Eating disorders are complex conditions that cause people to develop unhealthy eating behaviours. They can affect people of any age and gender. There are two main types of eating disorders; anorexia nervosa and bulimia nervosa. Both of these conditions have serious medical and physical consequences. It’s important to get the right diagnosis and treatment as early as possible.
Anorexia nervosa is characterised by an intense fear of gaining weight, a distorted body image and the inability to maintain a minimum healthy weight. The condition can lead to life threatening medical complications and is the leading cause of death among mental health conditions. People with anorexia nervosa experience extreme dietary restrictions which prevent the body from obtaining enough energy to function. There are two subtypes of anorexia nervosa; the restricting type and the binge/purging type. Both types of anorexia nervosa cause the same low body weight; however, the restriction type is characterized by the severe restriction of food whereas the binge/purging type of anorexia nervosa is characterized by episodes of binge eating followed by compensatory behaviour such as self-induced vomiting or laxative misuse.
The causes of anorexia nervosa are not fully understood. They can be a combination of genetic risk factors, personal and environmental influences and psychological factors. These can include a high level of perfectionism, obsessive-compulsive traits, feelings of inadequacy or low self-esteem, a tendency to depression and anxiety and the impact of stressful life events.
There are a number of treatment options for anorexia nervosa including nutritional rehabilitation, psychotherapy and medications. The key to success is restoring a healthy body weight and the correct balance of nutrients in the blood. This will allow the brain to begin functioning normally and will improve the chances of recovery. Treatment is typically delivered by a GP or mental health professional. In some cases, if the person has life threatening medical problems or is extremely underweight, they may need to spend time in hospital to receive nutritional stabilisation and more intensive therapy.
Psychotherapy treatments for anorexia nervosa often involve cognitive remediation therapy (CRT) and acceptance and commitment therapy (ACT). CRT helps to challenge rigid thinking processes and teaches the person how to focus on more than one thing at a time. ACT encourages the person to identify their core values and work towards goals that reflect those values.
Other specified feeding or eating disorder (OSFED) is a category used to describe any condition that doesn’t fit into the categories of anorexia, bulimia or binge-eating disorder. This includes people with orthorexia nervosa, which is characterized by an obsession with healthy foods and compulsive checking of ingredient lists, and/or following ‘healthy lifestyle’ accounts on social media. The DSM-5 has not yet recognised this as a separate disorder. However, research shows that it shares many of the same characteristics as these other disorders.