Definition and Overview

A term used to refer to a group of psychological illnesses, eating disorders are often characterized by abnormal eating habits. An eating disorder can involve abnormal amounts of food being consumed (too little or too much), or abnormal attitudes toward eating and food. The excessiveness or insufficiency of food needs to be detrimental to the patient’s health, both physical and mental, for it to be considered as an eating disorder.

Among the most common kinds of eating disorders are bulimia nervosa and anorexia nervosa. Anorexia nervosa involves restricting food intake in extreme levels, resulting in extreme weight loss and starvation. Losing a significant amount of weight can severely disrupt (or completely stop) a female patient’s menstruation cycle. Bulimia nervosa, on the other hand, involves a combination of binge eating and purging. The purging can come in the form of excessive exercise, self-induced vomiting, or the use of enemas, diuretics, and laxatives to empty the bowels.

There are two broad categories of eating disorders: those that are included in medical manuals such as the DSM-5 and/or the ICD-10, and those that are not. Eating disorders recognized by medical manuals include:

  • Anorexia nervosa. This eating disorder is typically characterized by the patient’s desire to maintain an “attractive” (often unhealthy) body weight, unrealistic perception of one’s body weight, a fear of gaining weight that borders on obsession, or failure to recognize the serious physical implications of losing excessive weight. Anorexia nervosa can lead to serious health problems, such as amenorrhea (cessation of menstrual cycle), bone loss, skin integrity loss, heart problems, and even death.

  • Bulimia nervosa. This eating disorder involves two elements: binge eating (excessive eating, usually done in one sitting) that is followed by purging, which the patient sees as a form of “compensation” for the excessive intake of food. The patient can also exercise excessively, induce vomiting, or use drugs such as laxatives and diuretics to empty the bowels.

  • Binge eating disorder. Also known as BED, this eating disorder involves binge eating that recurs at least once a week for over three months. During these instances, the patient feels helpless, without control, and very guilty. Research shows that BED can occur in a variety of individuals from different socio-economic classes and age range.

  • Other Specified Feeding or Eating Disorder. Also known as OSFED, this term usually refers to disorders that do not meet the full criteria set by the DSM-5 for the eating disorders above. A person suffering from OSFED might exhibit behaviours and thoughts commonly associated with anorexia nervosa, binge eating disorder or bulimia nervosa with some aberrant or differing traits. Night eating disorder and purging disorder are types of OSFED.

Other eating disorders not included in standardized medical manuals include:

  • Diabulimia. The patient, often diabetic, deliberately manipulates his or her insulin intake or levels to control body weight.

  • Compulsive overeating. This disorder involves the habitual excessive intake of food.

  • Food maintenance. This disorder is frequently exhibited by children who grew up in foster care, and is characterized by certain abnormal eating behaviours.

  • Selective eating disorder. The patient is extremely sensitive to how a certain food item tastes. This eating disorder does not require the patient to have extremely sensitive taste buds.

  • Gourmand syndrome. This is a relatively rare eating disorder. The patient typically has suffered from frontal lobe damage, which makes him or her obsess over fine foods.

  • Pregorexia. A pregnant woman limits food intake and exercises excessively to control her body weight during pregnancy. This can result in low birth weight for the infant, type 2 diabetes, stroke, depression, hypertension, and increased risk of cardiovascular disease.

Cause of Condition

Like many psychological illnesses, a wide variety of factors can cause eating disorders. Research shows that eating disorders can manifest with biological and psychological problems or abnormalities, and can be influenced by the patient’s environment as well. Many experts have concluded that a significant number of patients with eating disorders also suffer from body dysmorphic disorder, which can seriously and abnormally alter an individual’s self-perception.

Other causes include:

  • Genetic factors — research shows that some eating disorders can be inherited from a parent or grandparent. Biochemical factors can also play a role as the human eating behaviour is governed by the neuroendocrine system. When there are dysfunctions, irregularities, or abnormalities in this system, the patient can suffer from anorexia nervosa, bulimia nervosa, or depression.

  • Lesions in the temporal or frontal lobe. Several pathological issues in the brain can also lead to the development of psychological illnesses, including eating disorders. Tumours, brain calcification, and complications during foetal development are some of these issues.

  • Some studies also show that certain childhood personality traits can result in eating disorders. Child abuse, social isolation, parental influence, peer pressure, and cultural pressure can also be potential factors.

Key Symptoms

The symptoms of eating disorders are often linked to complications resulting from abnormal eating behaviours. With insufficient nutrition in the body, patients can suffer from acne, constipation, diarrhoea, scurvy, osteoporosis, oedema, tooth loss, amenorrhea, electrolyte imbalance, cardiac arrest, brain atrophy, and kidney failure. Patients also often suffer from fatigue, overall weakness, hair loss, decreased libido, developmental problems, and extreme sensitivity to cold temperatures.

Who to See and Types of Treatment Available

Patients suffering from eating disorders have many treatment options, depending on the kind and extent of the eating disorder they have. Treatment and management are typically psychological in nature. Cognitive behavioural therapy or CBT is usually employed, with the trained professional helping the patient to process thoughts to address abnormal behaviours and feelings. CBT aims to alter the way the patient thinks to change the way he or she reacts to the situation at hand.

Family therapy can also be an option, allowing the family members to help with the treatment. Medication can also be an option for some cases.

References:

  • Academy for Eating Disorders - www.aedweb.org
  • Overeaters Anonymous - www.oa.org
  • National Eating Disorders Association - www.nationaleatingdisorders.org
  • National Institute of Mental Health - www.nimh.nih.gov/health/publications/eating-disorders/
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