Understanding Eating Disorders

According to the Merck Manual, “eating disorders involve a disturbance of eating or of

behavior related to eating, typically including:

Changes in what and how much you eat

Measures people take to prevent food from being absorbed (for example, making
themselves vomit or taking a laxative)

Temporary habits that have been developed in order to lose weight short-term or
following a diet will not be considered an eating disorder as the behavior around food
has to :

● continue for a certain period of time

● cause significant harm
● to a person’s physical health
● and/or ability to function at school or work
● or negatively affect the person’s interactions with other people

● Eating disorders involve a persistent disturbance of eating or of behavior related to

eating that changes consumption and absorption of food.
● For the behavior to be considered an eating disorder it also has to cause significant
harm to one’s physical health and/or impair psychosocial functioning.

Frequency of Occurrence
● Eating disorders are very complex. They don’t always occur as in textbooks, which is
also the reason you can find several terms for this problem in the evolution of the MSD
(Diagnostic and Statistical Manual of Mental Disorders).
● Atypical Eating Disorder – Eating Disorder not otherwise specified – Other Specified
Feeding or Eating Disorder – Unspecified Feeding or Eating Disorder
● Eating Disorders have a lot of stigma flying around them, which makes it hard to ask for
help and seek out treatment. You don’t have to be hospitalized to have a serious eating
disorder.

Mortality Rate

● Eating disorders are among the deadliest mental illnesses, second only to opioid
overdose. Each year, there are approximately 10,200 deaths (1 death every 52 minutes)
that are the direct result of an eating disorder.

● Approximately, 26% of people with eating disorders attempt suicide.

 Eating Disorder:

● Complex mental illnesses with causes rooted in biological, psychological, and

environmental factors.

Biological Factors:

● Genes impact the likelihood of developing an eating disorder.

● Predisposition to other mental or medical illnesses can increase the risk.
● Autoimmune diseases like celiac disease can elevate the chances by 30%.

Psychological Factors:

● Specific personality traits contribute to the likelihood of an eating disorder (e.g.,

perfectionism, low self-worth, sensitivity, impulsivity).
● Eating disorders may serve as maladaptive coping mechanisms.
● Past or present trauma can increase susceptibility.

Environmental Factors:

● Social interactions and experiences influence how individuals perceive the world.
● Examples include family dynamics and beliefs about food and body image, media
influence (especially on social media), cultural and community dynamics (e.g.,
figure-skating, ballet), and interactions with peers or colleagues.

Kinds of eating disorders according to the DSM-5:

Anorexia Nervosa:
● Characteristics: Extreme restriction of food intake, intense fear of gaining weight,
distorted body image.

Bulimia Nervosa:
● Characteristics: Binge eating followed by compensatory behaviors (vomiting, excessive
exercise).

Binge-Eating Disorder:
● Characteristics: Recurrent episodes of consuming large amounts of food without
compensatory behaviors.

Pica:
● Characteristics: Eating non-nutritive, nonfood substances persistently; substance must
not be developmentally appropriate or part of a cultural tradition.

Rumination Disorder:
 ● Characteristics: Repeated regurgitation of food after eating without nausea or retching.
Avoidant/Restrictive Food Intake Disorder (ARFID):
● Characteristics: Restriction of food intake without a distorted body image or
preoccupation with body image.

Other Specified Feeding or Eating Disorder (OSFED):

● Characteristics: Diagnosis for cases not meeting specific criteria for anorexia nervosa,
bulimia nervosa, or binge-eating disorder.
● Examples: Atypical anorexia nervosa, bulimia nervosa of low frequency, binge-eating
disorder of low frequency, purging disorder.

Unspecified Feeding or Eating Disorder (UFED):

● Characteristics: Used for eating disorders that don't fit specific criteria, and the clinician
chooses not to specify the reason.
●
Note: OSFED and UFED are used when symptoms of a feeding or eating disorder cause
distress but do not precisely meet the criteria for other specified disorders.

Consequences and risks of eating disorders, focusing on Binge-Eating Disorder, Bulimia

Nervosa, and Anorexia Nervosa:

Consequences/Risks of Binge-Eating Disorder:

Recurrent episodes of consuming large amounts of food without compensatory behavior.

Health Risks:
● High blood pressure
● High cholesterol
● Cardiovascular disease
● Diabetes
● Liver and gallbladder disease
● Sleep apnea and breathing problems
Consequences/Risks of Bulimia Nervosa:

Recurrent episodes of binge eating followed by inappropriate compensatory behaviors.

Health Risks:
● Dehydration
● Electrolyte imbalances
● Irregular heartbeat
● Heart failure
● Tooth decay
● Acid reflux
● Esophageal inflammation and rupture
 ● Intestinal distress and irritation
Consequences/Risks of Anorexia Nervosa:

Relentless pursuit of thinness, morbid fear of obesity, distorted body image, and restrictive
intake leading to significantly low body weight.
Health Risks:
● Fatigue and fainting
● Slow heart rate
● Low blood pressure
● Heart failure
● Osteoporosis (reduction of bone density)
● Muscle loss and weakness
● Dehydration
● Kidney failure
● Lanugo (downy hair all over the body)
● Amenorrhea (loss of menstruation in women)
● Pregnancy complications
Note: Each eating disorder carries specific health risks associated with its symptoms and
behaviors. It's crucial to seek professional help for early intervention and appropriate treatment.

Treatment
Eating disorder treatment has to be tailored to the particular eating disorder one is living with.
Mayo Clinic states that a typical treatment plan includes a combination of psychological therapy
(psychotherapy), nutrition education, medical monitoring, and sometimes medication.
Treatment should also involve addressing the mentioned consequences and risks an eating
disorder brings with it.
Hospitalization or a type of inpatient program will be considered if an eating disorder doesn’t
improve with standard treatment.