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Eating disorders are mental health disorders involving unhealthy relationships with food that negatively impact the body or weight. Various eating disorders also adversely affect a person’s physical and psychological health.
What is an Eating Disorder?
Anyone can develop an eating disorder and can endanger your life if they’re not treated. Eating disorders are classified as mental illnesses. The National Institute of Mental Health defines disordered eating as a disturbance in a person’s eating behavior. This can include an obsession with one’s weight and body shape and with controlling food intake.
Types of Eating Disorders
Anorexia nervosa, bulimia nervosa, binge eating, pica, rumination and ARFID are common eating disorders. A person must meet the criteria as defined in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders to be diagnosed.
Anorexia Nervosa
Anorexia nervosa occurs when a person severely limits or restricts the amount of nutrients they consume to lower their body weight. They fear gaining weight to meet an idealized body image that’s often unhealthy.
They may show specific behaviors like calorie counting and restriction, portion control, excessive exercising, spitting out food after chewing, not eating in public and obsessing over their looks. If you have an eating disorder you might limit the types of foods they eat and may also take laxatives or enemas to get rid of the food they eat.
Bulimia Nervosa
Bulimia nervosa involves binge eating followed by unhealthy compensatory behaviors or getting rid of the food to avoid gaining weight. Binge eating refers to consuming much larger portions than someone typically eats and feeling unable to control their urges.
Purging refers to behaviors like self induced vomiting and taking laxatives or diuretics. Other signs include extreme exercising or fasting. A diagnosis for bulimia requires that a person exhibit this behavior at least once a week for several months.
Binge Eating
Binge eating refers to someone eating large amounts of food in a period of two hours or less. To be diagnosed with binge eating disorder a person must have at least three of the following behaviors at least once a week for three months or longer:
- Eat food faster than normal
- Overeat to the point of feeling sick
- Eat large amounts of food even when not physically hungry
- Eat in private to avoid embarrassment
- Feel guilty or disgusted after overeating
Binge eating can be classified as mild, moderate, severe or extreme based on the number of episodes someone has in a week. Mild disorders range from binge eating once to three times per week. Extreme binge eating involves more than 14 episodes per week.
PICA
PICA refers to someone eating nonfood substances without nutritional value for a period of at least one month, such as dirt, starches, paper, charcoal, chalk, paint, cloth, powders, coffee grounds or eggshells. Pica eating disorder is most often seen in young children, developmentally delayed persons or pregnant women.
Rumination
Rumination is a digestive disorder in which food is regurgitated soon after a person finishes eating a meal, sometimes within 15 minutes and then the person rechews the food and swallows or spits it out. It can affect children and adults and is sometimes misdiagnosed as acid reflux. Rumination often occurs unintentionally and can become habitual.
ARFID
Avoidant restrictive food intake disorder (ARFID) occurs when an individual significantly limits their food intake or avoids specific foods. This can lead to malnutrition, weight loss, psychosocial problems and deficiencies.
A person with ARFID does not have the body image issues associated with anorexia and bulimia nervosa but may avoid certain foods due to textures, tastes or other sensory problems.
What Does an Eating Disorder Feel Like?
People with eating disorders experience a wide range of feelings surrounding eating and most are unhealthy and unrealistic. These feelings produce negative thought patterns that take over their eating practices. These inner voices make them feel poorly about themselves and their body image.
Individuals with these negative thought patterns engage in almost any behavior to quiet the thoughts. They will purge, fast and restrict intake of food and they may misuse drugs and alcohol.
Unfortunately, these behaviors rarely silence these voices and they get stuck in a cycle of trying to control the negative thoughts with unhealthy behaviors. Doing so leaves them feeling a mixture of exhaustion, fear, confusion and frustration. These feelings can manifest in mental depression and even suicidal behaviors.
People with eating disorders often blame themselves. They typically fault themselves and believe they deserve to feel this way. They also worry that their eating disorder will last the rest of their lives. This can make them feel hopeless about their future.
Some people feel a sense of control with an eating disorder. Their lives may feel chaotic but they feel in control over what they eat or don’t eat. Other people with eating disorders may struggle with feeling the need to be perfect or that they must achieve specific goals including weight goals.
Symptoms and Causes of Eating Disorders
The symptoms and causes of eating disorders vary, depending on their feelings and life experiences. However, many cases share common eating disorder symptoms in how they approach and consume food.
- Those with anorexia nervosa tend to practice extreme restrictive eating and deny that they do so. They have an intense fear of gaining weight and a distorted perception of their body size, leading them to pursue extreme thinness. They tend to exercise excessively and reject food out of a fear of gaining weight.
- People with bulimia nervosa tend to binge on food. To compensate for overeating in a short time, they often force themselves to vomit after eating. They may also exercise excessively or fast to rapidly reduce the calories they have just consumed. These people may also take laxatives or other medications to rapidly expel consumed food.
