February 22-28 is National Eating Disorders Awareness (NEDA) week. This year’s focus is on dispelling myths and raising awareness of the signs of eating disorders. Not all eating disorders develop the same way for everyone, and NEDA is working to educate everyone on the importance of prevention and early intervention.

Eating disorders are psychological disorders characterized by eating either too much or too little. Typically affecting women and girls at a rate two and a half times that of men and boys, eating disorders usually begin in adolescence but can arise later in life as well. The prevalence of eating disorders is difficult to estimate, as many times they will go unreported or untreated, but in the U.S. approximately ten million people are diagnosed annually.

Two of the most well-known eating disorders are anorexia nervosa and bulimia nervosa (both more commonly known as anorexia and bulimia), but binge-eating disorder is now diagnosed more often than the other two.

Anorexia nervosa

This eating disorder is characterized by the deeply held belief that one is fat. People with anorexia look in the mirror and see bulges and bumps, even when they are nothing more than skin and bones. Their brain is sending them an image of an overweight person. As a consequence, anorexics severely limit caloric intake and sometimes exercise compulsively. They chronicle all of the calories that they consume and practice strict portion control. They may also restrict their diets to certain foods such as celery and cucumbers. In advanced cases, anorexics use laxatives and diuretics and may induce vomiting to lose weight.

Early warning signs of anorexia nervosa can include the following:

  • Fear of weight gain
  • Food restriction, either in kind of food or portion size
  • Distorted body image
  • Low body weight
  • Obsessive focus on and pursuit of losing weight
  • Compulsive exercise

As anorexia progresses, girls and women may stop menstruating. Both males and females may experience extreme fatigue, dizziness, and inability to focus. Because the body is not getting adequate nutrition, the following serious health consequences can occur:

  • Loss of hair, or brittle hair and nails
  • Muscle wasting
  • Anemia (low iron in the blood)
  • Dry skin with a yellow tone (indicating liver failure)
  • Constipation

Long-term health consequences include brain damage, development of osteoporosis, organ failure, and infertility.

Bulimia nervosa

Bulimia nervosa is characterized by a cycle of binging and purging. The person suffering from bulimia feels an uncontrollable urge to eat followed by an overwhelming surge of guilt that forces them to take action to eliminate the food from their bodies. This can include using laxatives, enemas, and, most commonly, inducing vomiting. They may also undergo periods of fasting to compensate for the binge or to “punish” themselves.

People suffering from bulimia are often able to maintain what appears to be a healthy body weight or may be slightly overweight. Nevertheless, they experience some of the same feelings as those with anorexia, including:

  • Fear of weight gain
  • Distorted body image
  • Feelings of guilt and shame
  • Disgust for their body and their behavior

Health consequences of bulimia are similar to anorexia but can also include:

  • Electrolyte imbalance (can lead to heart attack or stroke)
  • Chronically swollen and sore throat
  • Gastrointestinal disorders
  • Erosion of tooth enamel

The last health consequence is also often how this disorder is diagnosed. Dentists may notice eroded enamel especially at the back teeth and raise concerns.

Binge eating disorder

Binge eating disorder has surpassed anorexia and bulimia as the most-diagnosed eating disorder. Like bulimia, binge eating disorder is characterized by consumption of large quantities of food, but unlike bulimia, the person does not purge. As a result, binge eaters are overweight, with some being classified as morbidly obese. Chronically obese people have a high risk of cardiovascular disease, stroke, diabetes, and early mortality. As with the other two disorders, people suffering from binge eating disorder carry with them feelings of guilt and shame for their behavior.

Another side effect of all three disorders is pain. Chronic constipation and gastrointestinal disorders can cause abdominal pain, and long-term affects like osteoporosis can cause painful fractures. Nutritional deficiencies in vitamins and mineral are contributing factors to arthritis. Because eating disorders can also be accompanied by depression, this pain can feel amplified.

How to help

Treatment of eating disorders is complex and involves not only the patient but also their families. Unlike drug and alcohol abuse, the primary addiction is something that everyone needs to survive: food. Because one in ten people diagnosed with eating disorders are also diagnosed with depression, treatment is not as simple as telling the patient to eat more or eat less. Eating disorders are serious psychological conditions, but treatment can offer a positive prognosis. Most treatment plans include:

  • Therapy (individual, group, and family): Because eating disorders are a psychological disorder, therapy is one of the most powerful tools to help heal those with eating disorders. Many patients are able to understand the root cause of their illness and take steps to re-train their minds.
  • Medical interventions: This can include taking antidepressants as well as nutritional supplements in the early days of treatment. In serious cases this can include admission to the hospital for monitoring or for fluids or liquid nutrition.
  • Nutrition counseling and instruction: Many patients never knew or have forgotten how to properly feed themselves for proper nutrition. They will work with nutritionists to plan healthy meals for optimal nutrition.

The most important aspect of treatment is early detection and loving intervention. Visit NEDA’s site to get involved. If you have overcome an eating disorder, tell us what was key for you in the comments below.

Image by daniellehelm via Flickr

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