Although most of us are familiar with eating disorders, few of us can name any beyond anorexia and bulimia. The truth is that there are many different kinds of eating disorders, each with its own signs and symptoms.
This year, NEDAwareness Week (National Eating Disorders Awareness Week) will be taking place from February 21 to February 27, 2022. The purpose of this awareness week is to educate more people about eating disorders, what they look like, and how to find help.
The consequences of eating disorders can be far-reaching, impacting your mental health, physical health, relationships, and work/school life. Fortunately, though, they can be treated. It’s important to seek treatment as soon as possible.
What are eating disorders?
Eating disorders are psychological conditions that involve disturbed eating patterns and associated mental distress.
There are a few different kinds of eating disorders. Each eating disorder has its own diagnostic criteria. If you suspect that you have an eating disorder, it’s a good idea to seek help sooner rather than later, even if you’re not sure which category you fall into.
Anorexia nervosa is characterized by starvation and rapid weight loss. This is motivated by an extreme fear of gaining weight.
There are two types of anorexia:
- restricting type, where someone loses weight primarily by dieting, fasting or excessively exercising
- binge-eating/purging type, where someone engages in intermittent binge eating and/or purging behaviors
To fit the criteria for anorexia nervosa, you’d have to fit a certain weight criteria. Those who are not characterized as underweight, but have behaviors that fit the rest of the criteria, might be diagnosed with atypical anorexia nervosa.
Anorexia nervosa has one of the highest mortality rates of all psychiatric conditions, as it can take a serious toll on a person’s mental, physical, and social health. The good news is that it is treatable. The sooner treatment begins, the better.
Bulimia nervosa involves binge-eating and then engaging in “compensatory behaviors,” like extreme dieting, vomiting, or laxative use, to “make up” for binge-eating.
Someone with bulimia nervosa typically feels extreme shame and self-disgust while binge-eating. They’re usually preoccupied with thoughts about food, weight, and purging.
This eating disorder can result in a range of physical health issues, from dental decay to gastric rupture. Fortunately, it can be treated with therapy, self-care strategies, and/or medication.
Binge-eating disorder involves eating excessively – often to the point of feeling ill. Typically, you’ll eat even after feeling full, and even if it’s uncomfortable. Binging is associated with feeling out of control.
Therapy, especially cognitive behavioral therapy, is known to be an effective treatment for binge-eating disorder. In some cases, people with binge-eating disorder might benefit from antidepressant medication, which has to be prescribed by a doctor.
Pica involves eating non-food items (like chalk, paper, or clay) to the point of it warranting medical attention.
Avoidant Restrictive Food Intake Disorder
We all have our preferences when it comes to food – but if someone goes to extreme measures to avoid certain kinds of food, it could be ARFID.
Someone with ARFID might seem like a picky eater. The key difference between ARFID and picky eating is that ARFID can lead to severe illness or malnourishment. A picky eater is unlikely to starve because of their preferences.
The symptoms of ARFID include:
- Very limited range of things you’ll eat
- Low appetite
- Lack of interest in eating or food
- Extreme food avoidance based on sensory characteristics of foods (the smell, color, texture, etc.)
- Severe anxiety about the consequences of eating (fear of choking, vomiting, constipation, allergic reactions, etc.)
ARFID often develops after a traumatic event, such as choking or a bad allergic reaction. It can even develop in infants, who might struggle to swallow milk after an incident of choking or reflux.
Unlike anorexia nervosa or bulimia nervosa, ARFID isn’t associated with a fear of weight gain or with body image disturbances.
Although orthorexia is not classified as a mental disorder in the DSM-5 – the manual used by US healthcare practitioners to make diagnoses – it is often considered an eating disorder by advocates and experts.
Orthorexia is an excessive concern with healthy eating, to the point where it can get in the way of your day-to-day functioning.
The symptoms include:
- Compulsive or excessively checking ingredient lists and nutritional labels
- Excessive amounts of research on the healthiness of certain foods
- Unusual interest in other people’s diets
- Becoming distressed when you eat “unhealthy” food
- Obsessively sticking to certain food “rules”
- Cutting out multiple food groups
- Struggling to eat anything other than a narrow group of “healthy” foods
- Unusual interest in the health of what others are eating
- Spending hours per day worrying about food, including future meals
Orthorexia is often treated the way anorexia is treated. According to the NEDA site, many people with orthorexia also have obsessive-compulsive disorder (OCD), and OCD treatment may be necessary.
