Over 10 million people in the U.S. suffer from an eating disorder. Eating disorders can lead to serious physical health problems and cause considerable mental distress, so it’s important to recognize the signs early and seek treatment. Recognizing an eating disorder in a loved one is not always easy. Although some eating disorders cause noticeable weight loss, others have more subtle symptoms. Overeating, undereating, eating only particular types of foods, and purging after eating can all be signs of an eating disorder.
An eating disorder causes an obsession with food that is often so strong that it can affect your health, relationships, social life, ability to work, and daily life. If you find your relationship with food becoming increasingly fraught, or you notice that a loved one is struggling, seek help from a mental health professional to start the recovery process.
Signs and Symptoms of Common Eating Disorders
“Eating disorder symptomatology can be very deceiving, secretive, and tricky,” said Dara Bushman, Psy.D. “The symptoms and behaviors of eating disorders vacillate between the types, Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Orthorexia (obsessive compulsion with healthy foods or diets), compulsive exercise.”
Dr. Bushman noted that symptoms of all eating disorders include: “firm food rules, obsession with food, isolation, Mood changes, frequently checking one’s weight, and negative self-talk.”
People with eating disorders may cut out certain food groups or have a number of dietary restrictions. “This aids in the restriction of food intake if the individual has a list of things they no longer allow themselves to eat,” said Dr. Bushman.
“It is not uncommon for individuals with eating disorders to suddenly become vegetarian or vegan or have sudden food allergies, perhaps to wheat, gluten or other food groups.”
Having an eating disorder often feels very shameful and those who suffer tend to keep their disorder a secret. They may avoid eating in front of others, avoid situations where food might be present, make excuses not to eat at normal meal times, according to Dr. Bushman.
“Eating in a more healthy fashion or an interest in ‘clean eating’ or an intense interest in fitness can develop into harmful behaviors and can result in an unhealthy weight,” said Dr. Bushman.
Although eating disorders are most common in women, men can also struggle with anorexia, bulimia, and binge eating.
The most common eating disorders are anorexia, bulimia, and binge eating disorder. Look out for the following symptoms to identify these conditions.
Signs and symptoms of anorexia:
- A low body weight which is under 85 percent of the normal weight range for height and age
- Extreme fear of gaining weight
- Restricted eating, such as eating very small portions or avoiding fattening foods
- Feeling or complaining of being fat when in fact the person is thin or underweight
- Unwillingness to maintain a healthy weight
- “Compulsive behaviors, obsession or infatuation with food,” said Dr. Bushman
- “They will often spend more time preparing food in the kitchen, reading cookbooks or discussing food in general,” said Dr. Bushman.
- “Trouble falling and staying asleep at night,” said Dr. Bushman. “Starvation can trigger hunger cues, leading to increased restlessness and disruption of sleep.”
- “Cold all the time as result of malnutrition and low body fat,” said Dr. Bushman.
As the disorder progresses, people with anorexia often become very thin. They may also develop the following physical symptoms:
- Irregular or no periods (in women)
- Brittle nails and dry hair and skin.
- Fine hair growth all over the body. “This hair, known as lanugo, is a physical adaptation to the low weight and loss of body fat,” said Dr. Bushman.
- Low blood pressure
- Thinning bones that break easily
- Constant fatigue
- “Hair loss is common when someone is malnourished, their protein levels become depleted experiencing,” Dr. Bushman said. “This includes keratin, a protein which actually makes up the majority of your hair.”
Signs and symptoms of bulimia:
Bulimia nervosa is a disorder that causes sufferers to eat large quantities of food and then purge by vomiting, taking laxatives or exercising excessively in an attempt to get rid of the calories. Although people with bulimia nervosa are often at an average weight, they may display the following signs of the disorder:
- Chronic sore throat
- Swollen glands in the neck
- Worn tooth enamel due to exposure to stomach acid
- Acid reflux and other digestive problems
- Severe dehydration
- Electrolyte imbalance
- “Dry and blotchy skin, stemming from dehydration from frequent purging and laxatives. Dry mouth, sunken cheeks and eyes, and severe electrolyte imbalances also can occur,” said Dr. Bushman.
- “Appearance of calluses on the knuckles. These lesions are caused by repeatedly scraping the back of the hand against one’s teeth while inducing vomiting,” said Dr. Bushman.
- “Swelling along the jawline from purging,” said Dr. Bushman.
Signs and symptoms of binge-eating disorder:
People with binge eating disorder also eat large quantities of food in an out-of-control way, but unlike bulimia sufferers, they don’t purge. As a result, they are often overweight. You may also notice that someone with binge-eating disorder feels guilty or distressed about his or her eating habits.
According to Dr. Bushman, people with binge eating disorder may:
- Cook elaborate meals for others.
- Plan social functions always generating around food.
