Eating Disorders Fact Sheet
http://www.4woman.gov/owh/pub/factsheets/eatingdis.htm
Eating disorders are complex, chronic illnesses largely misunderstood and misdiagnosed. The
most common eating disorders - anorexia nervosa, bulimia nervosa, and binge eating disorder -
are on the rise in the United States and worldwide. No one knows exactly what causes eating
disorders. However, all socioeconomic, ethnic and cultural groups are at risk.
More than ninety percent of those with eating disorders are women. Further, the number of
American women affected by these illnesses has doubled to at least five million in the past
three decades.
Eating disorders are one of the key health issues facing young women. Studies in the last
decade show that eating disorders and disordered eating behaviors are related to other health
risk behaviors, including tobacco use, alcohol use, marijuana use, delinquency, unprotected
sexual activity, and suicide attempts. Currently, 1-4% of all young women in the United States
are affected by eating disorders.1 Anorexia nervosa, for example, ranks as the third most common
chronic illness among adolescent females in the United States.2
Eating disorders have numerous physical, psychological and social ramifications, from
significant weight preoccupation, inappropriate eating behavior, and body image distortion.
Many people with eating disorders experience depression, anxiety, substance abuse, and
childhood sexual abuse, and may be at risk for osteoporosis and heart problems. Moreover, death
rates are among the highest for any mental illness.
TYPES OF EATING DISORDERS
Anorexia Nervosa
Anorexia nervosa is a dangerous condition in which people can literally starve themselves to
death. People with this disorder eat very little even though they are already thin. They have
an intense and overpowering fear of body fat and weight gain, repeated dieting attempts, and
excessive weight loss. This particular eating disorder affects from 0.5% to 1% of the female
adolescent population with an average age of onset between 14 and 18 years.3 Anorexia is
identified in part by refusal to eat, an intense desire to be thin, repeated dieting attempts,
and excessive weight loss. To maintain an abnormally low weight, people with anorexia may diet,
fast, or over exercise. They often engage in behaviors such as self-induced vomiting or the
misuse of laxatives, diuretics, or enemas. People with anorexia believe that they are overweight
even when they are extremely thin. Often, the beginning of illness will occur after a stressful
life event such as initiation of puberty or moving out of the parents' home.
Those with anorexia are often characterized as perfectionists and overachievers who appear to
be in control. In reality, they suffer from low self-esteem and confidence and overly criticize
themselves. They are also very concerned about pleasing others.
Complications - The most severe and noticeable consequences of anorexia nervosa resemble those
of starvation. The body reacts to the lack of food by becoming extremely thin, developing
brittle hair and nails, dry skin, lowered pulse rate, cold intolerance, and constipation as
well as occasional diarrhea. In addition, mild anemia, reduced muscle mass, loss of menstrual
cycle and swelling of joints often accompany anorexia.
Beyond experiencing the immediate effects of anorexia nervosa, individuals suffer long-term
consequences throughout the life cycle, regardless of treatment. In addition to the risks of
recurrence, malnutrition may cause irregular heart rhythms and heart failure. Lack of calcium
places anorexics at increased risk for osteoporosis both during their illness and in later
life. A majority of anorexics also have clinical depression while others suffer from anxiety,
personality disorders or substance abuse, and many are at risk for suicide. Approximately 1 in
10 women afflicted with anorexia will die of starvation, cardiac arrest, or other medical
complication, making its death rate among the highest for a psychiatric disease.
Bulimia Nervosa
Individuals suffering from Bulimia Nervosa follow a routine of secretive, uncontrolled or binge
eating (ingesting an abnormally large amount of food within a set period of time) followed by
behaviors to rid the body of food consumed. This includes self - induced vomiting and/or the
misuse of laxatives, diet pills, diuretics (water pills), excessive exercise or fasting.
Bulimia afflicts approximately 1% - 3% of adolescents in the US with the illness usually
beginning in late adolescence or early adult life.3 As with anorexia nervosa, those with
bulimia are overly concerned with food, body weight, and shape. Because many individuals with
bulimia 'binge and purge' in secret and maintain normal or above normal body weight, they can
often hide the disorder from others for years. Binges can range from once or twice a week to
several times a day and can be triggered by a variety of emotions such as depression, boredom,
or anger. The illness may be constant or occasional, with periods of remission alternating with
recurrences of binge eating.
Individuals with bulimia are often characterized as having a hard time dealing with and
controlling impulses, stress, and anxieties. Bulimia nervosa can and often does occur
independently of anorexia nervosa, although half of all anorexics develop bulimia.
Complications - Most medical complications attributed to bulimia nervosa result from
electrolyte imbalance and repeated purging behaviors. Loss of potassium due to vomiting, for
example, damages heart muscle, increasing the risk for cardiac arrest. Repeated vomiting also
causes inflammation of the esophagus and possible erosion of tooth enamel as well as damage to
the salivary glands. Some individuals with bulimia struggle with addictions such as drugs and
alcohol, and compulsive stealing. Like those with anorexia, many people with bulimia suffer
from clinical depression, anxiety, obsessive-compulsive disorder and other psychiatric
illnesses.
Binge Eating Disorder (BED)
Binge eating disorder (BED) is the newest clinically recognized eating disorder. BED is
primarily identified by repeated episodes of uncontrolled eating. The overeating or bingeing
does not typically stop until the person is uncomfortably full. Unlike anorexia nervosa and
bulimia nervosa, however, BED is not associated with inappropriate behaviors such as vomiting
or excessive exercise to rid the body of extra food. The illness usually begins in late
adolescence or in the early 20s, often coming soon after significant weight loss from dieting.
