Eating Disorders

Information via accrediting organization American Association for Marriage and Family Therapy.

Eating disorders are extreme disturbances in an individual’s behavior and feelings related to food, weight, and body image. They are most likely to develop during adolescence and young adulthood. But children, preteens, adult women, and men also may develop these problems. They are serious problems with life-threatening consequences. Eating disorders and disordered eating often co-occur with other problems such as depression, anxiety, and suicidal ideation or behaviors.

Anorexia Nervosa

Anorexia Nervosa is characterized by excessive weight loss through self-starvation and sometimes through purging. Purging includes vomiting, using laxatives, and exercising excessively. Symptoms include:

• Refusal to maintain a normal weight
• Intense fear of weight gain
• Obsessive preoccupation with weight and shape
• Loss of menstrual periods
• Distorted body image

Bulimia Nervosa

Bulimia Nervosa is characterized by cycles of binge eating followed by purging, usually done in secret. The individual’s weight may range from below to above average, so it may be harder to detect. Symptoms include:

• Repetitive cycles of bingeing and purging
• Feeling out of control of food intake
• Purging after bingeing via self-induced vomiting, laxatives, diet pills, diuretics, excessive exercise, or starvation
• Obsessive preoccupation with weight and shape

Binge Eating Disorder

Binge Eating Disorder is characterized by recurrent episodes of binge eating that occur once per week for at least three months. A binge eating episode is defined as eating an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. Binge eating is also accompanied by a loss of control or feeling that one cannot stop or control how much they are eating. Symptoms include:

• Eating much more than normal
• Eating until feeling uncomfortably full
• Eating large amounts of food when not feeling physically hungry
• Eating alone because of feeling embarrassed by how much one is eating
• Feeling disgusted with oneself, depressed, or very guilty afterward

In addition, some people may have symptoms of an eating disorder without qualifying for anorexia, bulimia, or binge eating disorder. For this reason, they may be receive a diagnosis of Other Specified Feeding or Eating Disorder. Often there is a specific reason why individuals might receive an OSFED diagnosis such as engaging in eating disorder behaviors (i.e. food restriction, purging, or binge-eating) with low frequency or remaining within or above a normal weight range despite behaviors.

Eating Disorders Effect on Relationships

Eating disorders are consuming. They consume the individual in obsessive, negative thinking and behaviors, and they consume the individual’s relationships with family members, loved ones, and life. This is partially due to the effects of starvation. When people are not adequately nourished, they think about food constantly, sometimes even dreaming about it. Eating disorders are consuming. They consume the individual in obsessive, negative thinking, behaviors, and emotions, and they consume the individual’s relationships with family members, loved ones, and life. Loved ones find eating disorders extremely difficult to understand and accept. Seeing someone you love damage their body is stressful. Often, parents, partners, and others begin to become intrusive in their efforts to get the person to stop engaging in disordered eating behaviors. Soon, the individual may see these loved ones as enemies trying to control them rather than help.

Getting Help

At times it may be difficult for you to understand if your loved one is struggling with a real problem. If you notice any of the thoughts or behaviors mentioned above it is important that you take action and attempt to obtain help. Left untreated eating disorders can have life-threatening consequences. Although eating disorders severity vary, they usually don’t go away by themselves. People with eating disorders often fear getting help because it could be seen as a sign of weakness. Loved ones can help break through that by being open to getting help themselves and by examining how they or other family relationships or issues may help to maintain the problem. In a family, caregivers need to be involved in treatment. This challenge needs to be shared.

Serious Distress Signals

When these or other signs are present, professional help is urgently needed. Make an appointment with a physician and with an expert in eating disorders to find out how serious this is and to design a treatment plan that will help you cope.

• Fasts or severely restricts food intake
• Hides or sneaks food
• Spends excessive time in the bathroom after meals
• Vomits, takes laxatives, diet pills or other medications to lose weight
• Has lost a significant amount of weight
• Is tired and depressed
• Can’t concentrate
• Has irregular periods, swollen glands or joints, broken blood vessels or bloodshot eyes.
• Wears layers of clothes even in warm weather
• Faints or passes out

What Helps?

Usually, people with eating disorders need an interdisciplinary approach, including individual and family or couples therapy, nutritional counseling, medical monitoring, and sometimes medications or group therapy. Depending on the severity, inpatient, day hospital, residential treatment, or even tube-feeding or intravenous fluids may be necessary.

The sooner someone gets treatment, the more likely it is that person will recover. Get help soon. Treatment is effective. Family or marital therapy significantly improves the possibility of recovery. Family members and loved ones need to understand that the problem is not a simple one. Eating disorders are complex problems and eating and body issues may cover up much more complicated feelings. The eating disorder is an illogical system of thoughts and behaviors and may be an attempt to solve deep self-esteem and identity problems. But, remember that there is hope and effective treatment for eating disorders.

Resources

National Eating Disorders Association (NEDA): A nonprofit organization dedicated to increasing the awareness and prevention of eating disorders through education and community activism. 
Confidential Helpline: 1 800-931-2237; Monday-Thursday from 9:00 am – 9:00 pm and Friday from 9:00 am – 5:00 pm (EST)

The National Association for Males with Eating Disorders, Inc. (N.A.M.E.D.): A nationwide professional association committed to leadership in the field of male eating disorders. They aim to provide support for males affected by eating disorders, provide access to collective expertise, and promote the development of effective clinical intervention and research in this population. 

Families Empowered and Supporting Treatment of Eating Disorders (FEAST): An international organization of and for caregivers of eating disorder patients. F.E.A.S.T. serves families by providing information and mutual support, promoting evidence-based treatment, and advocating for research and education to reduce the suffering associated with eating disorders.

Binge Eating Disorder Association (BEDA): A national organization focused on providing leadership, recognition, prevention, and treatment of binge eating disorder (BED) and associated weight stigma.

My Body Screening: This website provides people with the option to take a free, anonymous self-assessment to gauge their risk of an eating disorder. The anonymous SMH online screening takes only a few minutes and consists of a series of questions, developed by treatment professionals in the eating disorders field, which are designed to indicate whether clinical help is needed. Written by Ashley Hicks White, PhD, LMFT