- Eat strange food combinations. They may “prepare dishes using an odd mixture of ingredients, such as mashed potatoes and Oreo cookies, or potato chips with lemon, pork rinds, Italian dressing, and salt,” said Dr. Bushman.
- Dress in extreme oversized clothes
- Constantly try new diets or food regiments
- Buy large quantities of food but gloss over it when others ask.
- Constantly go food shopping and plan their life around food.
- Go to many different food establishments and grocery stores.
What Causes Eating Disorders?
Many people wrongly believe having an eating disorder is merely a lifestyle choice. In fact, conditions like anorexia, bulimia, and binge eating are psychological disorders. The causes of eating disorders are still being studied, but they are known to be influenced by many complex issues. A combination of psychological, environmental and biological factors contribute to the development of eating disorders.
- Genetic and epigenetic factors mean that those with family members who have suffered eating disorders are more likely to suffer from one themselves.
- Many experts believe that unrealistic standards of beauty may play a large role in the development of eating disorders.
- Anorexia and bulimia often start with dieting, and eventually progresses to severe, unhealthy loss of weight
- Young people suffering from eating disorders often come from families with high stress levels, overly high expectations, and poor communications and problem-solving skills.
- Those who participate in sports and activities that emphasize thin physiques such as ballet, gymnastics, ice skating, wrestling, running, and wrestling are generally at higher risk of developing an eating disorder.
- Many patients with eating disorders also struggle with trauma disorders. Traumatic life events such as sexual or physical or abuse may precede the development of an eating disorder. Disordered eating behaviors can be a trauma survivor’s effort to regain control in their life or manage their painful emotions.
Specialists Who Treat Eating Disorders
- Primary care physicians such as family doctors, pediatricians or internists for initial diagnosis and treatment of co-occurring health problems.
- Mental health practitioners such as psychologists, psychiatrists and therapists (Licensed clinical social workers [LCSWs], licensed mental health counselors [LMHCs] and licensed marriage and family therapists [LMFTs]) Try to find a mental health professional who specializes in treating eating disorders.
- Dietitians or nutritionists to provide education on healthy nutrition and meal planning.
- Occupational therapists and rehabilitation therapists to help eating disorder patients practice healthy eating habits and other hands-on experiential learning therapy.
Eating Disorder Treatment
Experts recommend seeking treatment for eating disorders as soon as possible, as recovery can become more challenging if the condition goes untreated for a long time. If you notice that you are developing an unhealthy relationship with food, seek professional help right away.
For many people, the first step is to see a primary care physician. Depending on your individual symptoms, you may need a referral to a specialized mental health professional who can assess your condition and prescribe medication or talk therapy to help you recover.
When you talk to a physician or mental health specialist about your eating disorder, it’s important to give them all the details about your behaviors, such as restricting, binge eating, or purging. Treatment may include group therapy or one-on-one sessions with a psychotherapist, who will speak to you in depth about your relationship with food.
Fluoxetine, also known as Prozac, can help to reduce binge eating and purging. It also treats depression, which affects many people with eating disorders.
If someone is not able to reach a healthy weight with the help of therapy and medication, then inpatient treatment might be required. At an inpatient treatment facility, nurses carefully control the food intake of people with eating disorders to make sure they get the nutrition they need, and patients’ psychological needs are addressed through therapy.
Therapies for Eating Disorders
“Not clearing eating disorders from the root is like putting a coat of paint on a broken foundation,” said Dr. Bushman.
There are many therapies that can help address what causes eating disorders. Cognitive behavioral therapy may help you identify the thought patterns that lead you to restrict, binge, or purge and help you to change them. Some eating disorder patients may find success with dialectical behavior therapy, a type of talk therapy that helps people to accept themselves as they are and change their negative behavior patterns.
Dr. Bushman recommends a type of therapy that addresses the root cause of eating disorders called Rapid Resolution Therapy (RRT).
“Rapid Resolution Therapy identifies the emotional triggers that cause the individual to re-live continued eating disorder patterns,” said Dr. Bushman. “[RRT] addresses the neurobiology of the trauma and the problematic perceptions that caused the eating disorder. It gently applies experiential methods to integrate the psychological and physiological effects of the trauma causing the eating disorder and it examines and resolves secondary effects of trauma such as binging, purging, restricting, and over-exercising. Rapid Resolution Therapy heals through memory reconsolidation and constructs the reintegration into everyday behaviors that lead to a life of purpose.”
Eating Disorders and Related Health Issues
Eating disorders can lead to extreme weight loss or gain, which increases the risk of serious health problems, such as heart disease, osteoporosis, and infertility. Regularly vomiting or taking laxatives can also lead to electrolyte imbalances, which can trigger a heart attack.
Many people with eating disorders also struggle with depression or anxiety. These conditions can make recovery difficult, so it’s important to seek treatment for them in addition to addressing disordered eating.