The term “eating disorder” is a frequent inclusion in media when it comes to mental health, often ascribed to celebrities and teenagers. In some cases, the seriousness of these disorders is downplayed and made out to be more of a phase or temporary problem. That is very, very far from the truth. Let’s talk about it.
How Common are Eating Disorders?
According to the National Institute of Mental Health (NIMH), eating disorders are the 3rd most common mental health concern in the United States. About 6% of women and 4% of men will experience an eating disorder in their lifetime[1]. Unfortunately, one of the specific types of eating disorders, anorexia, also has the highest mortality rate out of all psychiatric diseases.[2]
Can children or teens be diagnosed with an eating disorder?
Eating disorders have been diagnosed in patients as young as 5-years-old. Females are about 2x more likely to develop an eating disorder than males, but people from all genders, race-ethnicities, & sexual orientations are at risk.[1]
The bottom line is this: eating disorders are shockingly common and can be deadly. The people suffering through them deserve kindness and help because no one wants to be a statistic.
Are There Different Kinds of Eating Disorders? What are the Symptoms?
There are four subcategories of eating disorders: Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder, Bulimia Nervosa, and Anorexia Nervosa.
Binge Eating Disorder looks like a recurring loss of control over how much and how often someone eats and a large amount of distress towards the action. Since this overeating is not followed by anything that compensates for the food intake, most people with binge eating disorder are overweight or obese.
Avoidant Restrictive Food Intake Disorder (ARFID) is also known as Selective Eating Disorder and involves a severe restriction in the amount or type of foods a person eats. There is no underlying distorted body image like with anorexia, but the restrictions lead to a calorie intake that is too low for normal growth and function. Many children experience “picky eating” as they age, but ARFID is the next level, involving clinically significant restriction. Along with the food restrictions, someone with ARFID might lack an appetite or show little interest in food overall, complain of stomach/intestinal issues with no known cause, and increasingly limited “acceptable” food choices.
Bulimia Nervosa starts with binge eating but is followed by one or more behaviors that are supposed to compensate for the binge. Examples are purging (vomiting, laxatives, or diuretics), fasting, and/or excessive exercise. Many people with bulimia have an average body weight, but they experience a great deal of fear around weight gain, body size, and body shape.
Anorexia Nervosa is the most deadly eating disorder and the major symptom is a significant, persistent reduction in food intake. Sufferers have extremely low body weight for their age, sex, and other health factors which leads to increasing problems over time. In addition to disturbed eating compulsions, people with anorexia feel a relentless need for “thinness”, intense fear of gaining weight, and distorted body image. Often they feel overweight even when starved or severely malnourished.
What Causes Eating Disorders?
Like most mental health conditions, the root cause of eating disorders is unknown. According to recent research on eating disorders among family members, particularly parent/child and twin studies, there seems to be a significant genetic risk of developing an eating disorder. Cultural and societal pressures seem to play a large role as well. For example, the difference in body image expectations between females and males in U.S. media helps account for a higher rate of eating disorders in females.
While the cause can’t be nailed down, there are risk factors to consider that make someone more likely to develop an eating disorder.
Who is at Risk for Eating Disorders?
There is a combination of physical, mental, and environmental factors that put someone at risk for developing an eating disorder.[3]
Physical
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Genetics. Such as having a close relative with an eating or other mental health disorder
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Gender. Females are more likely to develop anorexia, bulimia, & binge eating
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Early Childhood Eating/Intestinal Problems. Such as being a picky eater, allergies, or gastrointestinal diseases.
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Energy Imbalance. A history of frequently burning more calories than you consume, such as from dieting, heavy athletics, growth spurts, or illness.
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Type-1 Diabetes. Specifically, skipping insulin injections (called “diabulimia”), which can be deadly.
Mental
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Self-focused Perfectionism. One of the strongest risk factors for eating disorders, it involves setting unrealistic goals for oneself.
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Negative Self-image. Body type, shape, size, proportions, or weight.
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Anxiety Disorders. Especially social anxiety is associated with eating disorders.
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Inflexibility. Possibly related to perfectionism, this stems from the belief that there is always a “correct” way of doing things.
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History of Dieting. This is specifically related to the development of binge eating disorder.
Environmental
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Athletics. Especially competitions where leanness or aesthetics is emphasized
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Personal Trauma. This includes sexual abuse, neglect, teasing, and bullying especially when the trauma was related to weight or body image.
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Cultural Stigma & Idealization. Exposure to cultural messages about “perfect” body types or a “thinner is better” weight stigma.
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Acculturation. The assimilation of one culture into another, this is most noticeable when people undergo rapid Westernization.
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Loneliness & Isolation. This specifically seems to increase the risk for anorexia and many sufferers report less social support, fewer friends, and less social activity.
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Intergenerational Trauma. Such as within families of Jewish Holocaust survivors and Native Americans/Indigenous people that experienced European colonization.
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Parental Military Redeployment. Associated with more frequent adolescent shape & weight concerns.
As you can tell, there are a lot of potential triggers for developing an eating disorder, making it vitally important to take these disorders seriously when they occur.
What are the Treatment Options for Eating Disorders?
Like with other mental illnesses, treating an eating disorder is based on how severe it is, the sufferer’s personal situation, and what resources are available. One of the available treatment models gaining traction is called “stepped care”, where the patient can step up or step down a ladder of care options based on what works and how much progress they’ve made.
