Eating Disorders

By Gustavo Pérez

What are eating disorders? Eating disorders are complex conditions

that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors.

What are they? People with eating disorders often use food and the

control of food in an attempt to compensate for feelings and emotions that may otherwise seem over-whelming.

For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one’s life, but ultimately, these behaviors will damage a person’s physical and emotional health, self-esteem, and sense of competence and control.

Disorders Anorexia Nervosa Bulimia Binge Eating Disorder

Anorexia nervosa Characterized by self-starvation and excessive weight loss.

Symptoms include:

Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level

Intense fear of weight gain or being “fat” Feeling “fat” or overweight despite dramatic weight loss Loss of menstrual periods Extreme concern with body weight and shape

Bulimia Characterized by a secretive cycle of binge eating followed by

purging. Bulimia includes eating large amounts of food--more than most people would eat in one meal--in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse, or over-exercising.

Repeated episodes of bingeing and purging Feeling out of control during a binge and eating beyond the point

of comfortable fullness Purging after a binge, (typically by self-induced vomiting, abuse of

laxatives, diet pills and/or diuretics, excessive exercise, or fasting) Frequent dieting Extreme concern with body weight and shape

Binge Eating Disorder/Compulsive Overeating Characterized primarily by periods of uncontrolled,

impulsive, or continuous eating beyond the point of feeling comfortably full.

While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge.

People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating.

Body weight may vary from normal to mild, moderate, or severe obesity.

Psychological factors

Low self-esteem Feelings of inadequacy or lack of

control in life Depression, anxiety, anger, or

loneliness

Social Factors Cultural pressures that glorify "thinness" and

place value on obtaining the "perfect body" Narrow definitions of beauty that include only

women and men of specific body weights and shapes

Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths

Treatment Because eating disorders impact the whole person –

mind, body and spirit – treatment must be comprehensive and individualized. The best eating disorder treatment programs combine medical care, individual, group and family therapy, nutrition education, and other interventions tailored to the specific needs of each individual.  

Food Behavior Anorexic The person skips meals, takes only tiny portions, will

not eat in front of other people, eats in ritualistic ways, and mixes strange food combinations. May chew mouthfuls of food but spits them out before swallowing.

Grocery shops and cooks for the entire household, but will not eat the tasty meals.

Always has an excuse not to eat -- is not hungry, just ate with a friend, is feeling ill, is upset, and so forth.

Food Behavior Bulimic The person gorges, usually in secret, emptying

cupboards and refrigerator. May also buy special binge food.

If panicked about weight gain, may purge to get rid of the calories. May leave clues that suggest discovery is desired -- empty boxes, cans, and food packages; foul smelling bathrooms; running water to cover sounds of vomiting; excessive use of mouthwash and breath mints; and in some cases, containers of vomit poorly hidden that invite discovery.