December 17, 2021

Eating Disorders

Iris Zhou

Disclaimer and trigger warning: informative content about suicide, eating disorders, and associated terms e.g., purging, binge-eating, etc.

Defining an Eating Disorder (ED)

This mental health condition is defined by abnormal eating habits and behaviors relating to negative thoughts and emotions.

EDs are a mental and medical illness—not a diet gone wrong, a "lifestyle choice," or food/eating trends (National Eating Disorders Collaboration, 2019).  

Classifying an Eating Disorder (ED)

There are 3 major types of EDs (National Institute of Mental Health, 2016):

  • Anorexia nervosa (AN): continuous and extreme restriction in amount of food eaten causing low body weight (thinness)
  • Bulimia nervosa (BN): binge-eating (eating large amounts of food in short periods of time), feeling loss of control, performing behaviors to compensate for the binge
  • Binge-eating disorder (BED): recurrent binge-eating episodes accompanied by feelings of distress and lack of control, associated with obesity and being overweight

Signs and Symptoms of an Eating Disorder (ED)

Signs and symptoms can overlap, common ones include but are not limited to (National Institute of Mental Health, 2016):

  • Compensatory behaviors: purging, vomiting, fasting, excessive exercise, laxative/diuretic use, etc.
  • Physical symptoms of purging: sore/inflamed throat, acid reflux, gastrointestinal distress, dehydration, electrolyte imbalance, swollen salivary glands, worn tooth enamel and tooth sensitivity/decay
  • Obsession with physical appearance and weight
  • Distorted body image (denial) and low self-esteem
  • Hoarding/stashing food and refusing to eat around others
  • Ritualistic eating habits and rules

If you recognize yourself or your loved ones coping with the aforementioned signs, please seek help at the resources in the end of this blog post.

Eating Disorders (EDs) Can Co-occur: Not Always Independent of Other Mental Health Conditions

Risk Factors: What Causes Eating Disorders (EDs)?

EDs can be caused by interactions between biological, sociocultural, and psychological factors; this can include having a family member with an ED or mental illness, being a perfectionist, trauma, limited social and support networks, cultural influence, teasing/bullying/stigma, perfectionism, gene variations, different patterns of brain activity, and history of dieting (National Eating Disorders Association; National Institute of Mental Health, 2016). Frequency is higher in women and during teenage years to young adulthood (National Institute of Mental Health, 2016).  

People with EDs experience a sense of lacking control over their lives and emotions, not just their weight and food—again emphasizing the connection between physical (binging, purging, restricting) and mental health (coping mechanisms, anxiety, depression), as well as its overall impact on our wellbeing.  

EDs are multi-faceted and often co-occur (combination of two or more mental disorders or medical illnesses at the same time) with other mental conditions (Mahoney):

  • Anxiety disorders
  • Depression
  • Substance abuse
  • Self-injurious behavior, self-harm
  • Borderline personality disorder (BPD)
  • Obsessive compulsive disorder (OCD)

Comorbid residential treatment programs targeting treatment of multiple disorders are currently being researched and developed, but have already proven to be effective in reducing symptom severity significantly (Simpson et al., 2013).

Complete recovery is more than possible, given treatment and time (National Institute of Mental Health, 2016).

Let's destigmatize, humanize, and talk about EDs; spreading awareness can reduce shame and misconceptions that are damaging towards those suffering from EDs and those in the process of recovery. Challenge existing stereotypes and if you notice an individual is misinformed, gently intervene to educate them about how their statement makes you or others feel.

It's important to encourage equality between physical and mental illness; it’s perfectly acceptable to mention going to your therapist for EDs just as you would mention going to your primary care doctor for a sore throat or fractured bone. They don't discriminate and—like physical ailments or any other medical condition—don't pick and choose people based on personality or personal qualities.  

9% of the U.S. population struggles with EDs; to put it into perspective, that's over 28.8 million people (National Association of Anorexia Nervosa and Associated Disorders, 2021). People with EDs are not "unlike other people" because it's a global issue.  

Health Risks, Impairment, and Mortality

EDs are one of the most deadly and devastating conditions, being responsible for over 10,000 deaths per year or 1 every 52 minutes; AN has one of the highest mortality rates, being associated with starvation, suicide (31 times more likely than average person), and even heart problems, weakened bones, and hormone disruption (National Association of Anorexia Nervosa and Associated Disorders, 2021; Muhlheim, 2021).

Long-term impacts and complications may also involve social/functional impairment, psychiatric/behavioral problems, isolation, and disability (National Eating Disorder Collaboration, 2019).

Implications

The earlier an ED is discovered, the higher the success rate of recovery. Prevention and intervention could help lower symptom severity and save someone's life (Renton, 2021).

