See also . . . .
Anorexia
Nervosa
Binge Eating Disorder
Bulimia Nervosa
What are
eating disorders?
Eating
disorders are real illnesses that can affect how we eat and
how we feel about food. They can be treated to help people who
have them have healthy and full lives. From time to time, we
all change our eating habits. Sometimes we reduce the amount
of food we eat or go on a diet to shed some pounds, or we eat
more to gain weight. These can be healthy ways to control or
reach our ideal body weight. But, people who have eating disorders
have unhealthy ways, or patterns, of eating. They may eat too
much and become overweight, or way too little and become very
thin. Sometimes a person can eat so little, or nothing at all,
they actually begin to starve (called anorexia nervosa). A person
can also eat an extreme amount of food all at once and then
do things like vomit to rid the body of food (called bulimia
nervosa). And, a person may not be able to control the need
to overeat, often keeping it a secret (called binge eating disorder).
People can also have wrong ideas, or misperceptions, of their
body weight. People with eating disorders can feel certain they
weigh too much, even though they may be well under the ideal
body weight for a person their size.
Eating
disorders affect people of all ages, race, and income levels.
But, these disorders affect women much more than they do men.
Women make up more than 90 percent of people with these disorders.
Without treatment, an eating disorder can take over a person's
life and cause serious illness and death. These disorders can
increase risk for osteoporosis (thinning of the bones) and heart
problems. People who have eating disorders can also have depression
and anxiety, and may turn to alcohol and drugs for relief.
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Who is at
risk for eating disorders?
In
the United States and other Western countries, women are more
at risk for eating disorders than are men. These disorders affect
8 to 10 times more women than men. In the U.S., it was thought
that eating disorders affected mostly white women. But, recent
research has shown that black women are affected as well. One
study found that black women were more likely than white women
to have repeated episodes of binge eating disorder. This may
put black women more at risk for obesity (being overweight).
Women
may be more at risk for eating disorders because of a need to
have the "ideal" figure often shown in the media (TV,
magazines, movies). The "thin is best" view can affect
girls and young women in particular. They often go on strict
diets to look like the girls and women they see in the media.
Pressure from friends to be thin and to diet can also happen.
For women, body image, or how you feel about how you look, can
affect feelings about body weight. Not liking how much you weigh,
feeling fat, and wanting to be thin can make you worry more
about how you look than other things, such as your own ideas
or what you want to do in your life. Sometimes, young women
who are at a normal weight, or even underweight, may feel that
they are too fat. A woman may also feel that how she looks or
how much she weighs makes up a major part of her self-esteem.
While young women may be most at risk for eating disorders,
these disorders are affecting older women in growing numbers.
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What
causes eating disorders?
No
one knows for sure what causes eating disorders. It is known,
though, that these disorders can't be willed or wished away
- treatment is needed. If you or someone you know has an eating
disorder, don't wait to get help. Talk with a health care provider,
the sooner the better.
Much
research has been focused on how personality and environment
can put a person at risk for an eating disorder. People with
eating disorders are thought to share certain traits, such as
low self-esteem (how you feel about who you are), feelings of
helplessness, and a fear of becoming overweight. Eating disorders
seem to develop as a way of dealing with stress. These disorders
appear to run in families, affecting women more than men. Research
has shown that a woman's social environment, including her family
and friends, can affect how she feels about body weight. For
instance, frequent talk about being thin and dieting may put
pressure on a person to be thin. Being teased about being overweight
by family and friends can lead to low self-esteem and unhealthy
eating in young girls and women. Also, young people who are
involved in sports or activities that emphasize thinness (modeling,
dancing, long distance running, gymnastics) are more likely
to develop eating disorders.
Research
is also looking at the role genetics and a person's biological
make-up and body chemistry play in eating disorders. Studies
funded by the National Institute of Mental Health have focused
on serotonin, a substance found in the brain that can affect
appetite and a person's ability to control impulses and moods.
