Are you worrying about whether you have an eating disorder? You are in the right place to learn more. If you’ve been obsessing about your body weight, struggling to regain your self-esteem, or questioning your eating habits, you don’t have to go through it alone.
Come along as we break down the different types of eating disorders and the various treatment options available if you think you want to take the next step.
What is an Eating Disorder?
Eating disorders are complex mental health illnesses. Though women and girls are at a higher risk for developing disordered eating than men and boys, they can affect anyone. Here are some of the most common signs of an eating disorder:
- Obsession over body weight
- Excessive exercise, or exercising to compensate for food eaten
- Binging excessive amounts of food and purging later by vomiting, using laxatives, or taking diuretics
- Making excuses to avoid eating with others
- Missing out on plans with friends or family to avoid being around food
- Developing specific rituals around food and eating
- Excessive dieting, limiting, or completely restricting food intake
- Cooking meals for others, but not eating yourself
- Checking weight repeatedly
- Intense fear of gaining weight
- Dramatic weight loss
- Feeling lethargic or lacking energy due to a lack of eating
- Dysmorphic body image and low self-esteem
An eating disorder is not a cookie-cutter illness. Everyone’s struggle is different, and there is no magic bullet that will “cure” an eating disorder.
What Exactly Causes Eating Disorders?
It’s not easy to pinpoint the exact causes of eating disorders, but we know that an eating disorder is a mental health issue that can arise from any number of risk factors.
There is evidence that genetics and biology can play a role in developing eating disorders. Those with a sibling or parent with an eating disorder seem much more likely to develop one. Yet another thing we can blame our parents for — just kidding!
Many experts believe that a person’s personality traits can play a role in whether or not they develop an eating disorder. There are three personality traits that psychologists have linked with eating disorders:
All these traits can make you more likely to develop an eating disorder.
The cultural pressure — or at least the perceived pressure — to be thin is a huge component of eating disorder causes. In the United States and many other countries, there is a cultural preference for thinness that can be stifling.
The messages sent by media that promote being thin, often at great cost, can harm one’s self-esteem. Want to know what’s especially yucky?
Much of this messaging is intentionally geared toward young impressionable girls.
What Are the Different Types of Eating Disorders?
There are several defined eating disorders, each with its own symptoms, complications, and intricacies. Let’s get right into it! Here are the most common eating disorders and their traits.
When you think about eating disorders, do you picture a stick-thin person starving themselves and eating mustard on a celery stick? (Did we all watch the same after-school special in sixth grade?) No eating disorder is this black-and-white.
Anorexia nervosa is one of the most common and well-known eating disorders. Known as anorexia for short, this eating disorder manifests itself in refusal to eat, severe restriction of calories, and extreme fear of gaining weight, sometimes due to distorted body image.
Relentless pursuit of a slim and skinny physique is the trademark of anorexia, but we will note that low weight alone is not a diagnostic for anorexia. Often, anorexia comes with obsessive-compulsive traits and behaviors.
Restricting food and weight can become something to control, and when a person feels out of control, they will often do whatever they can to feel like they’ve got a grasp on things again. This behavior is sometimes referred to as avoidant/restrictive food intake disorder (ARFID).
Some physical symptoms that may occur as a result of long-term anorexia include:
- Weakening of the bones
- Thinning hair and nails
- Loss of menstrual cycle
- Heart and brain damage
- Multi-organ failure
Bulimia nervosa (aka bulimia) is characterized by binge and purge eating patterns. Those who struggle with bulimia can have difficulty controlling how much or how often they eat and then experience extreme guilt afterward and purge their food.
Contrary to popular belief, the binge and purge cycle is not all about weight loss or a fear of gaining weight, although it often is involved. Sometimes people use purging behaviors to relieve themselves of the stomach discomfort after a marathon binge session.
The thing about binge eating is this: people are not typically overeating salads and smoothie bowls. They usually eat the types of foods they would typically avoid out of fear of gaining weight, which will cause discomfort.
