Help With 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

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

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

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

About the Expert:

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