In women, researchers are exploring how eating disorders may
affect serotonin levels and how the brain signals the body about
hunger and fullness. For example, most women feel better - in
terms of fullness and mood - after eating. But for women with
anorexia, not eating can actually improve mood and feelings
of well-being. Knowing how serotonin affects eating disorders
will help researchers to figure out which women are more at
risk for these disorders and better ways to treat them.
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What are
the most common types of eating disorders? What effects do they
have on a person's health?
The
three most common types of eating disorders are:
Anorexia
nervosa - starving yourself by eating very little or
nothing at all. People who have this condition can have a strong
fear of body fat and weight gain. To stay thin, a person may
diet, fast, or exercise too much. Taking laxatives, diuretics,
or enemas to rid the body of food is also common. Women with
anorexia can have menstrual periods that are not regular, or
none at all. Girls with anorexia often get their periods later
than girls who don't have this illness. People with this illness
may think they are overweight, even when they are very skinny.
The process of eating becomes an obsession, or something you
can't stop thinking about. Eating habits develop that are not
normal, such as staying away from food and meals, picking out
only a few foods and eating these in small amounts, or carefully
weighing out food portions to eat. People with anorexia may
also check their body weight a lot.
Anorexia
can cause the same types of problems that happen when a person
is starving. The lack of food can cause a person to become
very thin, develop brittle hair and nails, dry skin, and a low
pulse rate, become not able to stand the cold, and suffer from
constipation and sometimes diarrhea. It can also affect a person's
blood count, causing mild anemia, reduce muscle mass, stop a
woman's menstrual period, and lead to swollen joints. Lack of
calcium, due to a poor diet, places anorexics at higher risk
for osteoporosis (bone thinning) later in life. Many people
with this illness have depression, anxiety, and problems with
alcohol or drugs. The most serious problems include death from
starvation, the heart stopping, or suicide.
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Bulimia
nervosa - when a person binges, or eats an extreme amount
of food all at once and then purges - vomits, takes laxatives
or diuretics (water pills) - to rid the body of food. Exercising
to excess and fasting can also occur to make sure no weight
is gained after binge eating. People with this eating disorder
feel no control during the times they are eating to excess.
This illness most often starts in the late teenage years or
early adult life. Like anorexics, people with bulimia have extreme
worry about food, body weight, and body shape. Many bulimics
binge and purge in secret, and still keep a normal body weight.
By doing so, a person can often hide this illness for years.
Feelings of disgust and shame after binge eating are common,
as well as feelings of relief after purging. Eating binges can
happen once or twice a week or as much as a few times a day.
They can be triggered by depression, boredom, or anger. The
need to binge and purge can be constant or can happen once in
a while, with periods of time where no bingeing occurs.
Health
problems from bulimia are mostly related to electrolyte imbalance
(when the amounts of sodium and potassium in the body become
too much or too little) and repeated purging behaviors. Purging
causes the body to lose potassium, which can damage heart muscle
and increase a person's risk for heart attack. Frequent vomiting
can inflame the esophagus (tube that connects the throat with
the stomach) and damage tooth enamel. Other problems caused
by bulimia include scarring on the back of fingers from pushing
them down the throat to cause vomiting, loss of or change in
menstrual periods, and no sex drive. People with this illness
can have trouble dealing with and controlling impulses, stress,
and anxiety. They may also have depression, obsessive-compulsive
disorder (an illness where you have unwanted thoughts and behaviors
you can't stop repeating), and other mental illnesses. Problems
with alcohol and drugs is not uncommon. Bulimics are also likely
to be anorexic.
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Binge
eating disorder (BED) - when a person can't control the
desire to overeat and often keeps the extreme eating a secret.
