Eating Disorders - Types of eating disorders and their characteristics






Anorexia Nervosa

Anorexia nervosa is a condition in which a person refuses to maintain a healthy body weight (persons whose weight is at least 15 percent below their normal body weight might fall into this category). The term anorexia nervosa means literally "nervous lack of appetite." However, this name is misleading as people with anorexia do not lack an appetite; rather, they battle hunger every day. Anorectics, as people who suffer from anorexia are referred to, are extremely afraid of gaining weight or becoming what they perceive to be fat.

Typically, what accompanies this fear of becoming fat is an anorectic's faulty perception of her body. Some anorectics may realize that they are indeed thin but will still view a particular part of their bodies, such as the stomach or thighs, as being fat and out of proportion. In fact, an anorectic's self-esteem is closely tied to this distorted view of her body. Continued weight loss is considered by anorectics to be a sign of achievement and self-discipline while any weight gain, even if it brings them closer to a healthy body weight, is considered a sign of weakness or a lack of self-control.

Eating Disorders: Words to Know

Adrenaline:
A hormone that is released during times of stress and fear.
Amenorrhea:
The absence of menstrual cycles.
Anorexia nervosa:
A term meaning "lack of appetite"; an eating disorder marked by a person's refusal to maintain a healthy body weight through restricting food intake or other means.
Binge-eating disorder:
An eating disorder that involves repetitive episodes of binge eating in a restricted period of time over several months.
Bingeing:
When an individual eats, in a particular period of time, an abnormally large amount of food.
Body set-point theory:
Theory of weight control that claims that the body will defend a certain weight regardless of factors such as calorie intake and exercise.
Bulimia nervosa:
A term that means literally "ox hunger"; an eating disorder characterized by a repeated cycle of bingeing and purging.
Depression:
Common psychological problem characterized by intense and prolonged feelings of sadness and hopelessness.
Diuretic:
A drug that expels water from the body through urination.
Edema:
Swelling.
Endorphin:
Any of a group of natural proteins in the brain known as natural painkillers that make people feel good after exercising.
Enema:
A process that expels waste from the body by injecting liquid into the anus.
Epidemiology:
The study of disease in a population.
Exercise addiction:
Also known as compulsive exercise, a condition in which participation in exercise activities is taken to an extreme; an individual exercises to the detriment of all other things in his or her life.
Hypertension:
High blood pressure.
Lanugo:
Fine hair that grows all over the body to keep it warm when the body lacks enough fat to accomplish this.
Laxative:
A drug that induces bowel movements.
Obesity:
The condition of being very overweight.
Purging:
When a person gets rid of the food that she has eaten by vomiting, taking an excessive amount of laxatives, diuretics, or enemas or engaging in fasting and/or excessive exercise.
Russell's sign:
Calluses, cuts, and sores on the knuckles from repeated self-induced vomiting.

Anorexia is often difficult to diagnose and treat because of the secretive nature of this illness. Anorectics are usually good at concealing their self-starvation with excuses, or they may even engage in purging (vomiting) if forced to eat. Furthermore, anorectics will often wear heavy clothes that both camouflage (hide) their excessive weight loss from others and keep them warm. (Due to their dangerously low weight and lack of insulating body fat, anorectics are often cold.)

In addition to avoiding eating whenever possible, anorectics will often display high levels of energy that seem at odds with their frail physical conditions. Anorectics may also develop odd oral habits, including chewing gum throughout the day, drinking an excessive amount of coffee or diet soda, and chain-smoking. Finally, many anorectics become obsessed with food, despite their unwillingness to consume any.

Bulimia Nervosa

Bulimia nervosa means literally "ox hunger." This term is appropriate on many levels as bulimia is characterized by a repeated cycle of binge eating and purging. A binge is when an individual eats, in a particular period of time, an abnormally large amount of food. (Of course, this doesn't refer to special occasions, such as holiday meals, when it is acceptable to eat more than usual.)

The binge is then followed by an episode of purging. Purging is when a person gets rid of the food that she has eaten by either making herself vomit, taking an excessive amount of laxatives (drugs that induce bowel movements), diuretics (drugs that expel water from the body through urination), or enemas (a process that expels waste from the body by injecting liquid into the anus), or engaging in fasting and/or excessive exercise. People with bulimia, known as bulimics, engage in such behaviors at least two times a week for a period of six months or more.

A particularly stressful event or depression often triggers an episode of binge eating, intense hunger that follows restricted food intake, or a variety of feelings tied to body weight, body image, and food. The binge eating may temporarily relieve a bulimic's feelings of depression or stress, but often deeper feelings of depression, disappointment, and anxiety may follow. This will then trigger an episode of purging. Many bulimics report feeling out of control when bingeing and use similar terms to describe their need to purge their bodies of the food they just consumed.

Pop singer Karen Carpenter, who died from complications as a result of anorexia at the age of 30. (AP/Wide World Photos. Reproduced by permission.)
Pop singer Karen Carpenter, who died from complications as a result of anorexia at the age of 30. (
AP/Wide World Photos
. Reproduced by permission.)

Bulimics, like anorectics, are usually ashamed of their behavior and will attempt to hide their illness from others. Because of this and the fact that many bulimics maintain a normal body weight, it is often hard to recognize that a person is, in fact, bulimic.

Many bulimics suffer from low self-esteem and may even have suicidal thoughts. Often they are rigid perfectionists who think in absolutes ("I am bad because I ate that"). Like anorectics, bulimics will make negative statements about their appearance and experience extreme guilt over eating even normal portions of food. They will begin to withdraw from social activities, particularly those that will make it difficult for them to purge without suspicion.

