Clinical Corner - What is an Eating Disorder?
Eating Disorders include a range of conditions that involve an obsession with food, weight and appearance to the degree that a person's heath, relationships and daily activities are affected.
Though commonly affecting young women, eating disorders are widespread and can impact people of all ages and sexes. It is estimated that several million people in the United States suffer from an eating disorder, and the statistics are growing. The number of men with an eating disorder has more than doubled in the last ten years.
Whether a person restricts food intake, binges and purges, binge-eats, compulsively overeats, excessively exercises, or abuses laxatives, these behaviors often are symptoms and not the problem. They often develop as a way of coping with stress or trauma, emotional pain, conflicts related to separation, low self esteem, depression.
Bulimia is a cycle of uncontrolled binge eating followed by purging through vomiting or the use of laxatives. Individuals with bulimia are often of normal weight or even slightly overweight. Bulimia can range from a mild and relatively infrequent response to stress to an extremely debilitating pattern that absorbs nearly all of a person's time, energy, and money. In its most severe forms, binge eating and purging may occur ten or more times a day.
Bulimia usually begins innocuously as an attempt to control weight. Purging may seem to be a convenient means for a person to overeat without gaining weight. It can quickly become a destructive process that cannot be controlled. Persons with bulimia are often aware that their eating patterns are abnormal and out of control and that their lives are dominated by their eating habits. They may feel guilty and depressed after a binge. Over time, the cycle becomes more and more dominant in the person's thoughts and behavior. It may impair personal relationships and interfere with other activities, leading to depression, isolation, and lowered self-esteem. Once caught in this pattern, the resulting shame and sense of helplessness may make it difficult for the person to seek the help that is needed.
Physical effects can also be serious. Frequent vomiting can cause permanent tooth damage from erosion of tooth enamel as well as damage to the tissues of the throat and esophagus. Kidney problems and seizures are also possible. Electrolyte imbalance with consequent risk of serious cardiac problems is also a significant danger and frequent cause of death.
Anorexia Nervosa is a disruption in normal eating habits characterized by an all consuming fear of becoming "fat". It typically starts in teenage women as a normal attempt to diet but gradually leads to more and more weight loss, often more than 25% of original body weight. There is an intense preoccupation with food and body size, which may involve compulsive exercising. As this happens, many normal activities may stop. Menstruation ceases in women and there are a number of physical symptoms of malnutrition such as lowered heart rate, low blood pressure, decreased metabolic rate and sensations of coldness particularly in the extremities.
People with anorexia nervosa are obsessed with food and deny that they have a problem or that they are too thin. They may be able to work or study and have some social life but usually function far below their potential. Frequently they are also depressed. Some persons with anorexia starve themselves to death. Others check the downward spiral of weight loss and maintain a steady but seriously underweight condition. In all cases, even severe weight loss does not diminish the perception of being "fat".
Binge Eating Disorder
An illness that resembles bulimia is binge eating disorder. Like bulimia, the disorder is characterized by episodes of uncontrolled eating or binging. However, binge eating disorder differs from bulimia because its sufferers do not purge their bodies of excess food.
Individuals with binge eating disorder feel that they lose control of themselves when eating. They eat large quantities of food and do not stop until they are uncomfortably full. Usually, they have more difficulty losing weight and keeping it off than do people with other serious weight problems. Most people with the disorder are obese and have a history of weight fluctuations. Binge eating disorder is found in about 2 percent on the general population--more often in women than men. Recent research shows that binge eating disorder occurs in about 30 percent of people participating in medically supervised weight control programs.
People with binge eating disorder are usually overweight, so they are prone to the serious medical problems associated with obesity, such as high cholesterol, high blood pressure, and diabetes. Obese individuals also have a higher risk for gallbladder disease, heart disease, and some types of cancer. Research at The National Institute of Mental Health and elsewhere has shown that individuals with binge eating disorder have high rates of co-occurring psychiatric illnesses--especially depression.
U.S. Department of Health and Human Services - Public Health Service - National Institutes of Health - National Institute of Mental Health