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Help With Eating Disorders

Curated and updated for the community by APA

Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological and social function. Types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica and rumination disorder.

Taken together, eating disorders affect up to 5% of the population, most often develop in adolescence and young adulthood. Several, especially anorexia nervosa and bulimia nervosa are more common in women, but they can all occur at any age and affect any gender. Eating disorders are often associated with preoccupations with food, weight or shape or with anxiety about eating or the consequences of eating certain foods. Behaviors associated with eating disorders including restrictive eating or avoidance of certain foods, binge eating, purging by vomiting or laxative misuse or compulsive exercise. These behaviors can become driven in ways that appear similar to an addiction.

Eating disorders often co-occur with other psychiatric disorders most commonly mood and anxiety disorders, obsessive compulsive disorder and alcohol and drug abuse problems. Evidence suggests that genes and heritability play a part in why some people are at higher risk for an eating disorder, but these disorders can also afflict those with no family history of the condition. Treatment should address psychological, behavioral, nutritional and other medical complications. The latter can include consequences of malnutrition or of purging behaviors including, heart and gastrointestinal problems as well as other potentially fatal conditions. Ambivalence towards treatment, denial of a problem with eating and weight, or anxiety about changing eating patterns is not uncommon. With proper medical care however, those with eating disorders can resume healthy eating habits, and recover their emotional and psychological health.

Read more on symptoms, & treatment

  • Oct 31, 2019
Body Dysmorphic Disorder and a Culture of Perfection

Body dysmorphic disorder is an obsessive-compulsive related disorder that has garnered some media attention recently. Contrary to the offhand way it sometimes referred to in the media, body dysmorphic disorder is a serious mental health condition with potentially severe consequences.  Individuals with body dysmorphic disorder are preoccupied with what they see as flaws in their physical appearance. They believe they look ugly or abnormal. These flaws are not noticeable to others or only seem to others as very minor.

  • Oct 02, 2019
Overtraining and Under Eating: Athletes at Risk of RED-S Syndrome

Regular exercise typically improves mood, promotes better sleep, and prevents health problems such as high blood pressure. However, if people exercise too much, as Katie Kirk did, they can experience a wide range of negative health effects. 

  • Feb 01, 2019
Eating Disorders, Weight-Shaming and “Clean” Eating

Eating disorders affect all kinds of people: women, men, young and old and from all racial and ethnic backgrounds. Many factors likely contribute to developing eating disorders, including a range of biological, psychological, and sociocultural factors. Having a close relative with an eating disorder or a history of dieting are risk factors. High levels of body image dissatisfaction and setting unrealistically high expectations for oneself (perfectionism) also increase the risk

Are there some common warning signs of eating disorders?

There is no one sign of an eating disorder, however there are red flags. For anorexia nervosa, bulimia nervosa and binge eating disorder these can include excessive “fat, weight or calorie talk,” a pattern of eating a limited choice of low-calorie foods, and/or a pattern of intermittent binge eating on calorie-dense foods. People with anorexia nervosa may excessively exercise or excessively stand, pace or fidget. Some individuals with eating disorders may avoid weight gain following meals by inducing vomiting or abusing laxative, diuretic and diet pills. Feeling self-conscious about one’s eating behavior is common. People with eating disorders often avoid social eating settings and eat alone. In avoidant restrictive food intake disorder, excessive concerns with weight and shape are generally absent, but those affected are at risk for malnutrition due to very selective eating. More

What causes an eating disorder?

There is no single cause of an eating disorder. Eating disorders, like several other psychiatric conditions, often cluster in families, and we now recognize that genetic vulnerability plays a significant role in risk for developing an eating disorder. Genes, however, are only part of the story and environment plays a role too, especially in triggering onset of an eating disorder, often in adolescence or young adulthood. Pressure to diet, or weight loss related to a medical condition or life stressor, can be the gateway to anorexia nervosa or bulimia nervosa. Losing those first five to 10 pounds, in someone who is genetically vulnerable, seems to make further dieting increasingly compelling and rewarding. More

How can I best help and support someone who has been diagnosed with an eating disorder?

Treatment for an eating disorder is challenging. It involves interrupting behaviors that have become driven and compelling, and overcoming anxiety about doing so. Recovery takes a team, which includes family, friends and other social supports, as well as medical and mental health professionals. Be empathic, but clear. List signs or changes in behavior you have noticed and are concerned about. Help locate a treatment provider and offer to go with your friend or relative to an evaluation. Be prepared that the affected individual may be uncertain or ambivalent about seeking treatment. Treatment is effective, many are able to achieve full recovery and the vast majority will improve with expert care. Treatment assists those affected with an eating disorder to change what they do. It helps them normalize unhealthy eating and weight control behaviors and challenge the irrational thoughts that sustain them. Food is central to many social activities and the practice of eating meals with supportive friends and family is an important step in recovery. More

We tend to hear about young women and eating disorders, but are there other groups of people that are more often affected by eating disorders?

Eating disorders do not discriminate and can affect individuals of any age and any gender. Although they are most common in younger women, it is not unusual for older women to have an eating disorder. Some have had one all their life, others were only mildly affected until some life event triggers clinical worsening – a stressor, physical illness, or co-occurring psychiatric illness, such as depression or anxiety. Evidence strongly suggests that anxiety disorders, especially social anxiety disorder, and obsessive-compulsive personality traits increase individual vulnerability to an eating disorder. Eating disorders occur in men and in transgender individuals too. An estimated 10 percent of people with anorexia nervosa and bulimia and a third or more of people with binge eating disorder are male. Avoidant restrictive eating disorder appears to be more common in males than in females. More

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About the Expert:

Angela Guarda, M.D.
Associate Professor of Psychiatry and Behavioral Sciences
Director, Johns Hopkins Eating Disorders Program
The Johns Hopkins University

Editor's Choice

MAY 24 2021

Pandemic created 'perfect storm' for eating disorders in teens

 

NBC News

The National Eating Disorder Association reports a more than 53 percent increase in call volume to its helpline since the start of the pandemic. Just over a third of those patients are ages 13 to 17, and about 36 percent are 18 to 24 years old. The National Association of Anorexia Nervosa and Associated Disorders, too, has seen a 50 percent jump in calls from teens and their parents since the pandemic began. Experts attribute the rise in unhealthy and potentially dangerous eating habits in teenagers to a combination of social confinement during lockdown and a feeling of losing control.

MAY 8 2021

Eating disorders, and demand for treatment, rise with the pandemic 

WHYY'

Over the course of the COVID-19 epidemic, mental illnesses have been heightened, medical experts say, and issues such as eating disorders are on the rise. “What we see at CHOP mirrors what people are reporting across the country and internationally, which is a rise in adolescents seeking out treatment for eating disorders, both in the outpatient setting and then also in the hospital setting,” said Alix Timko, a psychologist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia..

APR 27 2020

Worried your child has an eating disorder? This pediatrician has advice.
Washington Post

As a pediatrician, I’ve seen how the pandemic has deeply affected our youth; they are suffering from depression and anxiety as they were pulled from routines, school and peers for a year. But one effect I’ve seen that has been surprising: the number of tweens and teens who are suffering from eating disorders, probably brought on by this isolating time. “The number of new referrals, along with the amount of hospitalizations for eating disorders, has doubled at the hospital over the last year,” says Lisa Tuchman, chief of adolescent medicine at Children’s National Hospital in D.C.

Resources

Additional Resources and Organizations

National Eating Disorders Association

Mental Health America

National Institute on Mental Health

Screening for Mental Health, Inc.

Overeaters Anonymous

Physician Reviewed

Angela Guarda, M.D.
 March 2021