Eating Disorders

Eating Disorders: An Overview

Eating Disorders Overview

Understanding and treatment make restored health possible

About 30 million Americans suffer from eating disorders, and the number is on the rise. Because many people make every effort to hide their illness, many more may be struggling. Sadly, eating disorders carry one of the highest mortality rates of all mental health disorders. Yet few receive adequate treatment: Only 1 in 10 receives any treatment at all, and only 35 percent of those who receive treatment are managed in a specialized facility.

Eating disorders occur across all ages, genders, and ethnic backgrounds. Young women and adolescent girls are the most commonly affected. Eating disorders are characterized by consistently under- or overeating to the point at which physical health and/or psychosocial functioning are compromised. Untreated, eating disorders are usually progressive and worsen over time.

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Causes of eating disorders

According to the National Institute of Mental Health (NIMH), eating disorders are caused by “a complex interaction of genetic, biological, behavioral, psychological and social factors.” It is difficult to ascertain the role of each contributing factor, but successful treatment only requires an understanding of symptoms and underlying mental health issues.

Symptoms of eating disorders

The following are descriptions of the most common eating disorders, according to the American Psychiatric Association’s 2012 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):

  • Anorexia nervosa

Anorexia nervosa is self-starvation, or the “restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.” There is an “intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.” Severity of illness is based on body mass index.

Body image distortion is characteristic and defined as a “disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.” In other words, people with anorexia view themselves as fat.

Other symptoms of anorexia include:

  1. Elaborate food preparation and eating rituals
  2. Excessive exercise
  3. ­Amenorrhea (absence of menstruation)
  4. Cold intolerance
  5. Constipation, bloating
  6. Fatigue, weakness
  7. Cognitive impairment
  8. Hair loss or thinning
  9. Growth of lanugo (soft, fine newborn-like hair) on extremities, face and trunk
  • Bulimia nervosa

Bulimia nervosa includes both eating large amounts of food within a two-hour period and feeling out of control while doing so. Bulimia is characterized by “recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. The binge eating and compensatory behaviors both occur, on average, at least once a week for 3 months.” Severity is graded by number of episodes per week. Like with anorexia, bulimia is influenced by distorted body image.

Other symptoms of bulimia include:

  1. Sore throat
  2. Tooth sensitivity
  3. Eroded tooth enamel
  4. Gum disease
  5. Calluses, abrasions, bruising on hand and thumb
  6. Swollen but nontender parotid glands (large salivary glands in front of the ears)
  7. Abdominal tenderness
  8. Ankle swelling
  • Binge-eating disorder

Binge-eating disorder is characterized by “recurrent episodes of binge eating a large amount of food within a 2-hour period.” Those with binge-eating disorder feel a loss of self-control over what they consume. During a binge episode, they find themselves “eating very rapidly, eating until uncomfortably full, eating when not physically hungry, and eating alone due to embarrassment over the large quantity being eaten, and feeling disgusted, depressed, or very guilty afterward. Marked distress is present. The binge eating occurs at least once a week for 3 months.” Severity is graded according to the number of binges per week.

Other symptoms of binge-eating disorder include:

  1. Weight gain or fluctuations in weight
  2. Depression
  3. Anxiety
  4. Compulsive self-harm behaviors may or may not be present, such as hair-pulling or skin-picking

Pica is the consumption of nonnutritive, nonfood substances for at least a month. Rumination disorder can occur at any age and is marked by persistent regurgitation of food for at least a month in the absence of any gastrointestinal disorder. Avoidant/restrictive food intake disorder can occur at any age and is the avoidance or restriction of food consumption to the point at which nutritional needs are not met, but symptoms do not meet full criteria for anorexia nervosa. Unspecified feeding or eating disorder occurs when symptoms of an eating disorder are present resulting in impaired functioning, but do not meet full criteria for any specific diagnostic class. Night-eating disorder is characterized by excessive eating after the evening meal or waking up during the night to eat. There is a sense of loss of control, guilt, and self-loathing associated with night-eating disorder.

Consequences from eating disorders

Consequences resulting from eating disorders depend on the type, severity and duration of the disorder, as well as etiological factors. Consequences occur not only for the person with the disorder, but for all of the people in his or her life. A few possible consequences include:

  1. Infertility
  2. Tooth and gum disease
  3. Gastrointestinal disorders
  4. Neurological damage
  5. Multisystem organ failure
  6. Type 2 diabetes mellitus
  7. Impaired functioning in family, school, work and social roles
  8. Damaged relationships with family and friends
  9. Death from heart failure, organ failure, malnutrition, suicide

Co-occurring disorders

Eating disorders rarely occur in the absence of other emotional disturbances or mental illnesses. The most common underlying or co-occurring disorders are as follows:

  1. Depression
  2. Anxiety
  3. Post-traumatic stress disorder
  4. Substance use disorder
  5. Underlying mental illness

Treatment

Eating disorders are serious, life-threatening illnesses that tend to get worse over time without intervention. Eating disorders usually occur along with other mental health disorders that also must be addressed to promote successful outcomes. Fortunately, eating disorders are manageable and health can be restored.

About us

Sovereign Health of California offers state-of-the-art treatment to those suffering from eating disorders in a peaceful, therapeutic environment. Individualized plans define our program, which also treats co-occurring illnesses, such as depression, anxiety, and substance use disorders. Our treatment team understands how those with eating disorders suffer, and works together with patients and their families to find a solution.

Our holistic approach to treating eating disorders includes evidence-based treatments such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), as well as nutritional education, mindfulness and yoga, body image therapy, stress management, relapse prevention, lifestyle management, empowerment skills and supervised experiential outings. Sovereign Health of California provides a holistic array of behavioral health treatment services at both our San Clemente and Rancho San Diego facilities for women and adolescent girls from the ages of 12 to 17 years who have eating disorders. For more information about eating disorders or about our programs for eating disorders, please call our 24/7 helpline.