People with this eating disorder feel no control during the
times they are eating to excess. During binge eating, a person
may eat more quickly than normal, eat until feeling discomfort,
eat large amounts of food when not hungry, and eat alone. Unlike
bulimia and anorexia, a person doesn't try to rid the body of
extra food by doing things like vomiting, fasting, or exercising
to the extreme. Because of this, many people who have this illness
are overweight. A person can feel disgust, shame, and guilt
during a binge, which can lead to bingeing again, causing a
cycle of binge eating. Like with anorexia, people with BED can
fear gaining weight, want to lose weight, and dislike the way
their bodies look. BED most often starts in the late teenage
years or early adult years. Some experts believe BED is the
most common eating disorder. The illness often develops soon
after extreme weight loss from a diet. BED can be hard to diagnose
and can be mistaken for other causes of obesity (being overweight).
People with BED are often overweight because they maintain a
high calorie diet without exercising. Medical problems can happen,
like those found with obesity, such as high cholesterol levels,
high blood pressure, and diabetes. BED also increases a person's
risk for gallbladder disease, heart disease, and some types
of cancer. People with BED often suffer from depression.
There
are two other types of eating disorders. Eating disorder
not otherwise specified (EDNOS) is the name for disorders of
eating that don't fit into one of the three disorders described
above. With EDNOS, a person has some form of abnormal eating
but not all the symptoms needed to be diagnosed with an eating
disorder. For instance, a person with EDNOS may purge themselves
after eating, but do so with less frequency or intensity than
someone who has bulimia.
More
common than eating disorders is a condition called disordered
eating. This is when a person diets, binges, or purges, but
doesn't do so often or severely enough to be diagnosed with
an eating disorder. A person may change how they eat after a
stressful event or an illness, before an important speech or
work event, or before a sports competition. Disordered eating
can lead to weight loss or weight gain, but rarely requires
treatment. But, if the disordered eating becomes long lasting,
causes upset and stress, changes the way a person feels about
themselves or how they look, or starts to get in the way of
daily activities, they need to get help right away. Don't wait
to see if the problem goes away by itself, talk with a health
care provider about where to go for help.
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How can you
tell if someone has an eating disorder?
Because
many people with eating disorders keep them a secret, their
conditions can go unnoticed for long periods of time, even years.
With anorexia, signs such as extreme weight loss are easier
to see. But, bulimics who can stay at their normal body weight
may be better able to hide their illness. Family members and
friends may notice some of the warning signs of an eating disorder.
A
person with anorexia may:
Eat
only "safe" foods, low in calories and fat.
Have
odd rituals, such as cutting food into small pieces or measuring
food.
Spend
more time playing with food than eating it.
Cook
meals for others without eating.
Exercise
to excess.
Dress
in layers to hide weight loss.
Spend
less time with family and friends.
Become
withdrawn and secretive.
A
person with bulimia may:
Become
very secretive about food.
Spend
a lot of time thinking about and planning the next eating binge.
Keep
making trips to the bathroom after eating.
Steal
food or hoard it in strange places.
Eat
to excess.
A
person with binge-eating disorder may:
Become
very secretive about food.
Spend
a lot of time thinking about and planning the next eating binge.
Start
eating alone most of the time.
Steal
food or hoard it in strange places.
Eat
to excess.
Become
overweight.
Become
withdrawn, not wanting to go out or see family and friends.
If
you or someone you know has any of these warning signs, see
a health care provider right away. There is help for people
with these disorders and, with help, they can lead a healthy
and full life.
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What
are the treatments for eating disorders?
Eating
disorders can be treated and a person can return to a healthy
weight. Success in treating eating disorders is greatest when
they are found early and treated right away. The longer abnormal
ways of eating go on, the harder it is to overcome the disorder.
Plus, more damage is done to the body over time, which can result
in serious health problems.
There
is no one, or best, way to treat these complex disorders. Most
people with eating disorders are treated by a team of health
care providers and receive medical care, psychotherapy (sometimes
called "talk therapy"), and nutritional counseling.
