Eating Disorders

Definition
● An eating disorder is a psychological disorder shaped by abnormal eating
behaviours that negatively impact one’s physical or mental wellbeing.
● Types of eating disorders commonly include binge eating disorder (BED),
anorexia nervosa (AN), bulimia nervosa (BN), or eating disorders not
otherwise specified (EDNOS), and several others.
● Obesity differs from eating disorders.
● Depression, anxiety, and substance abuse are common amongst those
suffering from eating disorders.
Anorexia Nervosa
● Characterised by low weight, food restriction in general, fear of gaining
weight, as well as an overpowering desire to be thin.
● Many sufferers perceive themselves at a higher weight despite being
underweight, and the lower the weight the greater the severity of this
perception.
● The DSM-5 and research describe this symptom as ”body image
disturbance”.
● Some eat small amounts, some weigh themselves frequently, some overeat
then fast several days, over-exercise, abuse laxatives and/or diuretics, or
purge (called anorexia binge/purge subtype or AN-BP).
Anorexia Complications
● These may include osteoporosis, infertility, heart damage and several others.
● Loss of period can occur at any BMI, often presumed to be a sign of severe
danger, however electrolyte imbalances and other organ damage could occur
regardless of whether or not the menstrual cycle is lost.
● During weight restoration, people who persistently refuse means of weight
restoration and interventions are declared incompetent to make decisions by
a psychiatrist—in that case the patient may be force fed via nasogastric tube
or under restraint after asking their parents or proxies.
Bulimia Nervosa
● Characterised by binge eating followed by purging (portion and personal
perception of a binge varies), as well as excessive concern with body weight
and shape.
● The goal being expelling extra calories from the body after binging, emotional
and psychological associations of ridding the body from something play a role
as well.
● Purging may be done through vomiting or laxatives, as well as using diuretics,
stimulants and over exercising.
● The majority are usually at a normal weight, though some could be slightly
over or underweight.
Bulimia Complications
● Repetitive self-induced vomiting may cause Russell’s sign (thick skin on
knuckles) and breaking down of teeth.
● Frequently associated with other mental disorders such as depression,
anxiety, bipolar disorder, and drug or alcohol abuse.
● Increased risk of suicide and self-harm.
● The relationship shown (by clinical studies) between bulimia and vulnerable
narcissism to be a leading cause for social validation later in life.
Binge Eating Disorder
● An eating disorder characterised by frequent and recurring episodes of binge
eating, with associated negative social and psychological problems.
● Binge eating does not have the compensatory behaviours common among
bulimia nervosa, EDNOS, or anorexia binge/purge subtype.
● Leading causes remain unclear.
● Main symptoms being eating at a higher speed than normal, eating well
beyond satiety and discomfort, or eating large amounts even when not
hungry.
● It is a recently described condition which required to be distinguished from the
similar binging diagnosed in bulimia.
BED Complications
● Obesity, tooth decay, non-alcoholic fatty liver disease, acid reflux, heartburn,
amenorrhea, and disruptions in sleep.
● Sufferers often have an overall lower quality of life and are commonly prone
to experiencing social difficulties.
● Individuals with BED often have other conditions such as major depressive
disorder, personality disorder, bipolar disorder, substance abuse, body
dysmorphia, kleptomania, IBS, fibromyalgia, or anxiety disorder, as well as a
history of attempted suicide.
● While healthy people occasionally overeat, binge episodes target foods that
trigger the greatest chemical and emotional awards.
EDNOS
● A category that captures feeding and eating disorders, clinically severe, that do
not meet the diagnostic criteria for anorexia nervosa, bulimia nervosa, binge
eating disorder, and other eating disorders.
● This includes atypical anorexia, atypical bulimia of low frequency or duration,
binge eating of low frequency or duration, purging disorder, and night eating
syndrome (NES).
● EDNOS is not limited to these five examples and can include individuals with
heterogeneous eating disorder presentations.
● The term is used to describe individuals who meet the full diagnostic criteria
but the reason remains unspecified or lacks adequate information for definitive
diagnosis.
EDNOS Complications
● Those with the disorder suffer the same symptoms as anyone else with an
eating disorder, the difference being that sufferers may not qualify for
insurance coverage due to their failure to meet the guidelines for eating
disorders.
● Like those who meet the guidelines, EDNOS sufferers are in danger of
serious medical conditions, such as osteoporosis, stunted growth, kidney
problems, ulcers and heart failure, and like other eating disorders it could lead
to death.
● EDNOS is as serious as other eating disorders and should not be trivialised or
underestimated.
Orthorexia
● Orthorexia nervosa is an eating disorder that involves an unhealthy obsession
with healthy eating.
● Unlike other eating disorders, orthorexia mainly revolves around food quality
and not quantity in particular.
● As opposed to anorexia or bulimia, people with orthorexia aren’t necessarily
as fixated on weight loss.
● Sufferers have an extreme fixation with the purity or immaculation of their
food as well as an obsession with the benefits of healthy eating.
● The medical community is beginning to recognise the disorder, though it
remains to be officially defined as an eating disorder.
Orthorexia Complications
● The compulsive behaviours cause self-imposed anxiety; where feelings of
shame, fear of disease, sense of impurity or negative physical sensations
trigger anxiety.
● Severe dietary restrictions escalate over time causing malnutrition, severe
weight loss, or other medical complications and health conditions.
● Disrupt the individual’s lifestyle; with personal distress or difficult social or
academic functions inhibited due to behaviours or beliefs related to healthy
eating.
● Emotional dependence and fixation on body image, self-worth, identity, or
satisfaction revolving around self-imposed dietary rules.
Other Related Eating Disorders
● Pica; where the individual eats non-food items.
● Rumination Syndrome; where the individual regurgitates undigested or partially
digested food items.
● Avoidant/restrictive food intake disorder (AFRID); where sufferers have a
reduced or selective food intake due to psychological reasons.
● Prader-Willi Syndrome; caused by a defect in the hypothalamus, individuals
have an insatiable appetite.
● Night Eating Syndrome; sufferers typically eat little during the day and binge
during the evening.
● Bigorexia; also known as muscle dysmorphia or reverse anorexia, where
individuals worry about being too small.