Four Common Types Of Eating Disorders
There is so much I want to convey to you about eating disorders. I have been a student of eating disorder recovery for the past seventeen years, working in the trenches with recovering people and absorbing, night and day, any materials, knowledge or behaviors that could be helpful to them. With this said, I need first to start at the beginning, assuming you are educating yourself for the first time about this fatal disease, and in need of a basic overview of this illness, which manifests in four major forms (below) and currently affects more than 24 million Americans. Eating Disorders are an array of mental disorders that display unusual eating behaviors or habits with serious health consequences. All eating disorders are rooted in an obsession with food, the shape of one’s body or body weight. Fascinatingly, eating disorders are mental health issues that become physical health issues, interfering with every aspect of a person’s functionality, with a host of bodily implications as well as cognitive, psychological and social. Eating disorders are a leading cause of death in teenagers in the U.S.
The symptoms of eating disorders can include food restriction, binges on food, and purging by vomiting or by over-exercising. The average age of onset is 18 years-old for both bulimia nervosa and anorexia nervosa and 21 years old for binge eating disorder. People tend to suffer for a minimum of seven years, if they survive the course of disease. Some are affected throughout the lifespan, spending years in and out of treatment facilities, or worse, never receiving the proper help at all. I will begin my overview by discussing Binge Eating Disorder, which is characterized by recurring binge eating episodes during which a person feels a loss of control and marked distress over his or her eating. Unlike bulimia nervosa, binge eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge eating disorder often are overweight or obese.[1]
Bulimia Nervosa is characterized by binge eating (eating large amounts of food in a short time, along with the sense of a loss of control) followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives, or diuretics), fasting, and/or excessive exercise. Unlike anorexia nervosa, people with bulimia can fall within the normal range for their weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape.[2]
Anorexia Nervosa is characterized by a significant and persistent reduction in food intake leading to extremely low body weight in the context of age, sex, and physical health; a relentless pursuit of thinness; a distortion of body image and intense fear of gaining weight; and extremely disturbed eating behavior. Many people with anorexia see themselves as overweight, even when they are starved or severely malnourished. [3]
Avoidant Restrictive Food Intake Disorder (ARFID) — according the 5th edition of the Diagnostic Statistics Manual (DSM-5) is seen in my practice often in the pediatric population. Characterized by an eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following: significant weight loss (or failure to achieve expected weight gain or faltering growth in children), significant nutritional deficiency, dependence on enteral feeding or oral nutritional supplements, marked interference with psychosocial functioning. ARFID is made known as such when the disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice, and the eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced. To receive a diagnosis of ARFID, the eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention. ARFID goes beyond picky eating in toddlers, and needs treatment by an eating disorder professional therapist as well as a specialized nutritionist, and medical monitoring from a pediatrician who is educated in the condition. ARFID is not a phase and can morph into anorexia given the absence of treatment. The information I share is meant to provide a better understanding of four common eating disorders and to dismiss common misconceptions of what eating disorders are. It’s important to note that these are serious medical and mental disorders which do not work themselves out. If you think you have an eating disorder or know someone who might have one, call us today or see a healthcare practitioner who specializes in eating disorders.
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