What Are Eating Disorders?
Eating disorders frequently appear during adolescence or young adulthood, but some reports indicate that they can develop during childhood or later in adulthood. Women and girls are much more likely than males to develop an eating disorder. Men and boys account for an estimated 5 to 15 percent of patients with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder. Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes. They frequently co-exist with other psychiatric disorders such as depression, substance abuse, or anxiety disorders. People with eating disorders also can suffer from numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.
Eating disorders are a group of serious conditions in which you’re so preoccupied with food and weight that you can often focus on little else. The main types of eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.
Eating disorders can cause serious physical problems, and at their most severe can even be life-threatening. Most people with eating disorders are females, but males can also have eating disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females.
Treatments for eating disorders usually involve psychotherapy, nutrition education, family counseling, medications and hospitalization.
By Mayo Clinic staff
Symptoms
The signs and symptoms of eating disorders vary with the particular type of eating disorder.
Anorexia Nervosa
In the case of anorexia nervosa, one is obsessed with food and being thin, sometimes to the point of deadly self-starvation.
Anorexia signs and symptoms may include:
- Refusing to eat and denying hunger
- An intense fear of gaining weight
- Negative or distorted self-image
- Excessively exercising
- Flat mood or lack of emotion
- Preoccupation with food
- Social withdrawal
- Thin appearance
- Dizziness or fainting
- Soft, downy hair present on the body (lanugo)
- Menstrual irregularities or loss of menstruation (amenorrhea)
- Constipation
- Abdominal pain
- Dry skin
- Frequently being cold
- Irregular heart rhythms
- Low blood pressure
- Dehydration
Bulimia Nervosa
In the case of bulimia, one has episodes of binging and purging. During these episodes, you typically eat a large amount of food in a short duration and then try to rid yourself of the extra calories by vomiting or excessive exercise. You actually may be at a normal weight or even a bit overweight.
Bulimia signs and symptoms may include:
- Eating until the point of discomfort or pain, often with high-fat or sweet foods
- Self-induced vomiting
- Laxative use
- Excessively exercising
- Unhealthy focus on body shape and weight
- Having a distorted, excessively negative body image
- Going to the bathroom after eating or during meals
- Feeling that you can’t control your eating behavior
- Abnormal bowel functioning
- Damaged teeth and gums
- Swollen salivary glands in the cheeks
- Sores in the throat and mouth
- Dehydration
- Irregular heartbeat
- Sores, scars or calluses on the knuckles or hands
- Menstrual irregularities or loss of menstruation (amenorrhea)
- Constant dieting or fasting
- Possibly, drug or alcohol abuse
Binge-eating disorder
In the case of binge-eating disorder, one regularly eats excessive amounts of food (binge). You may eat when you’re not hungry and continue eating even long after you’re uncomfortably full. After a binge, you may try to diet or eat normal meals, triggering a new round of binging. You may be a normal weight, overweight or obese.
Symptoms of binge-eating disorder may include:
- Eating to the point of discomfort or pain
- Eating much more food during a binge episode than during a normal meal or snack
- Eating faster during binge episodes
- Feeling that your eating behavior is out of control
- Frequently eating alone
- Feeling depressed, disgusted or upset over the amount eaten
When to see a doctor
Because of its powerful pull, an eating disorder can be difficult to manage or overcome by yourself. Eating disorders can virtually take over your life. You may think about food all the time, spend hours agonizing over what to eat, and exercise to exhaustion. You may feel ashamed, sad, hopeless, drained, irritable and anxious. You may also have a host of physical problems because of your eating disorder, such as irregular heartbeats, fatigue, bowel troubles and dizziness. If you’re experiencing any of these problems, or if you think you may have an eating disorder, seek medical help.
Urging a loved one to seek treatment
Unfortunately, many people with eating disorders resist treatment. If you have a loved one you’re worried about, urge him or her to talk to a doctor. Even if your loved one isn’t ready to acknowledge having an issue with food, you may be able to open the door by expressing concern and a desire to listen. You may also want to consider contacting your child’s doctor about your concerns. You can get a referral to qualified mental health providers for treatment.
Keep in mind, however, that in children it’s sometimes hard to tell what’s an eating disorder and what’s simply a whim, a new fad, or experimentation with a vegetarian diet or other eating styles. In addition, many girls and sometimes boys go on diets to lose weight, but stop dieting after a short time. If you’re a parent or guardian, be careful not to mistake occasional dieting with an eating disorder. On the other hand, be alert for eating patterns and beliefs that may signal unhealthy behavior, as well as peer pressure that may trigger eating disorders.
Red flags that family and friends may notice include:
- Skipping meals
- Making excuses for not eating
- Eating only a few certain “safe” foods, usually those low in fat and calories
- Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
- Cooking elaborate meals for others, but refusing to eat them themselves
- Withdrawing from normal social activities
- Persistent worry or complaining about being fat
- A distorted body image, such as complaining about being fat despite being underweight
- Not wanting to eat in public
- Frequent checking in the mirror for perceived flaws
- Wearing baggy or layered clothing
- Repeatedly eating large amounts of sweet or high-fat foods
- Use of dietary supplements or herbal products for weight loss
Causes
The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes. Possible causes of eating disorders include:
- Biology. There may be genes that make certain people more vulnerable to developing eating disorders. People with first-degree relatives — siblings or parents — with an eating disorder may be more likely to develop an eating disorder too, suggesting a possible genetic link. In addition, there’s some evidence that serotonin, a naturally occurring brain chemical, may influence eating behaviors.
- Psychological and emotional health. People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behavior, anger management difficulties, family conflicts and troubled relationships.
- Society. The modern Western cultural environment often cultivates and reinforces a desire for thinness. Success and worth are often equated with being thin in popular culture. Peer pressure and what people see in the media may fuel this desire to be thin, particularly among young girls.
Complications
Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications. Complications may include:
- Death
- Heart disease
- Depression
- Suicidal thoughts or behavior
- Absence of menstruation (amenorrhea)
- Bone loss
- Stunted growth
- Seizures
- Digestive problems
- Bowel irregularities
- Kidney damage
- Severe tooth decay
- High or low blood pressure
- Type 2 diabetes
- Gallbladder disease