Bulimia can sometimes be difficult to spot in others, as those with the disease are likelier to stay within normal weight ranges than those who suffer from anorexia. The fact that people don’t become emaciated doesn’t mean that bulimia is without risks to one’s physical health — quite the opposite.
Here are some symptoms of bulimia and associated health risks:
- Episodes of binge eating and followed by purging.
- Fear of weight gain, despite being within completely normal weight ranges.
- Connecting self-esteem to body image and perceived body shape
- Imbalance of electrolytes (potential to lead to strokes or heart failure)
- Erosion of tooth enamel
- Persistent sore throat
- Swollen salivary glands
- Hormonal imbalances
- Ongoing chronic dehydration
- Permanent damage to gut health, including reflux
Binge Eating Disorder
You might not have realized this, but binge eating constitutes an eating disorder entirely on its own, separate from bulimia. Exactly what it sounds like, this disease involves eating to excess, typically foods that the person sees as “bad” or “unhealthy” food.
Though it doesn’t seem to get as much press as other eating disorders, binge eating disorder is the most prevalent. Commonly, it starts during adolescence or young adulthood, which is not surprising given the mixed messages that young adults get about food, weight, and health, especially on social media.
The symptoms of binge eating disorder are remarkably similar to those of anorexia and bulimia. For example, there is a feeling of lack of control when it comes to eating and a desire to regain control. The compulsion can also mask negative emotions with food as a self-soothing behavior.
The shame, guilt, and general negative feelings, including anxiety and depression, are common in all three EDs. There are a few things specific to binge eating disorder:
- Eating large amounts of food quickly and usually secretively.
- Poor nutritional choices overall and a much higher risk of developing diabetes or heart disease.
- No compensatory behaviors such as vomiting, using laxatives, or exercising excessively to make up for binge eating.
Some Less Common Eating Disorders
The three eating disorders we just discussed are by far the most common and also the most well-known. However, they are not the only ones. Here are some lesser-known eating disorders that can still wreak havoc on one’s life.
Rumination Disorder: This is a more recently recognized eating disorder. Rumination disorder occurs when a person vomits after eating, then re-chews the food and either spits it out or swallows it.
Believe it or not, this can develop as early as infancy, though it can also start in childhood or adulthood. It can result in malnutrition and vitamin deficiencies. Typically, it takes aggressive therapy to resolve this mental health issue.
Pica: A while back, there was a TV show that highlighted people who had strange addictions, and often the strange addiction was eating something odd, like the stuffing from a couch or one’s hair.
The people on that show were likely suffering from some form of pica. Pica is when the person desperately craves non-food items. Common cravings are dirt, soap, chalk, wool, rocks or pebbles, and cornstarch.
For obvious reasons, this can be incredibly dangerous. Depending on what is ingested, a person with PICA can become poisoned or even die. Pica is most common in those with other disorders that affect their daily functioning, such as autism or schizophrenia.
Night Eating Syndrome: This ED takes the concept of a midnight snack to the next level. People with night eating syndrome wake up in the middle of the night just to eat.
Sometimes, they will even eat in their sleep or while only half awake. It might not sound serious, but night eating syndrome is a psychological issue that can lead to weight gain and its associated health risks.
Other specified feeding or eating disorder (OSFED): For disordered eating that doesn’t exactly fit the criteria of any of the other categories, there is OSFED. Though it’s not officially recognized in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it’s still an important category.
A person might suffer from certain symptoms and exhibit some, but not all, behaviors from other named eating disorders. There needs to be a “catch-all” to allow them to get the help they need.
What Happens if an Eating Disorder Goes Untreated?
Treatment is essential for eating disorders. You wouldn’t tell someone with a broken arm to fend for themselves, so why would we think that someone with a serious illness like anorexia or bulimia will be able to just “snap out of it?”
Eating disorders, if left untreated, can wreak havoc on a person’s physical, social, and mental health. Long-term calorie and vitamin deficiencies quite literally overwhelm the body and brain. Your brain needs food to function properly as your body does!
