Eating disorders occur primarily in women and in societies where there is excessive emphasis on thinness and body image.
Anorexia Nervosa most commonly begins in younger women with an average age of 17. The symptoms include a refusal to maintain a normal body weight, cessation or delay of menstruation, and phobias of fatness or weight gain, despite being underweight. Anorexics usually severely restrict their food intake and see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Unusual eating habits such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food may develop. However, when anorexics lost control, they may exhibit binge-eating and purging behaviors, most often seen in individuals with bulimia nervosa.
Bulimia nervosa is usually diagnosed in the early 20’s and involves alternating between (typically high carbohydrate) binge-eating episodes and maladaptive methods of weight control. These methods, often referred to as compensatory behaviors, most often involve purging behaviors such as self-induced vomiting, laxative or enema abuse or diuretic misuse. However, bulimics may also resort to excessive fasting (such as is typically seen in anorexia nervosa) and use of diet pills. Bulimics tend to be within the normal weight range. Individuals suffering from bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet report feeling a sense of relief once they purge.
Individuals with binge-eating disorder tend to be overweight and sometimes morbidly obese. In the past, binge-eaters were characterized as “compulsive overeaters.” People with binge-eating disorder engage in frequent episodes of out-of-control eating, often with similar binge-eating symptoms as those with bulimia nervosa. The main difference is that individuals with binge-eating disorder do not engage in compensatory behaviors to purge their bodies of excess calories. Thus, they are frequently overweight. Feelings of self-disgust and shame associated with these behaviors increase the frequency of the binging episodes, thereby creating a vicious cycle.
Eating disorders can lead to serious physical illness and depression. Eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety disorders. Sadly, psychiatric symptoms resulting from these disorders symptoms are often a trigger for the maladaptive eating or purging behaviors. In addition, people who suffer from eating disorders can experience a wide range of physical health complications, including serious heart conditions and kidney failure which may lead to death. Recognition of eating disorders as real and treatable diseases, therefore, is critically important.
There are effective treatments for all three eating disorders. The initial phase of treatment should involve a thorough medical work-up to verify that there is no medical reason underlying the symptoms or any acute medical complication requiring immediate medical care. Following this, treatment is usually a combination of medication and psychotherapy. Medications prescribed usually involve antidepressants and mood stabilizers. Psychotherapy may be conducted individually or in a family or group setting. If the individual is medically ill, stabilization in hospitalization may be required. The best outcome is achieved with an interdisciplinary team approach that involves physicians, therapists, nutritionists and the patient’s family or support system. Learning more about the disease processes by contacting the following organizations may also be helpful.
Harvard Eating Disorders Center
15 Parkman Street
Boston, MA 02114
International Association of Eating Disorders Professionals (IAEDP)
P.O. Box 1295
Pekin, IL 61555-1295
Phone: (309) 346-3341
Fax: (775) 239-1597/(309) 346-2874
Toll Free: (800) 800-8126
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
Rm. 12-105 Parklawn Building
Rockville, MD 20857
National Institute of Mental Health
Office of Communications
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
Toll Free: 1-866-615-NIMH (6464)
American Psychiatric Association (APA)
1000 Wilson Boulevard, Suite 1825
Arlington, VA 22209-3901
American Psychological Association
750 1st Street, NE
Washington, DC 20002-4242
Toll Free: 1-800-374-2721