Eating disorders are serious psychiatric conditions characterized by preoccupation with food, weight or body image and related behaviors such as restrictive eating or diets, binge eating and purging behaviors (vomiting, laxative use or excessive exercise). People with these conditions often experience denial that they have a problem, and they may be at risk of physical health problems including malnutrition, heart and gastrointestinal complications and electrolyte imbalances. This is why it’s important to get treatment early, when the disorder can be most effectively treated.
There are several different kinds of eating disorders, but the three most common are anorexia nervosa, bulimia nervosa and binge-eating disorder. A person can have one or more of these conditions and it affects men and women of all ages, races, ethnicities and socioeconomic statuses. However, eating disorders are more commonly diagnosed in girls and young women than in boys and men. The reasons for this are not well understood, but may include a combination of social and cultural pressures to be thin and unrealistic genetic predisposition to be thin.
Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image. It is often associated with an underlying mood or anxiety disorder and has a high mortality rate. It is most commonly seen in those of adolescent age, but can occur at any age. Anorexia nervosa may be associated with other medical conditions including osteoporosis, heart disease and depression.
Binge-eating disorder is characterized by episodes of binge eating followed by feelings of guilt or shame. During binge episodes, people often eat quickly and eat to the point of discomfort or fullness. They often eat foods that are high in calories and/or fat, such as fast-food and sweets. They may also engage in other compensatory behaviors such as vomiting or laxative misuse, over-exercising and fasting. People with bulimia nervosa sometimes alternate between binge eating and dieting, or eating low-calorie “safe” foods while occasionally binging on “forbidden” high-calorie foods.
Other eating disorders include compulsive overeating, rumination disorder and orthorexia, which is an obsession with “healthy” or “clean” eating. Symptoms of orthorexia include chewing food for longer than necessary and hiding or concealing food. Other symptoms of eating disorders include extreme weight changes, lack of appetite, secretive or erratic eating patterns, avoiding family meals and dining in public, a desire to eat alone, hiding or throwing away food, frequent trips to the bathroom during or after eating, disappearance of food, eating in private, a change in menstrual cycle and loss of or disruption to periods. Psychiatric conditions that can co-occur with eating disorders include anxiety and mood disorders, especially depression. Those with eating disorders often have perfectionism and cognitive-behavioral inflexibility, which can lead to self-defeating behavior.