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Eating disorders are psychological illnesses defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Bulimia nervosa and anorexia nervosa are the most common specific forms of eating disorders.
Causes of Eating Disorders
Eating disorders are complex diseases and not just a condition that can be treated with willpower. They meet the definition of a disease because, like other diseases, they have a particular destructive process for an individual, with a particular cause, be it known or unknown and display a set of characteristic symptoms. Eating disorders are all primary mental health diseases, rather than being the secondary result of another condition. The conditions are chronic with an progression both identifiable and predictable. Eating disorders can be caused by a mix of sociological, psychological and genetic factors.
Sociological. Environmental conditions reinforce the practice of an eating disorder like anorexia, bulimia or compulsive overeating. We live in a society that reinforces the idea to be happy and successful we must be thin. Today, you cannot read a magazine or newspaper, turn on the television, listen to the radio, or shop at the mall without being assaulted with the message that fat is bad. During adolescence, a particularly vulnerable time to the development of an eating disorder, the influence of peers becomes important. Self monitoring and comparing ourselves to others becomes central to our psyche. It’s common for individuals with eating disorders to have experienced a background of peer teasing and pressure to conform. As bodies change and develop, body image is strongly affected by how others react to these changes. Other sociological issues that can affect body image include dysfunctional families, sexual abuse, physical abuse, domineering coaches and controlling relationships.
Psychological. Eating disordered behavior can be seen as a survival mechanism, in many cases a way to express something that the individual hasn’t found another way to express. Much like how alcoholics depend on alcohol, individuals with eating disorders like bulimia or compulsive overeating syndrome use restricting, bingeing or purging behaviors as a way of coping with overwhelming emotions. Eating disordered individuals often use their disorders to gain a partial sense of control over their seemingly out-of-control lives. Some psychological issues that often correlate with eating disorders include depression, low self-esteem, damaged self-worth, problems communicating with family members, or an incapability to manage emotions. These psychological factors can contribute to the manifestation of eating disorders.
Genetic. It’s the belief of many researchers that there is a genetic link to eating disorders. Studies have demonstrated that identical twins have a greater co-occurrence of anorexia and bulimia than fraternal twins. Identical twins are more genetically similar than fraternal twins, which supports the fact that eating disorders have an inherited component.
More research into the genetic factors of eating disorders has keyed in on neurochemistry. It has been shown that the neurotransmitters neuroepinephrine and serotonin are severely diminished in patients that are suffering with acute cases of bulimia and anorexia nervosa. These are the same neurotransmitters that function abnormally when individuals are struggling with depression. This correlation has led some researchers to surmise that there could be a link between eating disorders and depression. In addition to creating feelings of emotional and physical satisfaction, the neurotransmitter serotonin also is responsible for feelings of fullness after eating.
Additional brain chemicals have been examined for their potential role in eating disorders. The hormones cortisol and vasopressin have been observed at elevated levels in individuals with eating disorders like bulimia nervosa and anorexia. Both cortisol and vasopressin are released in response to emotional and physical stressors. Heightened levels of these hormones may be contributing factors to some dysfunction experienced by individuals struggling with eating disorders. Other research has indicated that individuals with bulimia and anorexia have heightened levels of the brain chemicals peptide-YY and neuropeptide-Y. Tests of laboratory animals have indicated that these chemicals can stimulate eating behavior. Also, the hormone cholecystokinin (CCK) has been shown to be diminished in women who are struggling with bulimia. Likewise, this hormone has caused laboratory animals to experience fullness and stop eating.
Eating Disorders such as anorexia, bulimia, and binge eating disorder include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.
Types of Eating Disorders
Eating disorders include a range of conditions that can affect someone physically, psychologically and socially. The most common eating disorders are:
- Anorexia nervosa. When someone tries to keep their weight as low as possible, for example by starving themselves or exercising excessively
- Bulimia. When someone tries to control their weight by binge eating and then deliberately being sick or using laxatives (medication to help empty their bowels)
- Binge eating. When someone feels compelled to overeat
Some people, particularly young people, may be diagnosed with an eating disorder not otherwise specified (EDNOS). This is means you have some, but not all, of the typical signs of eating disorders such as anorexia or bulimia.
