Eating Disorders are an array of psychological conditions that can cause an unhealthy relationship in an individual with food. A majority of them involve an intense focus on the individual’s weight, body, calorie consumption, and the food they eat. Distressing thoughts and emotions are thus, often associated with persistent disturbances in the eating habits of the individual suffering. It can overall be an extremely serious condition affecting the psychological, physical, and social functioning of that individual.
A range of eating disorders can be identified. Amongst the most commonly heard ones are Anorexia Nervosa (or just Anorexia), Bulimia Nervosa (or Bulimia) and Binge-eating Disorder. The lesser-known ones are Pica, Rumination Disorder, Avoidant/Restrictive food intake disorder, Night Eating Syndrome and OSFED.
Anorexia Nervosa
Anorexia is one of the most well-known eating disorders. People who develop Anorexia often tend to view themselves as overweight, even if they might in actuality be severely underweight. Thus, one of its defining features is an intensely distorted perception of the body and weight.
People with Anorexia are preoccupied with constant attempts at severely restricting their diets and monitoring their weight. They tend to avoid certain food types which they might consider to be fattening. They also suffer from a nagging fear of gaining weight, so they keep a calorie count to combat the same. By doing so, the individuals often become malnourished and have low body weight. This, in turn, significantly interferes with their life and daily functioning.
Anorexia Nervosa is officially categorised into two subtypes; the restricting type and the binge eating and purging type. People who experience the restricting type of anorexia lose weight by fasting, excessively exercising and dieting. On the other hand, people who experience the binge eating and purging type often binge on large quantities of food, followed by situations where they might eat very little. Irrespective of the amount of food they intake, it is always followed by them purging, using laxatives and diuretics, vomiting or intense exercising.
Its common symptoms are:
- A distorted body image
- Denial of being severely underweight
- Restricted eating patterns
- A restless pursuit of being and remaining thin
- Intense fear of gaining weight
- Obsessive-compulsive symptoms such as preoccupation with constant thoughts revolving around food, obsessively collecting recipes or hoarding food
- Sometimes, a person can also experience difficulty eating food in public
It generally develops around the early ages of adolescence or young adulthood. Also, it affects women a lot more than men, statistically speaking.
Overall, Anorexia is a damaging psychological disorder, which can severely affect the body and well-being of an individual. It can cause the thinning of the bones and nails, brittle hair and even infertility. In severe cases, it may also result in brain, heart or multi-organ failure, along with extreme starvation to death.
Bulimia Nervosa
Bulimia Nervosa is another commonly known eating disorder, found to develop during adolescence and early adulthood. People with Bulimia often experience binge-eating episodes, followed by purging. They frequently eat unusually large amounts of food, until they are painfully full. During such episodes, the individual feels as if they can’t stop eating or control the amounts that they eat. While people with Bulimia can experience binge-eating episodes with any kind of food, it often occurs with the ones that the individual might usually avoid.
After binging, they then resort to purging, by forced vomiting, fasting, using laxatives, enemas or excessively exercising. This is because they attempt to compensate for the amounts of calorie intake during their binge eating episodes. It is also done to relieve gut discomfort. It is also common for people with Bulimia to restrict their eating and calorie intake throughout the day. This often results in them binge-eating and purging during the night instead.
In terms of symptoms, Bulimia is very similar to binge-eating and purging subtypes of anorexia nervosa. However, what sets it apart is the fact that while people suffering from anorexia are usually underweight, or actively trying to lose weight, in Bulimia, the weight of the individual remains relatively constant. They maintain a relatively typical weight rather than losing a great amount.
The common symptoms of Bulimia are:
- Recurrent episodes of binge-eating
- Feeling a lack of control over the amounts of food an individual indulges in
- Recurrent purging episodes to compensate for the calorie intake during binge-eating
- Fear of gaining weight, even if the individual may have a normal weight
- The self-esteem of the individual may get overly influenced by their weight and body shape
Due to recurrent binge-eating and forceful purging, the individual also gets prone to developing various side effects. They may experience a sore throat, swollen salivary glands, worn-out tooth enamel or inflamed throat. Tooth decay, severe dehydration, acid reflux, hormonal imbalances and irritation of the gut and compromised gut health are also possible. In severe cases, it may cause an imbalance in the levels of electrolytes in the body, which can cause a stroke or even a heart attack.
Binge-eating Disorder
Binge-eating disorder is one of the most chronic illnesses and prevalent forms of eating disorders amongst adolescents. Typically, it develops during adolescence or young adulthood, but also has the possibility of developing later on in life.
In binge-eating, people often eat an extremely large quantity of food, in very short amounts of time. They experience a lack of control when it comes to indulging in such behaviours. However, unlike in Anorexia or Bulimia, people don’t actively try to restrict their calorie intake or use purging techniques to recompense for their binging behaviours.
People suffering from binge-eating often eat way too much food in short periods or indulge in eating more than what their normal diet calls for. Due to the lack of control that they feel, it can get difficult for individuals to stop eating even after feeling uncomfortably full or even nauseous. But what follows such eating sprees is the unmistakable feeling of guilt, disgust or shame. It can also lead to people eating alone, to avoid reliving the embarrassment in front of others.
