Eating Disorders: Causes, Types & Treatment Options

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What are Eating Disorders and How to Get Help

Eating disorders are about more than appearance or weight — they cause life-threatening problems. In the early stages, they can also be difficult to detect. In their later stages, however, the resulting health problems they cause become obvious. Recovering from an eating disorder requires professional help and a multidisciplinary approach. That is because the roots of every eating disorder lie in mental health, and the physical consequences require medical as well as nutritional intervention.


What to Know About Eating Disorders

An eating disorder is a harmful relationship with weight and food that interferes with many aspects of a person’s life, according to Anorexia Nervosa and Associated Disorders. Most individuals with an eating disorder often regard themselves extremely critically, holding themselves to unrealistic standards. They cannot control thoughts about food and weight, and intense and even unhealthy exercise sometimes accompanies eating disorders. Individuals who participate in judged sports such as gymnastics and figure skating are at higher risk, as are those who participate in ballet. As the problem grows, the disorder alters normal bodily functions and daily habits. Serious health problems develop, including life-threatening changes in heart rhythm.

Most individuals with eating disorders are women, although the incidence of eating disorder diagnosis among men is rising. Young women are particularly at risk, but eating disorders occur among individuals of all ages and nationalities.

Most people who suffer from an eating disorder do not get help for it. Those who do enter treatment usually attend a facility that does not have a specialized eating disorder program. Given that eating disorders cause more deaths than any other type of mental health illness, this is shocking. Death from an eating disorder can result in a number of ways, but the most frequent causes are heart failure, organ failure, malnutrition and suicide.


Types of Eating Disorders

There are several types of eating disorders. They include:

  • Anorexia nervosa — People who suffer from anorexia nervosa believe they are fat even though low weight is obvious. They suffer from a distorted body image and are likely to starve themselves by strictly limiting caloric intake and “purging” (vomiting). They may attempt to lose a lot of weight in a short amount of time by any means necessary, including diet gimmicks and drug use. Anorectics may turn to illicit drugs such as stimulants to keep off or lose weight.
  • Bulimia and binge eating — Individuals with bulimia may eat large amounts in a single setting and then purge to avoid weight gain. It is important to note individuals with bulimia may not always vomit after eating but may instead use laxatives, water pills, excessive exercise or calorie restriction. If purging is the method of choice, the first sign of the disorder may arise after a dental checkup.
  • Binge eating disorderBinge eating disorder is uncontrolled eating that is not followed by purging. They may eat huge quantities of food, then hate themselves afterward, but they continue to binge eat anyway. Sometimes people with binge eating disorder will alternate periods of bingeing with periods of fasting or dieting.
  • Compulsive overeating — People who compulsively overeat may eat thousands of more calories than consumed through normal eating. Compulsive overeating may result from an inability to cope with everyday stress or to fill a void.
  • Night eating (NES) — This newly identified eating disorder affects millions of Americans. People with NES eat more than half the daily caloric intake after 8 p.m. One third of individuals with morbid obesity suffer from NES.
  • Pica — When people eat nonfood items for a period lasting longer than one month, it may be pica. Nonfood items may include soap, cloth, dirt or talcum powder. Eating nonfood items can lead to serious infections or poisoning. It commonly occurs alongside spectrum disorders or intellectual disability.
  • Rumination disorder — An individual with rumination disorder regurgitates, re-chews and re-swallows or spits out food.
  • Avoidant or restrictive food intake disorder — Individuals who fail to meet daily nutritional requirements because they are afraid of choking, gaining weight or simply dislike certain textures, tastes or smells suffer from avoidant disorder.


Causes of Eating Disorders

Eating disorders are complex mental health problems medical researchers still struggle to understand. What is clear is they are about far more than appearance, and there is still healthy debate in the scientific community about the underlying causes of these damaging disorders. Overall, professionals believe biological, behavioral, emotional, interpersonal, psychological and social factors play a role.

