Eating Disorders

Eating Disorder Treatment Team

What Are Eating Disorders?

Eating disorders comprise a group of disorders including Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. In addition, the term Eating Disorder Not Otherwise Specified is used when someone experiences disordered eating and concern with weight and shape that causes problems in their school, work, or social functioning, but does not meet criteria for one of the other eating disorders. For example, an individual may eat small amounts of food and then purge (called Purging Disorder, it is currently being studied whether this pattern of behavior is a separate eating disorder). In addition, many individuals who do not have fully developed eating disorders experience disordered eating that may be a cause for concern.

Anorexia Nervosa is a complex disorder characterized by low body weight, intense fear of gaining weight, and a distorted body image. Although “anorexia” means “lack of appetite”, often individuals with Anorexia Nervosa have an intense preoccupation with food. Some people with anorexia also have binge eating and purging symptoms. Anorexia Nervosa is very serious and can be life threatening; it has the highest premature mortality rate of any mental illness (Sullivan, 1995).

Bulimia Nervosa is characterized by recurrent episodes of binge eating followed by behaviors meant to compensate for the binge. Binge eating occurs when someone eats an unambiguously large amount of food (much more than most people would eat at one sitting) and has a sense of loss of control at the time, meaning that they do not feel they can stop eating. During binges, it may be common to eat in secret, to eat much faster than one normally would, and to eat until one is uncomfortably full. Behaviors meant to compensate for the binge can include self-induced vomiting, laxative and diuretic abuse, excessive exercise, and fasting. Individuals with Bulimia Nervosa often also have a fear of becoming fat as well as a distorted body image.

Binge Eating Disorder is similar to Bulimia Nervosa in that it is characterized by recurrent episodes of binge eating, except that the person does not engage in compensatory weight control strategies.

Read more from the National Eating Disorders Association.

Facts and Statistics

In the United States, conservative estimates indicate that, after puberty, 5-10 percent of girls and women (up to 10 million girls and women) and one million boys and men are struggling with eating disorders including anorexia, bulimia, binge eating disorder, and other types of eating disturbance (Crowther et al., 1992; Fairburn et al., 1993; Gordon, 1990; Hoek, 1995; Shisslak et al., 1995). These numbers are likely underestimates because of the secretiveness and shame associated with eating disorders. In addition, many individuals struggle with body dissatisfaction and subclinical eating disorder attitudes and behaviors. In a study on college students, 18 to 19 percent of participants scored in the eating disordered range on a brief screen for eating disorders (Zivin et al., 2009).

While most individuals that struggle with eating disorders are female, eating disorders can be found in individuals from every gender, age, race, ethnicity, and socioeconomic status. Many times, eating disorders begin with dissatisfaction with one’s body and dieting. In addition, eating disorders often begin in adolescence. Research has shown that 80 percent of American women are dissatisfied with their appearance and on any given day, 25% of American men and 45% of American women are on a diet (Smolak, 1996). Dieting can progress to become problematic; 35 percent of “normal dieters” progress to pathological dieting and of those 35 percent, 20 to 25% progress to partial or full-syndrome eating disorders (Shisslak et al., 1995).

Read more facts on eating disorders from the National Eating Disorders Association.

Health Consequences of Eating Disorders

Eating disorders can cause a significant amount of physical damage, and some of their potential medical complications may be life threatening. Common psychological sequelae of all eating disorders include depression, anxiety, and intense preoccupation with food (for example, being unable to concentrate in class due to thoughts about food).

In an eating disorder when the individual is significantly underweight (usually defined as a Body Mass Index below 18.5; What’s my BMI?), they are essentially in a state of starvation. The psychological effects of being significantly underweight include difficulty thinking clearly, remembering things, or concentrating. Physically, being underweight can lead to the following, depending on severity: decrease in muscle mass (including heart muscle), decrease in blood pressure and heart rate, heart beat irregularities, amenorrhea (the absence of a menstrual period), deterioration in bone strength, decrease in intestinal motility, constipation, downy hair growth (lanugo), hair loss from the scalp, and cold sensitivity due to impaired temperature regulation. The health consequences of Bulimia Nervosa include electrolyte imbalances that can affect heartbeat and potentially lead to heart failure, tooth decay, and bleeding and possible rupture of the esophagus from frequent vomiting.