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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

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

OCT 13 2020

How Patients With Eating Disorders Have Been Affected by the Pandemic
Smithsonian Magazine

A recent study suggests that worries related to Covid-19 may exacerbate conditions including anorexia and binge eating. Scientists have found that since the start of the pandemic many people with anorexia have become more restricted, and many with binge eating disorder or bulimia, have had more binging episodes. The study’s findings line up with an increase in calls to the helpline of the National Eating Disorders Association. The nonprofit reported 69 percent more calls in June and July of 2020 than in June and July of 2019.

OCT 13 2020

UNC is mapping the genetics of eating disorders to develop better treatments

News Observer

A new initiative at UNC-Chapel Hill is kicking off a genetic study of eating disorders that it says will be the largest of its kind. If successful, the study, conducted by the Eating Disorders Genetic Initiative (EDGI), will be able to identify hundreds of genes that influence a person’s likelihood of suffering from three prominent disorders: anorexia nervosa, bulimia nervosa and binge-eating disorder. That knowledge could significantly improve the way those illnesses are treated, said Cynthia Bulik, a professor at the UNC School of Medicine and head of EDGI.

OCT 4 2020

Watching out for eating disorders in kids and teens 
Contemporary Pediatrics

Eating may become disordered for some pediatric patients. A presentation at the virtual 2020 American Academy of Pediatrics National Conference & Exhibition gives guidance on how to identify and manage eating disorders in pediatrics. There is a shifting epidemiology of eating disorders, it is becoming more prevalent in younger children, males, and minorities. He also spoke about the sex differences that are noted in eating disorder prevalence, stating that the 9:1 ratio of girls to boys only seems to apply to teenagers and young adults. In children aged 9 to 10, the ratio is 1:1..

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