Despite the differences of opinion, some common factors do exist among individuals with eating disorders. They include:

  • Low self-esteem — Cultural and social factors that contribute to low self-esteem include unrealistic expectations and fantasies the fashion industry often perpetuates. Society’s strict definitions of beauty that glorify men and women of certain shapes and body weights contribute to low self-esteem as well.
  • Lack of control and problems expressing feelings — An individual who feels overwhelmed by life’s pressures may respond by controlling food intake and/or purging. A reduced ability to share emotions compounds the problem.
  • Depression and anxiety — About half of individuals with an eating disorder also have clinical depression. Stress, loneliness, discrimination, a history of bullying due to weight and anger are just a few of the underlying factors causing these mental health disorders. Sexual, physical and emotional abuse are more all-too-common causes.
  • Genetics — A family history may make future generations more likely to develop an eating disorder.

Eating Disorder Signs and Symptoms

Identifying an eating disorder isn’t always easy because the signs and symptoms aren’t always clear until health problems grow serious. They include:

  • Avoiding eating, while making excuses for skipping meals. “I already ate” is a common refrain.
  • Adopting a rigid vegetarian or vegan diet.
  • Focusing excessively on healthy eating.
  • Preparing separate meals because what everyone else is eating isn’t healthy enough.
  • Frequent complaints or comments about being fat, or being overly desirous of losing weight — especially if weight loss is not necessary. This may be accompanied by expressions of disgust or guilt about needing to eat.
  • Obsessively looking in the mirror to identify perceived problems, or an unrealistic focus on perfection.
  • An unhealthy obsession with exercise.
  • Using drugs, supplements, laxatives or other products whose side effects include weight loss.
  • Symptoms of purging, which include calloused knuckles and weakened tooth enamel and decay.
  • Leaving in the middle of mealtime to go to the bathroom.
  • Eating in secret.
  • Withdrawal from normal activities.

Eating Disorder Effects

Eating disorders can have a serious effect on the brain and body. The most common eating disorder effects include:

  • Sensitivity to cold.
  • Changes in menstruation.
  • Fine hair growth on body or face.
  • Listless or dull behavior, and difficulty concentrating.
  • Irregular moods.
  • Dizziness, shortness of breath and chest pain.
  • Swollen salivary glands, sore throat, tooth decay and gum disease.
  • Low energy and body temperature.
  • Swollen stomach or gastric rupture.
  • Frequent constipation or irregular elimination.
  • Dehydration and kidney complications.

Intervention and Prevention

While there are no methods by which you can definitively stop an eating disorder from developing in someone you love, there are certain habits you can practice that reduce the risk one will develop. They include:

  • Eating meals together — When you dine together, you can demonstrate your own healthy eating habits while encouraging others to consume a balanced diet featuring nutritious foods and reasonable portions.
  • Limiting diet talk — Avoid discussing fad diets and especially pills, especially around children and teenagers.
  • Encouraging self-esteem — Praise healthy body images and avoid criticizing your own physique. Build acceptance and reassurance by respecting your own appearance as well as those around you.
  • Schedule a visit to the doctor — Your physician is an excellent resource and is well-positioned to identify a burgeoning eating disorder.

If someone you care about has already developed an eating disorder, you can arrange an intervention. The earlier you intervene in an eating disorder, the easier it is to treat. Intervention is a powerful way to help an individual who is struggling with an eating disorder. For the most successful intervention possible, you should:

  • Choose the right participants — Select up to five people who are close to your loved one. Choose a leader or hire a professional interventionist. Plan ahead and choose a meeting time that works for everyone.
  • Identify problem behaviors and incidents — Each participant should prepare to share one behavior or incident that caused concern. Get together beforehand to practice what you’ll say.
  • Use non-confrontational, threat-free language — “I worry about your eating habits because you don’t eat with us anymore, and you’ve lost a lot of weight.”
  • Offer a solution — If the intervention is successful, your loved one will agree to get help right away. Have a counseling or inpatient treatment solution prepared. Avoid insensitive, too-simple solutions such as “just start eating!”