The Common Symptoms of binge eating are:
- Eating large amounts of food in small periods of time
- Eating in secret
- Eating till uncomfortably full or eating without feeling hungry
- Feeling a lack of control during their bingeing episodes
- Feelings of distress, shame, disgust or guilt when thinking about binging behaviours
- Not resorting to purging or calorie-restrictive diets
When people with binge-eating disorders consume excessive amounts of food, they do not necessarily make nutritional food choices. Constantly eating large amounts of junk food can increase an individual’s risk of developing heart disease, stroke and type 2 diabetes.
Pica
Pica is a relatively lesser-known eating disorder. It involves an unusual behaviour where an individual eats substances with no nutritional value or benefits to them. Individuals with Pica crave non-food substances such as hair, cloth, paper, dirt, ice, wool, chalk, soap, pebbles, cornstarch or laundry detergent. It is a serious disorder which people of any age group can suffer from.
Pica usually develops in individuals with conditions that affect their daily functioning, such a individuals who are intellectually challenged, autistic or with mental health disorders such as schizophrenia.
It is important to remember that to diagnose a person with Pica, it should be ensured that the non-food substances that they eat shouldn’t be a typical practice of the culture or religion that the individual identifies with. In other words, the practice of eating such substances should not be considered to be a socially acceptable custom.
Since individuals with Pica eat non-food substances, it can have a toll on their bodies. They can get more prone to developing infections and gut injuries, along with nutritional deficiencies and being at a higher risk of poisoning. Depending on what the individual digests, Pica can prove to be extremely fatal.
Rumination Disorder
Rumination disorder is also a lesser-known eating disorder. In this disorder, an individual regurgitates, that is, brings up the food that they have previously chewed and swallowed, only to re-chew it again. They then either re-swallow the food or spit it out. The process is very similar to how cows digest the food stored in their humps. This process usually occurs within the first 30 minutes of eating a meal.
The disorder can develop at any stage of life, from infancy to adulthood. In infants, it usually develops around 3 to 12 months of age and gets resolved on its own. If not resolved, the child can experience weight loss and severe malnutrition, which may even be fatal. On the other hand, children and adults having such an eating disorder require medical attention and therapy to resolve it.
Adults usually develop such an eating disorder by restricting the amount of food that they eat in public, losing weight and becoming undernourished.
Losing weight is a prevalent symptom that shows up either when the individual spits out the ruminated food, or if they start eating very fewer quantities to avoid such behaviours.
Avoidant/restrictive food intake disorder
Avoidant/restrictive food intake disorder, or ARFID, is a new name for an eating disorder earlier termed as ‘Feeding Disorder of the Infancy and Early Childhood’, a diagnosis that was usually made for children below the age of 7 years.
People with this disorder experience disturbed eating habits due to distaste for certain tastes, smells, textures, colours or temperatures or simply because of a lack of interest in eating something.
Common symptoms of the same include:
- Weight loss
- Poor development in terms of the age and height of the individual
- Nutrient deficiencies
- Dependence on tube feeding
- Dependence on supplements to acquire the needed nutrition
- Eating habits that interfere with societal norms such as eating with other people
- Avoiding eating food
- Restriction of food intake
ARFID is much more complicated than picky eating in toddlers or lower food intake by older people. It also does not account for the avoidance or restriction of food intake due to availability difficulties, or religious or cultural practices of the individual suffering from it. It is characterised by the failure of a person to meet their minimum daily nutritional requirements, avoiding food due to certain sensory characteristics that an individual does not prefer, lack of interest in eating itself and in some rare cases, avoiding food due to fear of the consequences that might follow, such as the possibility of choking on it.
Other Eating Disorders
In addition to the above-stated eating disorders, there are also a few more that can be considered within the spectrum. These include:
- Purging Disorder: Individuals with purging disorder usually resort to behaviours such as vomiting, taking laxatives, diuretics or excessive exercise to control their weight and size. They also tend to avoid eating during the day but end up binging during the night, usually after waking up from their sleep.
- Night Eating Syndrome: Similar to the above-stated typical behaviours, individuals with such a syndrome usually eat a lot at night, sometimes even after being woken up from their sleep.
- Other specified feeding or eating disorder (OSFED) is not mentioned in the DSM-5 but is being mentioned in this list because it possesses symptoms similar to those of eating disorders. One disorder falling within OSFED is orthorexia. People with orthorexia tend to excessively focus on healthy eating to such an extent that it starts disrupting their daily routine and functioning. They compulsively check the ingredient lists and nutritional labels of the food they consume. They also obsessively follow fitness accounts on social media platforms, and may even eliminate certain types of foods because they see them as ‘unhealthy’, among other symptoms. It can lead to malnutrition, emotional distress and severe weight loss. But what sets it apart is that individuals suffering from orthorexia aren’t focused on losing weight but rather, on living a ‘healthy’ lifestyle. Their self-worth, identity or satisfaction are all driven by the same motive and complying with their set routines.
Conclusion
One of the most beneficial ways to constructively navigate an Eating Disorder is to understand that it’s not a matter of shame. You aren’t alone in this. Loved ones, Healthcare Professionals and the mutual trust and friendship of the people around you, who might have struggled with similar problems, can truly make an impactful difference.
Recognizing the signs that you or your loved one may have developed an eating disorder is an important first step in the treatment cycle. The more promptly the treatment begins, the more effective it can be.
You can schedule an online session with an RCI Licensed Clinical Psychologist on Venthrapy today.