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Help With Eating Disorders

Curated and updated for the community by APA

Eating disorders are illnesses in which the people experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become pre-occupied with food and their body weight. Eating disorders affect several million people at any given time, most often women between the ages of 12 and 35. There are three main types of eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder.

People with anorexia nervosa and bulimia nervosa tend to be perfectionists with low self-esteem and are extremely critical of themselves and their bodies. They usually “feel fat” and see themselves as overweight, sometimes even despite life-threatening semi-starvation (or malnutrition). An intense fear of gaining weight and of being fat may become all-pervasive. In early stages of these disorders, patients often deny that they have a problem.

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

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Are there some common warning signs of eating disorders?

There is no one sign of an eating disorder, however there are red flags. These can include excessive “fat, weight or calorie talk,” a pattern of eating a limited choice of low-calorie food or a pattern of occasional binge eating of calorie-dense foods. People with anorexia nervosa may excessively exercise or excessively stand, pace or fidget. Affected individuals may severely limit the amount of calories they consume or 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. Affected individuals often avoid social eating settings and eat alone. More

What causes an eating disorder?

There is no single cause of an eating disorder. We know that genetics play a large role, but genetic vulnerability is only part of the story. Environment plays a role too, especially in triggering onset, which often occurs in adolescence. Pressure to diet or weight loss related to a medical condition can be the gateway to anorexia nervosa or bulimia. For those who are genetically vulnerable to anorexia nervosa, once they lose the first five to 10 lbs, dieting becomes increasingly compelling and rewarding. Looked at another way, if eating disorders were the result solely of social pressure for thinness we would expect eating disorder rates to have increased as obesity has in the past few decades, yet anorexia nervosa and bulimia remain relatively rare and often cluster in families. 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. 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 behaviors 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 about seeking treatment. Treatment is effective, many are able to achieve full recovery and the vast majority will improve with expert care. Treatment assists affected individuals to change what they do. It helps them normalize their eating and reframe the irrational thoughts that sustain eating disordered behaviors. 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 anyone. Although they are most common in young 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 a co-occurring psychiatric illness, such as depression or anxiety. Recent 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 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. 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

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Helena’s Story

Helena was a 16-year-old girl who lived at home with her parents and younger sister. Throughout her teenage years, she had been a normal weight but she worried a great deal about her body weight and shape. She often compared her body weight with that of other girls and women she met or saw — and then judged herself as too heavy.

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Editor's Choice

MAR 30 2020

Eating Disorders Thrive in Social Isolation, but Virtual Resources Can Help

NBC News

For people with eating disorders, the long periods of social isolation being enforced due to the coronavirus pandemic can make things worse. That’s why healthcare providers are moving quickly to provide virtual resources to help patients weather the storm. 

MAR 13 2020

iCarly star Jennette McCurdy writes about eating disorder

The Daily Targum of Rutgers University

In an age where “influencer culture” is so prominent on social media, young people are constantly observing perfection all around them. This behavior is fueling the immense social pressure and unrealistic expectations young girls have for themselves, and thus, perpetuating body dysmorphia and eating disorders. Admirably, former "iCarly" star Jennette McCurdy has recently come out with an extensive article with Huffington Post on her 13-year battle with anorexia and bulimia where she discussed the tremendous amount of pressure put on her by those whom she trusted and admired most..

MAR 12 2020

The role of eating disorder symptoms in gastroenterology

Minnesota Daily

Eating disorder symptoms motivated by concerns about body shape/weight can be present in or develop in gastroenterology patients, often contributing to maintenance of gastrointestinal symptoms. Importantly, eating disorder symptoms lie along a spectrum—there are many individuals who do not meet full-threshold criteria for a “classic” eating disorder — anorexia nervosa, bulimia nervosa, binge eating disorder — yet have symptoms that could interact with their gastrointestinal presentation. To facilitate evaluation and treatment of patients with eating disorder symptoms, it can be helpful to understand that symptoms generally fall into two categories: thoughts and behaviors.

Resources

Additional Resources and Organizations

National Eating Disorders Association

Mental Health America

National Alliance on Mental Illness

National Institute on Mental Health

Screening for Mental Health, Inc.

Overeaters Anonymous

Physician Reviewed

Ranna Parekh, M.D., M.P.H.
 January 2017