Getting Help: Therapy for Eating Disorders (EDs)

Lifestyle Changes

Disordered eating and associated behaviors are often a coping mechanism; consider exploring new habits to cope and help resist the urge to turn towards them (Renton, 2021).

Psychotherapy

Treatment emphasizes relationship between EDs and emotions—again, emphasizing the connection between mental health and physical wellbeing; from improving your support system to monitoring moods/eating habits (journaling, nutritional counseling) and even identifying "triggers," patients can achieve more normalized eating patterns and maintain a healthy weight (Renton, 2021).

Cognitive behavioral therapy (CBT) also helps patients identify disordered thinking patterns and recognize/change false beliefs (National Institute of Mental Health, 2016).

Medication and Hospitalization in Severe Cases

Medications—antidepressants, antipsychotics, or mood stabilizers—usually target co-occurring mental health conditions such as depression and anxiety; hospitalization occurs in medical emergencies and can involve (intensive) outpatient treatment, partial hospitalization programs (PHP), and residential treatment centers (National Institute of Mental Health) (Renton, 2021; National Institute of Mental Health, 2016).

Lastly, it's great to be honest and open about treatment: it’s still considered a confusing process by many, but seeing a therapist, psychiatrist, or psychologist simply means you’re on a path to recovery. Normalizing conversation about mental illness and EDs can reduce discrimination and establish a platform for lasting change, so choose empowerment over shame (Apland, 2021).

Mental illness exists to no one’s fault, it's not "taboo"; be productive, be proud, be persistent, take treatment seriously, and show compassion because even the smallest contribution matters.  

Resources:

If you or a loved one are coping with an ED or notice any signs/symptoms, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237. NEDA has a social media awareness campaign under #NEDAwareness with graphics and images to share online to start a conversation about EDs. NEDA are also holding awareness walks as cities light up in their colors, blue and green, to spotlight EDs and spur discussion about life-saving resources.

The National Suicide Prevention Lifeline (NSPL) is provides 24/7 service to anyone in crisis or distress at 1-800-273-8255; English and Spanish translations available.

If you are in a crisis and need help immediately, text “NEDA” to 741741 to be connected with a trained volunteer at Crisis Text Line. Crisis Text Line provides free, 24/7 support via text message to individuals who are struggling with mental health, including eating disorders, and are experiencing crisis situations.

Citations:

Apland, Babette. Normalizing Conversations About Mental Health. (2021, February).  

Retrieved October 15, 2021 from https://liberatehealth.medecision.com/normalizing-conversations-about-mental-health/.

Mahoney, Ben. Common Mental Health Disorders Associated with Eating Disorders.  

Retrieved October 15, 2021 from https://centerfordiscovery.com/blog/common-mental-health-disorders-associated-eating-disorders/.

Muhlheim, Lauren. (2021, August 16). Eating Disorders in Midlife. Retrieved October 15,  

2021 from https://www.verywellmind.com/midlife-eating-disorders-4177137.

National Association of Anorexia Nervosa and Associated Disorders. (2021, February 22).  

Eating Disorder Statistics. Retrieved October 15, 2021 from https://anad.org/get-informed/about-eating-disorders/eating-disorders-statistics/.

National Eating Disorders Association (NEDA). Risk Factors. Retrieved October 15, 2021  

from https://www.nationaleatingdisorders.org/risk-factors.

National Eating Disorders Collaboration. (2019). What is an Eating Disorder? Retrieved  

October 15, 2021 from https://nedc.com.au/eating-disorders/eating-disorders-explained/the-facts/whats-an-eating-disorder/.

National Institute of Mental Health. (2016, February). Eating Disorders. Retrieved October 15,

2021 from https://www.nimh.nih.gov/health/topics/eating-disorders.

Renton, Catherine. (2021, February 7). Signs and Treatments for Different Eating Disorders.

Retrieved October 15, 2021 from https://www.verywellhealth.com/signs-and-treatments-for-different-eating-disorders-5087761.

Simpson, H. B., Wetterneck, C. T., Cahill, S. P., Steinglass, J. E., Franklin, M. E., Leonard, R.  

C., … Riemann, B. C. (2013). Treatment of obsessive-compulsive disorder complicated by comorbid eating disorders. Cognitive Behaviour Therapy, 42(1), 64–76. https://doi.org/10.1080/16506073.2012.751124  

ABOUT THE AUTHOR
About the author: Hiya, my name is Iris and I'm a recent U.C. Berkeley graduate; I dedicate the majority of my time towards research in developmental psychopathology and neurodegenerative diseases at the Berkeley Psychophysiology Lab, but I also enjoy digital illustration, aqua-scaping for my pet turtle (Guava), and competitive swimming!