Eating Disorders 101 – The Types, Signs, and Consequences of EDs

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This week, we’re bringing you a 3-part series from Jacqueline, aka Fitarella, titled Eating Disorders 101. Below is part 1, which focuses on the types of Eating Disorders and their symptoms, and parts 2 & 3 will follow on Wednesday and Thursday.

I started dieting when I was 8, went to my first Weight Watchers meeting at 9 and began taking diet pills at 10.  By the time I was in high school I had tried just about every diet in existence, was taking speed, snorting coke and smoking to control my appetite, and had become a full fledged member of the coveted bulimia club.  It was my personal hell.

I am so thankful that I don’t live in that hell anymore, but there are so many that do.  What follows are the basics that I think everyone should know about Eating Disorders.  I’m not looking to preach to anyone, come off like I know everything or have all the answers.  I just want you to be informed of the basics. There are differences of opinion among experts and some of the literature out there.  I encourage you to explore these topics further, using all means available to you.  Since it’s a lot of info to digest in one sitting I’ve broken it down to a 3 part series.  Today we’ll focus on Anorexia Nervosa and Bulimia Nervosa.

In the U.S., as many as 10 million females and 1 million males are fighting a life and death battle with an eating disorder (ED) such as anorexia or bulimia, and millions more are struggling with binge eating disorder.  Many others struggle with body dissatisfaction and sub-clinical disordered eating attitudes & behaviors. It has been shown that 80% of American women are dissatisfied with their appearance. 80%!!!!!!!!!!!!!!!!!!!!!! How CRAZY is that?!

EDs are complex conditions that arise from a combo of long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors. Scientists/researchers are still learning about the underlying causes of these emotionally & physically damaging conditions. While eating disorders may begin with preoccupations with food & weight, they are most often about much more than food. People with EDs often use food and the control of food in an attempt to compensate for feelings/emotions that may otherwise seem over-whelming. For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one’s life, but ultimately, these behaviors will damage a person’s physical and emotional health & self-esteem.  For me, it was a way to cope with having been sexually molested when I was a child.

Factors that can contribute to EDs are:

Psychological:

  • Low self-esteem
  • Feelings of inadequacy or lack of control in life
  • Depression, anxiety, anger, or loneliness

Interpersonal:

  • Troubled personal relationships
  • Difficulty expressing emotions and feelings
  • History of being teased or ridiculed based on size or weight
  • History of physical or sexual abuse

Social Factors:

  • Cultural pressures that glorify “thinness” and place value on obtaining the “perfect body”
  • Narrow definitions of beauty that include only women and men of specific body weights and shapes
  • Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths

Biological:

  • Scientists are still researching possible biochemical or biological causes of eating disorders. In some people with EDs, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be unbalanced. The implications of this are still under investigation.
  • EDs often run in families. Current research indicates that there are significant genetic contributions to EDs.

There are 3 types of eating disorder classification in the Diagnostic and Statistical Manual of Mental Illness (DSM-IV). The DSM IV is created by the American Psychiatric Association and used by insurance companies for the purposes of reimbursement for services.  Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are both formal diagnosis according to the DSM IV; however Binge Eating Disorder (BED) is not yet, hopefully with the 5th version it will be. (Later in the series we will go over Orthorexia, Diabulimia and Exercise Addiction. These are not classified in the DSM-IV.)

Anorexia Nervosa

Anorexia nervosa is a serious, potentially life-threatening ED characterized by self-starvation and excessive weight loss.  It has 4 primary symptoms:

  1. Resistance to maintaining body weight at or above a minimally normal weight for age and height.
  2. Intense fear of weight gain or being “fat,” even though underweight.
  3. Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight.
  4. Loss of menstrual periods in girls and women post-puberty.

Warning Signs of AN:

  • Dramatic weight loss.
  • Preoccupation with weight, food, calories, fat grams, and dieting.
  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
  • Frequent comments about feeling “fat” or overweight despite weight loss.
  • Anxiety about gaining weight or being “fat.”
  • Denial of hunger.
  • Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate).
  • Consistent excuses to avoid mealtimes or situations involving food.
  • Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury,
  • the need to “burn off” calories taken in.
  • Withdrawal from usual friends and activities.
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Health Consequences of Anorexia Nervosa:

Anorexia nervosa involves self-starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in dry, brittle bones.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.
  • Dry hair and skin, hair loss is common.
  • Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

Bulimia Nervosa

Bulimia nervosa is a serious, potentially life-threatening ED characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.  It has 3 primary symptoms:

  • Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior.
  • Regular use of behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
  • Extreme concern with body weight and shape.

Warning Signs of BN:

  • Evidence of binge eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
  • Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in.
  • Unusual swelling of the cheeks or jaw area.
  • Calluses on the back of the hands and knuckles from self-induced vomiting.
  • Discoloration or staining of the teeth.
  • Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions.
  • Withdrawal from usual friends and activities.
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Health Consequences of BN:

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can damage the entire digestive system and purge behaviors can lead to electrolyte & chemical imbalances that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture is an uncommon but possible side effect of binge eating.

Part 2 will focus on Binge Eating Disorder and Orthorexia and Part 3 on Diabulimia and Exercise Addiction.

If you or someone you love need help you can find information on treatment providers here.  Feel free to email me anytime at [email protected]  I’ve been there and I want to help.

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Thirty-eight year-old wife and mom to BJ (10) and Mia (6). I’m the editor at the Sisterhood, and I really love to run (really), read, cook amazing things, and photography is my fledging passion. My motivation is motivating other people to realize they can do this whole weight-loss and exercise thing. I’m living proof!