Professionals who provide psychotherapy can be therapists, psychologists,
psychiatrists, social workers, or counselors. Types of psychotherapy
include cognitive-behavioral therapy (changes how a person thinks
about, and then reacts to, a situation that makes them anxious
or fearful) family therapy, and group therapy. In some cases,
a person may need to go into the hospital or into an in-patient
or residential program. Medication is also sometimes used to
treat the disorder and prevent relapse (or keep it from coming
back). Certain antidepressants, called selective serotonin reuptake
inhibitors or SSRIs, have been shown to help maintain weight
and reduce anxiety for people with anorexia and bulimia. Training
to build self-esteem can also be helpful.
Talk
with your health care provider about treatment options. Also,
look under mental health services in your local phone book or
call the National Association of Anorexia Nervosa and Associated
Disorders, (847) 831-3438, for referrals to service providers,
treatment centers, and special programs.
Will having
an eating disorder keep me from getting pregnant or having a
healthy baby?
Having
an eating disorder can make it harder for a woman to get pregnant.
It may cause early delivery, or premature birth, which can cause
problems (sometimes life threatening) in a newborn. Women with
eating disorders have higher rates of miscarriage than do women
who don't have these disorders. If a woman doesn't eat lots
of different healthy foods during pregnancy, she and her baby
can have health problems. It is best to get treated for an eating
disorder before you try to get pregnant. But, even if your eating
disorder was treated and now gone, it could come back during
the stress of pregnancy. Making sure you have good support from
family, friends, and your health care provider is key to having
a healthy pregnancy. Keep in mind you will also need plenty
of support after the baby is born. Some women can feel "blue"
or have depression after giving birth, which can make an eating
disorder come back. Talk with your health care provider if you
are thinking about getting pregnant or are pregnant.
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What
should you do if you or someone you know has an eating disorder?
Support
is important when you or someone you know has an eating disorder.
Tell someone you trust about your problem. It may be a family
member, friend, counselor, religious or community leader, or
doctor. Talking to a school counselor or mental health professional
is a good place to start. Seeing a health care provider as soon
as you can is important too. Your doctor can help you get the
help you need for your eating disorder. You can also learn about
healthier ways to eat. Don't put off seeing a doctor, thinking
you will get better on your own. Keep in mind, an eating disorder
can cause serious harm to your body and to your emotional health.
What
is the latest research on eating disorders?
The
National Institutes of Mental Health (NIMH) conducts and funds
research on eating disorders. Researchers are looking at how
well psychotherapy and medications work, either when used alone
or together, to help people with these disorders. Also being
studied is the role family background (genetics), appetite and
exercise, and emotions and social behaviors play in eating disorders.
New research is focused on whether brain serotonin (a substance
that affects appetite, impulses and moods) is linked to eating
disorders in women. To find information on government-sponsored
clinical trials for eating disorders, go to http://www.clinicaltrials.gov.
This FAQ was adapted from eating disorder fact sheets from
the National Institute of Mental Health and the Department of
Health and Human Services Office on Women's Health.
For More Information...
You can find out more about eating disorders by contacting the
National Women's Health Information Center (800) 994-9662 or
the following organizations:
National Institute of Mental Health
Phone Number(s): (301) 443-4513 (Public Inquiries) or (301)
443-8431
Internet Address: http://www.nimh.nih.gov
Weight-Control Information Network (WIN)
Phone Number(s): (877) 946-4627
Internet Address: http://www.niddk.nih.gov
National Mental Health Information Center, SAMHSA, HHS
Phone Number(s): (800) 789-2647
Internet Address: http://www.mentalhealth.org
Academy for Eating Disorders
Phone Number(s): (703) 556-9222
Internet Address: http://www.aedweb.org
Eating Disorders Awareness and Prevention, Inc.
Phone Number(s): (800) 931-2237
Internet Address: http://www.nationaleatingdisorders.org
Harvard Eating Disorders Center
Phone Number(s): (888) 236-1188 ext. 100
Internet Address: http://www.hedc.org