Other Types of Disordered Eating

There are those individuals whose behavior does not fall under the categories of anorexia or bulimia; rather, these people can exhibit a wide range of disordered eating and unhealthy weight management symptoms. Since they cannot be diagnosed as anorexic or bulimic, these individuals will typically receive a diagnosis of an "eating disorder not otherwise specified." An example of disordered eating includes a person of normal weight who eats no fat and occasionally purges. She would not be considered bulimic because she is not bingeing, and she also is not anorectic because she is not dangerously underweight. She would therefore be diagnosed with an eating disorder not otherwise specified.

There are other disorders, such as binge-eating disorder and exercise addiction, that are not yet official psychological diagnoses but which are becoming more and more prevalent. These problems are often diagnosed as "eating disorder not otherwise specified" as well. They often occur in conjunction with anorexia and bulimia. However, they can also occur independently of other disordered eating and may soon have their own official diagnoses.

EATING DISORDERS NAMED

English physician Richard Morton first documented cases of self-starvation in the seventeenth century. The term anorexia nervosa was later coined by French neurologist Charles Lasegue and English physician Sir William Gull in the mid-1870s. The symptoms of bulimia (bingeing and purging) were not recognized as a separate condition from self-starvation until the 1940s. English physician Gerald Russell formally named bulimia nervosa in 1979.

BINGE-EATING DISORDER. Like bulimia, binge-eating disorder involves repetitive episodes of binge eating in a restricted period of time over several months. This illness is different from bulimia, however, because people suffering from binge-eating disorder do not purge after a binge. This disorder has more to do with an absolute lack of control over eating than with the conciliatory acts (purging) that follow a bulimic's binge.

Binge eaters will eat very rapidly, usually until they are uncomfortably full. They will eat big portions of food even if they are not actually hungry. Because of this, many binge eaters engage in binges secretively as they are embarrassed by how much they have eaten and feel guilty and depressed following these episodes. Similar to the binges experienced by bulimics, binge eaters report that depression and anxiety usually trigger their binges. During the binge itself, sufferers often feel out of control or disconnected from their actions.

EATING DISORDER STATISTICS

Eating disorder organizations qualify that eating disorder statistics are estimates because the illnesses are often hidden and difficult to diagnose. It is likely that the actual figures are higher than they appear due to the secretive nature of eating disorders.

  • About 8 million people in the United States suffer from an eating disorder. Among young women, it is estimated that 15 percent suffer from some kind of disordered eating behavior.
  • Females make up 90 to 95 percent of the people who suffer from anorexia.
  • 1 percent of young women between the ages of ten and twenty have anorexia.
  • 85 percent of the time, anorexia starts between the ages of thirteen and twenty.
  • 10 to 15 percent of anorectics will die from the disease.
  • 2 to 5 percent of anorectics will commit suicide.
  • About 1,000 women die from anorexia each year.
  • 30 to 50 percent of anorectics in treatment show signs of bulimia as well.
  • 4 percent of college-aged women have bulimia.
  • 10 to 15 percent of people with bulimia are male.
  • Of psychological disorders, eating disorders have the highest rate of deaths.
  • About 60 percent of eating disorder sufferers recover with treatment.

These statistics are based on information from the following organizations: Anorexia Nervosa and Related Eating Disorders, Inc.; American Anorexia/Bulimia Association, Inc.; and National Depressive and Manic-Depressive Association.

Binge eaters usually suffer from obesity (being very overweight). Furthermore, many have been "yo-yo" dieters (experiencing large fluctuations in weight from a cycle of dieting) their entire lives. Both of these effects can cause binge eaters to feel worse about their inability to control their eating habits. (Not everyone who is obese suffers from binge-eating disorder. Rather, obesity must be paired with certain behaviors for it to be evidence of binge-eating disorder.)

Christy Henrich, a competitive gymnast, died in 1994 after a long battle with two eating disorders that had reduced her weight to just 60 pounds. (AP/Wide World Photos. Reproduced by permission.)
Christy Henrich, a competitive gymnast, died in 1994 after a long battle with two eating disorders that had reduced her weight to just 60 pounds. (
AP/Wide World Photos
. Reproduced by permission.)

Other signs of binge-eating disorder can include food disappearing from cabinets and cupboards at a rapid rate, or even finding an excessive amount of food wrappers concealed under someone's bed or in her trash. The consumption of odd foodstuffs such as raw cookie dough or condiments can also point to binge-eating disorder.

EXERCISE ADDICTION. Exercise addiction, or compulsive exercise, seems like a strange term as most people consider exercise to be good for their health. Exercise is a fun way to relieve stress and increase energy levels. It releases endorphins (the body's natural painkillers, which make people feel good after exercising). However, when a person's interest and participation in exercise activities are taken to extremes, exercise can turn into an addiction that must be performed each day; the act of exercising provides that person with a temporary high. If an exercise-addicted person cannot exercise, he or she will experience a great deal of guilt and anxiety over the inactivity.

Exercise-addicted individuals will exercise to the detriment of everything else in their lives. Someone who is addicted to exercise will exercise with serious physical injuries, pass up opportunities to spend time with loved ones in favor of exercise, and even miss work or school to spend time exercising. Depression, low self-esteem, and repressed anger are all characteristics of exercise-addicted individuals because no matter how much they exercise or achieve in other areas of their lives, they believe they should do more.

Because some sports demand a certain body type (such as gymnastics or ice skating) or depend on how much a person weighs (such as wrestling or horse racing), exercise addiction often develops in elite athletes like dancers, ice skaters, gymnasts, jockeys, and wrestlers, in their quest to perform the best in their sport. Exercise addiction can also be linked to those suffering from anorexia or bulimia because they feel unsatisfied with their bodies and think excessive exercise can help them get thin. Bulimics will often use compulsive exercise as a method of purging.



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