Eating Disorders: Anorexia, Bulimia, Binge Eating

Eating disorders are illnesses characterized by unhealthy behaviors associated with food or eating, such as starving, overeating, or bingeing.

Eating Disorder Types

• Binge eating
• Anorexia nervosa
• Bulimia nervosa
• Night eating syndrome
• Pica
• Rumination disorder

Binge eating disorder is the most common eating disorder, involving episodes of extreme overeating. Both males and females are affected, and most of those affected are overweight or obese. Unlike bulimia, there is no association with purging the excess calories by vomiting, fasting, or intense exercise. Binge eating disorder can occur at any age, but it is often diagnosed in middle-aged people. This condition can cause serious problems.

Binge Eating Disorder Complications

• Type 2 diabetes
• Heart disease
• Hypertension

Binge eating disorder is more than simply overeating from time to time. Sufferers of binge eating disorder describe a loss of control associated with eating. They may eat quickly, binge when they are not hungry, or eat until they are painfully full.

What Triggers Binge Eating?

• Anxiety
• Stress
• Boredom
• Depression

After an episode of binge eating, sufferers may experience binge eating disorder symptoms including guilt, shame, or depression. This can cause a vicious cycle that leads to further episodes of bingeing. The feelings of guilt often cause people to hide the behavior, making it hard to detect or properly diagnose.

Weight fluctuations are a typical symptom of binge eating disorder, since binge eaters may diet to make up for the binge episodes. Weight-loss attempts are not likely to be successful until the bingeing behavior is controlled. Weight gain may also occur as a result of binge eating.

One diagnostic sign of binge eating disorder is bingeing at least twice a week for a period of six months or longer. As mentioned, people may hide this behavior so it is even more difficult to diagnose. The diagnostic process typically also includes a physical exam and a thorough exploration of family history, medical history, and eating habits.

A combination of modalities may be used to manage binge eating disorder. Cognitive behavioral therapy can help identify and change unhealthy thinking patterns that lead to bingeing episodes. Other helpful treatments include nutrition counseling, family therapy, and support groups. Weight-loss programs can help the sufferer achieve and maintain a healthy weight. Medications may be prescribed to help manage depression if it is present.

Anorexia nervosa is a condition characterized by an abnormal fear of gaining weight, driving people to starve themselves and become dangerously thin. It is more common in females but does occur in males as well. Sometimes a life change or traumatic event may be associated with the development of the illness, or even a desire to excel in sports. Anorexia poses serious health risks but can be successfully treated.

Those who suffer from anorexia adopt numerous strategies to lose weight. In addition to starving themselves, they may abuse diuretics or laxatives or take diet pills. Despite appearing perilously thin, they may continue to push themselves to lose weight.

Many people with anorexia are obsessed with food -- thinking about it constantly even though they eat little. Other behaviors may include weighing food, calorie counting, careful portioning of food, or consuming very small amounts of restricted foods. Others may move food around on the plate without eating any of it.

Despite their thin appearance, people with anorexia nervosa typically see themselves as fat or overweight. They may be critical and perfectionistic regarding themselves. The urge to achieve a perfect body can become a life-threatening obsession.

Anorexia can cause long-term health problems, including bone thinning, anemia, heart damage, and organ failure. It can also be fatal.

Typical Signs and Symptoms of Anorexia Nervosa

• Yellowish skin
• Brittle nails and hair
• Sensitivity to cold
• Lethargy
• Constipation
• Absence of menstrual periods (amenorrhea)

To diagnose anorexia nervosa, tests may be performed to rule out other causes of weight loss and wasting. Typical signs include being less than 85% of normal weight, having an intense fear of gaining weight, and having a markedly distorted body image. Getting a prompt diagnosis is important since this condition can have serious health consequences.

Those who suffer from anorexia may have other mental-health problems such as anxiety, substance abuse, or depression. Some may think about suicide. If you or someone who know is having suicidal thoughts, call 911 or the national suicide hotline: 800-273-TALK (800-273-8255). Risky behaviors, talking about death or suicide, and withdrawing from loved ones are all warning signs.

If a person with anorexia nervosa has suicidal thoughts or has serious health complications from the condition, a short hospital stay may be required to begin treatment. Other treatment programs involve attending daytime outpatient appointments while living at home.

Family therapy, including parents, is helpful for young people with anorexia. Food and nutrition counseling are part of an effective anorexia treatment method.

Anorexia Treatment's Three Main Objectives

• Restoring a healthy weight
• Reducing thoughts or behaviors that could lead to relapse
• Managing accompanying psychological problems

Medications, including antidepressants, can be prescribed to help manage mood problems in people suffering from anorexia. Medications are effective for some people while others may relapse. A combined approach of medications along with psychotherapy tends to be most effective.

Bulimia nervosa is characterized by episodes of binging and purging. Purging is commonly self-induced vomiting, but it can also include the misuse of diet pills, laxatives, diuretics, or excessive exercise. Up to 90% of those affected are female, and the condition often develops in teens and young adults. Factors thought to be involved in bulimia include life stresses, biological factors, and societal pressure to be thin. Treatment can help.

For a person with bulimia, binging and purging can occur many times in one day or a few times a week. Purging may involve self-induced vomiting, laxatives, or excessive exercise. The bingeing is associated with a feeling of loss of control, and sufferers may try to hide the behaviors.

In contrast to anorexia, those with bulimia are usually of normal weight or slightly overweight. They have an intense fear of gaining weight and may have a distorted body image, believing they are very overweight.

The cycle of bingeing and purging is associated with an attempt to control negative thoughts in many people. They may experience depression or anxiety. Others may struggle with substance abuse. Other symptoms can include mood changes and withdrawal from loved ones.

Bulimia nervosa symptoms and signs include:

• Worn tooth enamel
• Swelling of the salivary glands
• Sore throat
• Heartburn
• Constipation
• Irregular menstrual periods
• Dehydration
• Electrolyte imbalances in the blood (that can lead to heart problems)

The fact that many people try to hide bingeing and purging behavior can make diagnosing bulimia challenging. To make the diagnosis, the doctor will ask about the individual's eating patterns and history. Early diagnosis and treatment offer the best chances for a successful outcome.

If you suspect a loved one may have an eating disorder, talk to them respectfully about your worries. Don't make them feel guilty or blame them. Encourage the person to seek help and let them know you support.

As with other eating disorders, the most successful treatment for bulimia involves a combination of approaches including psychotherapy, nutrition counseling, and antidepressant medications, if necessary. Antidepressant medications have been shown to be successful at helping to break the binge-purge cycle and prevent relapse.