The consequences of ED can be severe, even in the short term. If disordered eating habits persist and aren’t addressed, the results can be catastrophic.
What Are My Options for Eating Disorder Treatment?
Luckily, there is a silver lining: eating disorder treatment centers can provide successful, effective treatment in most cases. Let’s get into the various available treatment options and how treatment can help people recover completely.
Buckle up because the options are vast and can be overwhelming, But don’t worry; we will talk you through them all! We will start from the least intensive to most intensive options and get into some of the aftercare therapy vital in caring for an eating disorder.
Intensive Outpatient or Outpatient
This option means that the person would still be able to live at home, go to work, and proceed with their daily lives for all intents and purposes. In the process, they would attend classes, go to therapy (possibly group therapy), see doctors, and potentially work with nutritionists and dieticians to promote healthy eating.
To qualify for this type of treatment, it is important that the patient:
- Is medically stable, with minimal medical complications
- Does not need to be monitored daily for medical concerns
- Is psychologically stable
- Has symptoms relatively under control, enough to function in day-to-day life
A partial hospitalization program (PHP) is the happy medium between outpatient treatment and a fully residential program.
A PHP's common features are individual counseling, family sessions, and group therapy. It’s also likely that the person undergoing treatment will receive some form of medication management and nutritional counseling.
The primary distinction between a PHP and a residential treatment program is that patients spend the day in the treatment centers but then go home to sleep in their own beds. This provides the structure and monitoring of residential care and allows for practicing life skills as patients transition out of treatment.
Those who are good candidates for a PHP may:
- Be medically stable, but lack the ability for basic day-to-day functioning
- Need daily monitoring of psychological and mental state
- Engaging in chronic binge eating, purging, restrictive food intake, and other damaging weight control behaviors.
In residential treatment programs, the patient gets round-the-clock supervision and medical monitoring. Here, you would stay at a facility overnight and attend programming during the day.
Typically, most programming is group-based and includes developing coping skills, processing trauma, and gaining healthier eating habits. Of course, individual and family therapy are still components of this type of treatment.
Depending on their progress and health insurance limitations, those in residential treatment may stay for as little as two weeks or up to a year.
Residential treatment is a good fit for those who:
- Are medically stable and do not require any intensive medical interventions.
- Are psychologically/psychiatrically impaired and are unable to achieve success in a PHP or outpatient program.
Full Inpatient Hospitalization
The most intense level of care, inpatient hospitalization, means that you would be living in a facility, monitored around the clock, and given medical interventions such as IV hydration, bed rest, or NG tubes (feeding tubes).
Note: this is no spa experience. Be prepared to have locked bathrooms, supervised snacks and meals, and intense psychotherapy sessions. The length of stay in this level of treatment tends to be shorter since, in a perfect world, you would be able to progress to a lower level of supervision as you get better.
Inpatient programs are best for those who:
- Are deemed medically unstable.
- Undergo testing that confirms they present an acute health risk.
- Have complications due to coexisting medical problems.
- Are deemed psychiatrically unstable and have rapidly worsening symptoms.
- Are suicidal and unable to maintain their safety.
Once the patient completes their treatment programs, it is often recommended that they continue receiving cognitive behavioral therapy (CBT) from mental health professionals and nutritional advice from a dietitian.
Who Gets To Decide the Level of Treatment?
This is a group effort and a decision based on many factors. The healthcare facilities, eating disorder specialists, and health insurance plans are all part of this process.
With family support and guidance, you or your loved one can have a say in the treatment they will need. Again, a combination of professional treatment and family support is ideal.
Battling an eating disorder can be a long and lonely road, but it doesn’t have to be. If you’re struggling, the time to reach out is now.
Eating disorder treatment is not a silver bullet, and there isn’t a “one-size-fits-all” approach. No matter what type of disordered eating you or your loved one is experiencing, you may be able to find help through outpatient, residential, PHP, or inpatient programs. You can do this, and we are here to help.