Many people who suffer with eating disorders show no outward signs, but still experience overwhelming internal feelings that prompt them to rely on symptoms to control intense pain, anxiety or other troubling emotions. Eating disorders are not a phase of adolescence or an expression of vanity. It is critical for a sufferer to seek medical treatment for eating disorders at the earliest sign of symptoms. Research shows that early and adequate intervention leads to the best clinical outcomes.
Disordered eating behaviors stand in the way of the healthy experience of emotional, social and spiritual development, and prevent the sufferer from living a full life. They are not “normal” efforts to “eat healthy”, and they require professional eating disorder treatment. Behaviors associated with eating disorders may include:
- Constant adherence to increasingly strict diets, regardless of weight
- Habitual trips to the bathroom immediately after eating
- Secretly bingeing on large amounts of food
- Hoarding large amounts of food
- Increase in consumption of laxatives, diuretics or diet pills
- Exercising compulsively, often several hours per day
- Using prescription stimulant medications (like Adderall) and/or illicit stimulant drugs (like cocaine) to suppress appetite
Despite different symptoms, eating disorders share common roots that depend on genetics, environmental factors, medical history, life experiences, and the presence of co-occurring psychiatric and addictive disorders. Common signs of the emotional changes associated with having an eating disorder are:
- Withdrawal from friends and family, particularly following questions about her disease or visible physical/medical side effects
- Avoidance of meals or situations where food may be present
- Preoccupation with weight, body size and shape, or specific aspects of one’s appearance
- Obsessing over calorie intake and calories burned via exercise, even as one may be losing significant amounts of weight
Eating Disorders Treatment
Eating disorder treatment depends on your particular disorder and your symptoms. It typically includes a combination of psychological counseling (psychotherapy), nutrition education, medical monitoring and sometimes medications.
Eating disorder treatment also involves addressing other health problems caused by an eating disorder, which can be serious or even life-threatening if they go untreated for long enough. If an eating disorder doesn’t improve with standard treatment or causes health problems, you may need hospitalization or another type of inpatient program.
Having an organized approach to eating disorder treatment can help you manage symptoms, regain a healthy weight, and maintain your physical and mental health.
You may start by seeing your family doctor or mental health counselor, such as a psychologist. You may also need to see other health professionals who specialize in eating disorder treatment. Other members of your treatment team may include:
- A registered dietitian to provide nutritional counseling.
- A psychiatrist for medication prescription and management, when medications are necessary. Some psychiatrists also provide psychological counseling.
- Medical or dental specialists to treat health or dental problems that result from your eating disorder.
- Your partner, parents or other family members. For young people still living at home, parents should be actively involved in treatment and may supervise meals.
Setting Up A Treatment Plan
- Treat physical complications. Your treatment team monitors and addresses any medical issues that are a result of your eating disorder.
- Identify resources. Your treatment team can help you discover what resources are available in your area to help you meet your goals.
- Work to identify affordable treatment options. Hospitalization and outpatient programs for treating eating disorders can be expensive, and insurance may not cover all the costs of your care. Talk with your treatment team about financial issues ― don’t avoid treatment because of the potential cost.
- Normalize your eating patterns and achieve a healthy weight
- Exchange unhealthy habits for healthy ones
- Learn how to monitor your eating and your moods
- Develop problem-solving skills
- Explore healthy ways to cope with stressful situations
- Improve your relationships
- Improve your mood
- Cognitive behavioral therapy. This short-term, structured treatment focuses on addressing behaviors, thoughts and feelings related to your eating disorder. After helping you normalize your eating behaviors, it helps you learn to recognize and change distorted thoughts that lead to eating disorder behaviors.
- Family-based therapy. With family-based therapy, family members learn to help you restore eating patterns and achieve a healthy weight until you can do it on your own. This type of therapy can be especially useful for parents learning how to help a teen with an eating disorder.
- Group cognitive behavioral therapy. This type of treatment involves meeting with a psychologist or other mental health provider along with others who are diagnosed with an eating disorder. It can help you address thoughts, feelings and behaviors related to your eating disorder, learn skills to manage symptoms, and regain healthy eating patterns.
- Working toward a healthy weight
- Understanding how nutrition affects your body, including recognizing how your eating disorder causes nutrition issues and physical problems
- Practicing meal planning
- Establishing regular eating patterns generally, three meals a day with regular snacks
- Correcting health problems that are a result of malnutrition
- Taking steps to avoid dieting or bingeing