Learn About Eating Disorders

What exactly are eating disorders, and why should we care about them?
Eating disorders are considered one of the deadliest mental health disorders, second only to opioid addiction.  It is estimated that eating disorders claim 10,200 lives annually. Eating disorders impact the individual experiencing it, along with family and loved ones. Everyone impacted experiences a range of emotions, including grief, guilt, confusion, fear, sadness, anger, and stress.
While eating disorders affect an estimated 28.8 million Americans, many of us are unaware of what eating disorders consist of and what it means to have this complex condition.
 
Types of Eating Disorders
When the term eating disorder is used, most of us will think of anorexia. While anorexia nervosa is a common and well-known eating disorder, it is only one in this group of disorders, which includes.

• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• Other eating disorders
  • Purging disorder
  • Night eating

Anorexia nervosa: Out of all the eating disorders, anorexia nervosa is the most well-known. It can be described as a drive for thinness. Individuals with anorexia nervosa view themselves as obese, and they fear becoming heavier. Therefore, they are driven to undo this fear. Symptoms of this disorder include:

• Low body weight
• Fear of gaining weight
• Pursuit of thinness
• Reluctant to maintain a healthy body weight
• Behaviors to avoid gaining weight
• Restricted eating patterns
• Distorted body image
• Thinning of bones
• Brittle hair and nails

Bulimia nervosa: This is another common disorder and is more prevalent than anorexia nervosa. It is different than anorexia nervosa in that it is not as life-threatening, and usually, those experiencing it are older at the onset.  Bulimia nervosa can be defined as binging and purging. Individuals will binge (eating an excessive amount at one time) and then purge (forced vomiting, fasting, laxative and diuretic use, enemas, or excessive exercise).  Symptoms of this disorder include.

• Reoccurring binge eating
• Feelings of lack of control
• Low self-esteem
• Fear of gaining weight
• Inflamed sore throat
• Tooth decay
• Dehydration

Binge eating disorder: This disorder is the most prevalent form of eating disorders and is unique from others in that it is characterized by consuming large amounts of food in very short periods of time. While this is like bulimia nervosa, these individuals do not purge. Other characteristics include:

• Feeling a loss of control during binging
• Eating until uncomfortably full
• Feelings of guilt and/or depression after binging
• Feelings of distress, shame, disgust, or guilt when thinking about the binging behavior

Other eating disorders: Other eating disorders include purging disorder and night eating. Purging disorder involves frequent purging without the binging behavior. These individuals have an intense fear of gaining weight and obesity. Night eating or night eating syndrome is when someone eats frequently and excessively only at night. Often waking up to eat. While these individuals are aware of the overeating behavior, they cannot control it. This results in distress. They will also experience insomnia.
 
Characteristics
While we have identified some symptoms specific to each eating disorder, characteristics of eating disorders involve psychological aspects as well, including (Boyd & Luebbert, 2022).

• Ritualistic behaviors
• Perfectionism
• Impulsivity
• Boundary problems
• Low self-esteem
• Body dissatisfaction
• Powerlessness
• Obsessiveness
• Compulsiveness

When reviewing these characteristics, it is apparent that many people suffering from an eating disorder also experience.

• Depression
• Anxiety
• Obsessive behavior
• Substance abuse

Eating disorders and anxiety often occur together.  A recent study revealed that 47.9 % of those with anorexia nervosa, 80.6% of those with bulimia nervosa, and 65.1% of those with binge-eating disorder also experienced an anxiety disorder.
Treating eating disorders can be complicated, and even more so when co-existing conditions, such as anxiety, are present.
 
Treatments
The treatment of eating disorders must be holistic and should include psychotherapy, medical care, nutritional counseling, and medications. Frequently, a combination of these approaches must be used to achieve the treatment goals, which should include.

• Adequate nutrition
• Restoring weight to a healthy level
• Reducing excessive exercise
• Stopping binge-purge and binge-eating behaviors

While treatment can be a complex process, it is essential to realize that eating disorders can be treated successfully. An essential part of treatment is family involvement. Family members can provide support and encouragement. Research has proven that family involvement in treatment improves success.
Eating disorders can be very personal, and as a result, the person can feel very alone. Family members can play a crucial role in getting these individuals help. Family members are usually the first to notice the eating disorder and to attempt to obtain treatment and help.
Family members and loved ones of those with eating disorders should also remember to take care of their health and needs. There are many resources available to assist with dealing with eating disorders, such as.
 
Eating disorder hope: This website provides a hotline for assistance. It also provides support and resources.
https://www.eatingdisorderhope.com/treatment-for-eating-disorders/eating-disorder-hotlines
 
National Association of Anorexia Nervosa and Associated Disorders:  This website provides support and help for those suffering from an eating disorder, family, and friends.
https://anad.org/
 
UPMC: This website provides many resources specifically for families.
 
Eating disorders are a complex and concerning disorder. While we have covered many key components of this disorder, it is important to continue to increase our knowledge and awareness of this very important condition. Experiencing an eating disorder, or having a loved one with an eating disorder, can be traumatic for all involved. Understanding symptoms, treatments, and resources may help someone when they need it the most.
 
                                                                                                      Peggy Fossen DNP, RN, CNE
 
 
References
 
Admin. (2021, November 2). Connection between anxiety and eating disorders: Toledo center. Toledo Center | Eating Disorders Treatment Center. https://toledocenter.com/resources/the-connection-between-anxiety-and-eating-disorders/
Boyd, M. A., & Luebbert, R. (2022). Psychiatric nursing: Contemporary practice. Wolters Kluwer.
Eating disorder statistics: ANAD - National Association of Anorexia Nervosa and associated disorders. ANAD National Association of Anorexia Nervosa and Associated Disorders. (2024, January 11). https://anad.org/eating-disorder-statistic/
Family involvement: The role of family in eating disorders. Eating Disorder Hope. (2023, October 7). https://www.eatingdisorderhope.com/treatment-for-eating-disorders/family-role
Graber, E. (2022, January 13). Eating disorders are on the rise. American Society for Nutrition. https://nutrition.org/eating-disorders-are-on-the-rise/
O’Donoghue, S. (2019, October 3). The impact of an eating disorder can have on you and your family. Tabor Group. https://www.taborgroup.ie/news/the-impact-of-an-eating-disorder-can-have-on-you-and-your-family/
Petre, A. (2022, May 18). Learn about 6 common types of eating disorders and their symptoms. Healthline. https://www.healthline.com/nutrition/common-eating-disorders
U.S. Department of Health and Human Services. (n.d.). Eating disorders: About more than food. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/eating-disorders#:~:text=Treatment%20plans%20for%20eating%20disorders,weight%20to%20a%20healthy%20level