating disorders, like anorexia or bulimia, the person diets and restricts the caloric intake to lose weight. In anorexia, patients may altogether avoid eating, failing to provide the body with the nutrients it requires and losing excessive weight. In bulimia, restrictions are followed by episodes of binge eating, where the person loses control and eat vast amounts of food in a short period.
Eating disorders can cause important physical issues in the heart, digestive system, bones, and teeth and trigger other diseases. Frequently, these disorders manifest in teenagers and the first years of adulthood, although they can develop at any age.
Types of eating disorders
Eating disorders can be varied. Here we present the most common ones:
- Anorexia nervosa: it is characterised by an important food restriction, lower than what is recommended, with the purpose to lose weight or avoid gaining weight. The person has an intense fear to gain weight and a distorted body image. Perception of anorexia can also be altered, and people with the condition can see themselves as thinner than in reality.
- Bulimia nervosa: people with bulimia suffer frequent episodes of binge eating followed by compensating behaviours and restrictions. During the binge eating episodes, they can eat a large amount of food in limited periods, feeling a loss of control and intense guilt and shame. To avoid putting on weight and compensate for the calories eaten during the binge, they perform compensatory behaviours, such as vomiting, laxatives, fasting, or excessive working out. As in anorexia, behind bulimia, there is an extreme worry about thinness and body weight.
- Binge eating disorder: people with binge eating disorder suffer frequent episodes of binge eating, where they eat large amounts of food during a limited period. They tend to eat faster and with a sense of loss of control over food and shame. The main difference with bulimia is that there are no compensatory behaviours in binge eating disorders. People with this condition often gain weight and have obesity.
- Avoidant restrictive food intake disorder: people with this issue avoid or restrict eating food. They don’t eat because they dislike the smell, taste, texture or colour of the food and may fear vomiting or choking with food. However, they don’t suffer from anorexia or bulimia, don’t fear to gain weight or have a distorted body image. Because they don’t eat what’s needed, people with the disorder may lose weight or fail to maintain a healthy one.
- Orthorexia: it is an obsession for eating healthily, leading to the restriction of certain types of food and sometimes malnutrition. They often spend excessive time planning their diet, although it may be an unbalanced one.
- Bigorexia: also known as muscle dysmorphia, is a body dysmorphic disorder that shares some symptoms with anorexia nervosa. It is more frequent in men, and it is presented as an extreme obsession with building muscles. They have a distorted perception of their bodies and try to compensate by consuming products to increase their muscles and work out intensively.
Different factors influence the development of eating disorders:
- Genetics: having a family member with an eating disorder increases the probability to suffer one. However, having a parent or brother with an eating disorder doesn’t mean you will develop the same issue, as other factors are also essential to triggering these disorders. There is only a genetic predisposition.
- Psychological factors: certain personality traits, such as perfectionism, can increase the vulnerability to develop an eating disorder. For instance, people with obsessive traits are more prone to develop anorexia, and those with anxiety are more susceptible to having bulimia. Having low self-esteem or the tendency to lose control can lead you to use food to compensate for your problems in other areas of your life. Stress, low tolerance to frustration and emotional instability can trigger eating disorders.
- Social: culture and society pressure individuals to follow specific beauty standards. A thin culture constantly transmits the idea that being slim is a synonym of success, and fatness means failure. These thinness standards are unrealistic, making most people feel inadequate and often pushing them to risky diets that lead to obsessions with food and weight.
The symptoms of eating disorders include physical, behavioural, psychological and social problems. However, they depend on the type of eating disorder. Some of the symptoms that can be seen in eating disorders are described below.
- Physical symptoms: diets not only affect weight it also impacts the metabolism and endocrine systems. When the body doesn’t get the nutrients it needs, you can get headaches, sleeping problems, focus issues, tiredness and fatigue. In the most extreme cases, if you suffer from anorexia, you can have anaemia, hypotension or malnutrition. Additionally, it is common for women with eating disorders to lose their period.
- Mood changes: food intervenes in producing hormones and neurotransmitters; hence, the person can be more irritable and more prone to develop depression with an unbalanced diet.
- Social relationship issues: people with eating disorders can isolate socially to avoid social events related to food, increasing the feelings of loneliness.
- Psychological symptoms: eating disorders change the way you see and relate to yourself. Body image may be distorted, and there are often feelings of shame and guilt.
To reduce the probability to develop an eating disorder, certain things can be done:
- Learning healthy eating behaviours
- Promoting active and moderate exercising
- Cultivating self-esteem and self-compassion
- Question the cultural messages that associate thinness with success and beauty
- Avoid diets and food restriction
- Seek psychological help if the worry about the body weight and shape becomes a problem
Health professionals can diagnose eating disorders by analysing the medical history, symptoms, thought patterns, food behaviour and physical exploration.
Psychotherapy is essential to recover from an eating disorder. Therapy can help replace unhelpful patterns of thought for others more realistic, teach problem-solving skills, improve social relationships, increase positive mood, develop new ways to cope with unpleasant emotions, and learn how to eat healthily.
The following types of therapies can help in eating disorders:
- Cognitive-behavioural therapy (CBT): CBT has been proven successful therapy for eating disorders. The person learns his pattern of thoughts, feelings, physical reactions and behaviours in distressful situations, and challenges unhelpful and unrealistic thoughts that cause problems, replacing them with others more valid.
- Systemic therapy: this is a therapy that involves the whole family. All the members learn about the condition and help the patient recover and gain healthy eating behaviours.
When necessary, dietitians work with psychotherapists to help you learn and acquire healthy eating behaviours. The goals of nutrition education are:
- Obtaining a healthy weight.
- Address physical issues caused by malnutrition or obesity.
- Learning how food affects the body and discovering the psychical consequences of eating disorders.
- Practising meals planning.
- Establishing regular eating patterns.
- Raising awareness about the negative impact of diets and binges
Medication can’t treat an eating disorder by itself. They are more effective when used in combination with psychotherapy.
Antidepressants are the most used drugs used for eating disorders which symptoms include binges or purges. Hence, they tend to be used in cases of bulimia or binge eating disorders. They can only be prescribed when there are also symptoms of depression or anxiety.
- BEAT – Eating disorders charity
- NHS information about eating disorders
- Most common types of eating disorders