Other Specified Feeding and Eating Disorder
If someone has an eating disorder that doesn’t fit into the above categories, the OSFED label might apply to them.
With OSFED, someone experiences distress around food and disrupted eating behaviors, even if it doesn’t fit the diagnostic criteria for another eating disorder. An example of an OSFED is atypical anorexia nervosa. As mentioned above, this is when someone’s thought patterns and behavior fit the criteria for anorexia nervosa, but they’re not underweight.
Identity and eating disorders
It’s important to remember that anybody can develop an eating disorder, no matter their race, gender, culture, religion, age, sexual orientation size, class, or any other aspects of their identity.
Most representations of eating disorders in the media focus on young, thin, straight, white women. Because of this, many of us stereotype and assume eating disorders seldom happen to anybody else.
It’s important to remember that eating disorders can affect anyone. These stereotypes can also make it difficult for people to seek help and receive compassionate, culturally sensitive treatment.
The NEDA website has a range of resources for some of the specific communities that are affected by eating disorders, from the disability community to older adults and beyond.
Body image plays a huge role in certain eating disorders, particularly anorexia and bulimia. In a society where we’re taught to value the way we look, it’s no wonder that many people develop unhealthy relationships with their body image.
Research has shown that people with poorer body image are more likely to develop eating disorders. This develops at a young age: according to some research, 40 to 60 percent of elementary school girls (ages 6 to 12) are concerned about gaining weight.
Thanks to the body-positive movement, more of us are openly embracing our bodies, even when they aren’t what society considers to be perfect. But poor body image isn’t something we can change overnight: it takes time and effort.
If you’re hoping to improve your body image, you might benefit from:
- therapy (even if you don’t have an eating disorder)
- attending a support group
- trying workbooks, such as The Body Image Workbook: An Eight-Step Program for Learning to Like Your Looks and the Your Body Is Not an Apology Workbook: Tools for Living Radical Self-Love
- replacing weight-loss content with body-positive content (e.g. following body positive influencers/accounts, reading body-positive articles, watching body-positive movies/series)
- practicing positive self-talk
Although there’s no easy cure for negative body image, it can improve over time.
There’s no need to wait until you fit the criteria for an eating disorder to get help. Even if you don’t have a diagnosable disorder, you will probably benefit from therapy.
The good news is that eating disorders can be treated and managed effectively.
Your first port-of-call is to speak to a therapist who specializes in eating disorders. If you’re not sure where to find one, ask your GP for a referral. You can also read this guide to finding a therapist.
We encourage Knew Health Members to reach out to us if they need help. We have a range of services and perks, such as free Health Coaching and telemedicine services, which can help you take the first step in feeling better and help manage costs effectively.
For more information on eating disorders, we recommend checking out the NEDA website. They have a range of resources.
You might find the following links helpful:
Lastly, remember that healing is possible. Many people with eating disorders struggle to imagine a future where they have a better relationship with food and their bodies, but it can happen. Thousands of people successfully treat and manage their eating disorders every year – and that journey starts with asking for help.
Body image. (2022). https://www.nationaleatingdisorders.org/body-image-0
NEDAwareness Week. (2022). https://www.nationaleatingdisorders.org/get-involved/nedawareness
Orthorexia. (2022). https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia
Risk factors. (2021). https://www.nationaleatingdisorders.org/body-image-eating-disorders
Treatment. (2021). https://www.nationaleatingdisorders.org/treatment
What are eating disorders? (2021). https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
Disclaimer: This information is being provided to you for educational and informational purposes only. It is being provided to educate you about how to take care of your body and as a self-help tool for your own use so that you can reach your own health goals. It is not intended to treat or cure any specific illness and is not to replace the guidance provided by your own medical practitioner. This information is to be used at your own risk based on your own judgment. If you suspect you have a medical problem, we urge you to take appropriate action by seeking medical attention.