Some researchers believe that BED is the most common eating disorder, affecting 15% - 50% of
participants in weight control programs. In these programs, women are more likely to have BED
than males. Current findings suggest that BED affects 0.7% - 4% of the general
population.3
To the lay person, BED can be difficult to distinguish from other causes of obesity. However,
the overeating in individuals with BED is often accompanied by feeling out of control and
followed by feelings of depression, guilt, or disgust.
Complications - People with BED are often overweight because they maintain a high calorie diet
without expending a similar amount of energy. Medical problems for this disorder are similar to
those found with obesity such as increased cholesterol levels, high blood pressure, and
diabetes, as well as increased risk for gallbladder disease, heart disease, and some types of
cancer. Researchers have shown that individuals with BED also have high rates of
depression.
Eating Disorder not Otherwise Specified (ENDOS)
The Eating Disorder Not Otherwise Specified (EDNOS) category is for disorders of eating that do
not meet the criteria for any specific eating disorder. In EDNOS, individuals engage in some
form of abnormal eating but do not exhibit all the specific symptoms required to diagnose an
eating disorder. For instance, an individual with EDNOS may meet all the criteria of anorexia
nervosa but manage to maintain normal weight while someone else may engage in purging behavior
with less frequency or intensity than a diagnosed bulimic.
Disordered Eating
Far more common and widespread than defined eating disorders are atypical eating disorders, or
disordered eating. Disordered eating refers to troublesome eating behaviors, such as
restrictive dieting, bingeing, or purging, which occur less frequently or are less severe than
those required to meet the full criteria for the diagnosis of an eating disorder. Disordered
eating can be changes in eating patterns that occur in relation to a stressful event, an
illness, personal appearance, or in preparation for athletic competition. The 1997 Youth Risk
Behavior Surveillance Study found that over 4% of students nationwide had taken laxatives, diet
pills or had vomited either to lose weight or to keep from gaining weight.5
While disordered eating can lead to weight loss or weight gain and to certain nutritional
problems, it rarely requires in depth professional attention. On the other hand, disordered
eating may develop into an eating disorder. If disordered eating becomes sustained,
distressing, or begins to interfere with everyday activities, then it may require professional
evaluation.
DIAGNOSIS
Because of the secretive habits of many individuals with eating disorders, their conditions
often go undiagnosed for long periods of time. In the cases of anorexia nervosa, signs such as
extreme weight loss are more visible. Bulimics who maintain normal body weight, on the other
hand, may be able to hide their condition to the casual observer. Family members and friends
might notice some of the following warning signs of an eating disorder:
A Person with Anorexia may…:
- Eat only 'safe' foods, usually those low in calories and fat
- Have odd rituals, such as cutting food into small pieces
- Spend more time playing with food than eating it
- Cook meals for others without eating · Engage in compulsive exercising
- Dress in layers to hide weight loss
- Spend less time with family and friends, become more isolated, withdrawn, and secretive
A person with Bulimia may…:
- Become very secretive about food, spend a lot of time thinking about and planning the next binge
- Take repeated trips to the bathroom, particularly after eating
- Steal food or hoard it in strange places
- Engage in compulsive exercising If an individual is displaying any of these
characteristics, they should be taken to a physician, nutritionist, or other professional with
expertise in diagnosing eating disorders.
TREATMENT AND RECOVERY
:
Eating disorders are most successfully treated when diagnosed early. The longer abnormal eating
behaviors persist, the more difficult it is to overcome the disorder and its effects on the
body. In some cases, long term treatment and hospitalization is required. Families and friends
offering support and encouragement can play an important role in the success of the treatment
program.
Treatment
Presently, there is no universally accepted standard treatment for anorexia nervosa, bulimia
nervosa, or binge eating disorder. Ideally, an integrated approach to treatment would include
the skills of nutritionists, mental health professionals, endocrinologists and other physicians.
Various types of psychotherapy may be employed, including cognitive-behavioral therapy,
interpersonal therapy, and family and group therapy. Self-esteem enhancement and assertiveness
training may also be helpful. Antidepressants and other drugs have been part of some
therapeutic regimes.
The status of eating disorders as curable diseases has been controversial, since relapse rates
for disturbed eating patterns can be very high.
[Note from Annaleigh: Life with an ED can only be described as pure torment. Self-image in the
the ED sufferer is so twisted. Having developed my ED by grade 9, it took another 5 years before
the day came in the dentist's chair when he told me "maybe" they could save my teeth from the
damage my bulimia had caused it. You need not continue to live with that kind of agony in secret.
Help is available.]
Links:
National Eating Disorders Association
Mirror-Mirror
Something Fishy
Eating Disorders Anonymous
Eating Disorders Association (UK)
Anorexia Nervosa and Related Eating Disorders, Inc (ANRED)
ED Referral
National Eating Disorder Information Centre (Canada)
Eating Disorders In A Disordered Culture
Caring Online
Eating Disorders Online
Eating Disorder Foundation of Victoria (Australia)
Anorexia Nervosa @ NAMI
Eating Disorders Coalition for Research, Policy, & Action
Eating Disorder Education Organization
Advocacy For You
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