Facts and Statistics About Eating Disorders

The consequences of eating disorders include death. Getting help is essential. Although up to 30 million people suffer from eating disorders, only 10 percent ever receive treatment. Consider these additional facts:

  • For adolescents, anorexia is the third most common chronic disorder.
  • Eating disorders have the highest rate of death compared to all other mental health disorders.
  • A quarter of college-aged females use bingeing and purging as a weight-management technique.
  • Over 80% of 10-year-old children are afraid of being fat.
  • Over 50% of teenage girls and almost 33% of teenage boys skip meals, fast, smoke, vomit or take laxatives to control weight.
  • Over one-third of dieters progress to pathological dieting, and 25% of pathological dieters develop an eating disorder.
  • Women are more likely to develop an eating disorder, but men are less likely to get help.
  • The “ideal” body type as identified by modern advertising is possessed naturally by 5% of American women.
  • Twenty percent of individuals with anorexia will die prematurely from eating disorder complications, including heart problems and suicide.


Exercise Addiction and Eating Disorders

One of the most common coexisting problems of eating disorders is exercise addiction. If the person you care about shows signs of an eating disorder and seems to spend a lot of time working out, then exercise addiction may be a problem. People with an addiction to exercise:

  • Organize their lives around their exercise habits, rather than their exercise habits around their lives.
  • Obsessively measure progress and, possibly, caloric intake.
  • Exercise regardless of current health problems, weather conditions or life events.
  • Are overly preoccupied with appearance.

Treatment for Eating Disorders

There are diverse options for eating disorder treatment. The first step is intervening with a loved one who demonstrates signs or symptoms, or asking someone else for help. It is scary to accept an eating disorder is a problem, but the sooner you get help, the easier treatment can be.

Cognitive behavioral therapy (CBT) is one of the most common eating disorder treatments. CBT tackles the unhealthy habits and the negative thoughts that precede them. During CBT, clients identify the emotional triggers that lead to destructive habits, such as caloric restriction, purging and excessive exercise. They also learn how to deal with those triggers in healthier, life-affirming ways. Safe weight management and relaxation techniques, in addition to better coping skills, are also taught as part of CBT.

There are many other treatments for eating disorders, including:

  • Hospitalization or inpatient rehabilitation, if the physical symptoms threaten life — Malnutrition is considered life threatening. Alternate choices include full-day rehabilitation in which the individual returns home at night.
  • Psychotherapy and medication — This may include family-based therapy. Medication won’t cure an eating disorder, but it can reduce symptoms of depression or anxiety.
  • Nutrition education — Understanding the effects of nutrition on the body and why the body needs certain nutrients to function is essential.

05-get-helpGet Help for an Eating Disorder

Eating disorders are complex diseases that have psychological and physical elements. Successful treatment typically includes nutrition education as well as psychotherapies that identify and heal the root causes of the disorder. If there is an additional mental health disorder requiring treatment, such as depression or anxiety, the treatment will incorporate additional therapies. With the right treatment and supportive loved ones, the prognosis for recovery can be excellent.

Individuals with life-threatening symptoms such as heart arrhythmia should enroll in a treatment program immediately. Inpatient treatment allows the suffering individual time and space to focus exclusively on healing without any of the distractions of everyday life. A hospital setting can provide lifesaving interventions, but it may not offer the necessary follow-up care. Treatment programs that use a holistic approach, whether inpatient or outpatient, often do.

Holistic treatment addresses a person’s physical, psychological and spiritual health and well-being. Urgent care, behavioral therapy, psychotherapy, pharmacological treatment, nutrition, family therapy, life skills training and safe exercise often comprise a comprehensive holistic care program. After care ends, your loved one can continue therapy on an outpatient basis and join one or more communities where he or she can receive ongoing eating disorder support.

Get Help with an Eating Disorder Today

When it comes to eating disorders, it is never too soon to seek help. The longer an eating disorder continues, the more harm it does on the body and brain. Healing from an eating disorder becomes more difficult as the brain becomes programmed to the behavioral. No matter how long you or your loved one has been battling an eating disorder, there is help. Speak with your healthcare professional or research your treatment options online.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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