- Binge eating symptoms include gorging large amounts of food rapidly and in a short time period. They tend to overeat until they feel physically sick or uncomfortable for having eaten so much. They tend to eat in private or avoid social eating because they feel depressed about their condition.
- Individuals with PICA generally consume nonfood substances with no nutritional value. They tend to eat only one or two specific nonfood substances.
- Rumination generally consists of regurgitation without effort. Those experiencing rumination may have stomach pain or discomfort, which can include accompanying digestive problems and nausea. They may experience weight loss without trying to lose weight.
- People with ARFID tend to lack interest in food. This uninterest may stem from stomach pain or digestive problems. They tend to be extremely picky regarding which foods to eat.
Eating disorders have multiple causes that differ for each person. However, certain risk factors make a person more likely to develop an eating disorder. Some common risk factors include genetic influences from family members who have had mental health disorders.
Personal traumatic experiences, such as sexual or emotional abuse, surviving a natural disaster or anything else that signifies a loss of control, can lead individuals to develop eating disorders.
If an individual is placed on diets at a very young age then that person may develop an unhealthy relationship with food. Participating in sports and activities that focus on weight or body image, such as modelling, may also play a role in shaping how an individual regards food.
Biological risk factors can also influence the onset of eating disorders. Neurotransmitter dysfunction in the brain, such as lower release of dopamine and serotonin, can contribute to mental health disorders.
Disordered eating may cause a temporary release of the neurotransmitters, making someone repeat the negative behaviors in search of a feel good sensation.
How Common are Eating Disorders?
According to the National Eating Disorder Association, more than 28 million people have an eating disorder in their lifetime. In the same study, 22% of teens worldwide have eating disorders. Females have higher rates of developing eating disorders than males.
How Do I Know if Someone Has an Eating Disorder?
Someone with an eating disorder may exhibit physical, psychological and behavioral changes. Other than having noticeable or dramatic weight loss, someone may also experience physical ailments, such as aches and pains, problems with sleep or body dysfunctions like a missed period or reduced sex drive.
Their behavior may also change, especially concerning their eating habits. They may start to lie about how much they have eaten and their weight.
To avoid scrutiny, they may also start hiding their bodies by wearing oversized clothing or layers of clothing or rearrange their food on their plates to make it seem like they are eating more than they are. Others with eating disorders may also eat in isolation, avoid eating with others or just excuse themselves after they finish dining.
To reduce weight, they might start taking medicines or supplements to manage weight. They might also frequently hit the gym right after eating.
If you notice sudden or gradual changes in a person’s eating behaviors then they may have an eating disorder. At this point, it’s crucial to help that individual.
What Are the Treatment Options for Drug Addictions and Co-occurring Eating Disorders?
You can access multiple treatment options for co-occurring drug addiction and eating disorders. Depending on the conditions’ severity, individuals can enter inpatient or outpatient care.
Inpatient Treatment for Co-occurring Disorders
Inpatient treatment is necessary if someone can’t control their eating disorder and/or addiction without the help from medical and mental health teams to stabilize them. Inpatient services often include round the clock nursing supervision with access to physicians.
Clients receive individual and group therapy, family counseling and classes on building healthy lifestyle habits. This often includes a focus on preventing the relapse of either condition.
Anyone who has any thoughts of suicide or hopelessness may also be eligible for inpatient stays. Existing medical conditions are also considered when determining whether inpatient care is needed.
Outpatient Treatment for Co-occurring Disorders
Outpatient treatment may be a better fit for those with mild SUD or eating disorders and who have support systems in their home environment. They can attend intensive outpatient programs during the day or evenings and maintain other responsibilities between sessions. Intensive outpatient programs meet several days a week for three to four hours daily.
An outpatient treatment setting consists of the same services as inpatient care, such as individual and family therapies. However, clients aren’t monitored 24/7 and they have more independence befitting their milder symptoms.
In outpatient treatment you’ll learn healthy coping skills and engage in counseling to help you achieve wellness in mind and body. Depending your needs and recovery pals, you might also be prescribed medications to help you manage your eating disorder, your addiction, or both.
Aftercare
Aftercare planning occurs at inpatient and outpatient levels of care. It involves making connections with community resources to help someone maintain good health once they graduate from their program.
Aftercare services may include attending support groups, appointments with doctors and psychiatrists, finding a job and completing education courses, transitional housing, childcare and building a support system.
Where to Get Help
If you or someone you know has a co-occurring disorder or if you want to learn more about the various types of treatment then there are many experts and agencies available.
They can connect you with professionals who can answer your questions regarding substance addiction, anorexia and bulimia, binge eating disorder treatment, rumination, PICA eating disorder or ARFID eating disorder.
Experts can also connect you with a treatment provider to assess your symptoms and devise a dual diagnosis treatment plan to address both your addiction and your disordered eating. They can refer you to resources to help overcome your dual diagnosis and maintain your recovery.
