Mental Health 202: Eating Disorders
An overview of EDs
by Lindsey Turnbull
As part of mental health month, we wanted to look more closely at mental health conditions. We examined anxiety and depression, which often go hand in hand. As part of NEDA Week, we provide an overview of eating disorders, which are serious mental health conditions.
Our culture has complicated relationships with food, exercise, and appearance.
30 million Americans will struggle with a full-blown eating disorder and millions more will battle food and body image issues that have untold negative impacts on their lives.
But because of stigma and old stereotypes, many people don’t get the support they deserve. via National Eating Disorders
If TV and media are to be believed, people with eating disorders fit a specific pattern: a young, white, usually well-off, thin girl. While people with EDs may fit that description, the reality is that ANYONE can have an eating disorder, regardless of race, sex, gender identity, sexualty, income level, or ability.
You cannot tell by looking at someone if they have an eating disorder.
Simply put, an eating disorder as a serious condition related to eating that negatively impact your health, your emotions, and your ability to function in important areas of life. Eating disorders can seriously harm your body and can harm the heart, digestive system, teeth, bones, and they can even be fatal.
Eating disorders are most common in teen and young adult years, although they can happen at other points in life. With treatment- the earlier the better- someone with an eating disorder can return to a healthier life, and sometimes even reverse complications.
Let’s confront this myth right now: Eating disorders are NOT “diets gone wrong.” They are serious and “sometimes fatal illnesses [that] cause severe disturbances to a person’s eating behaviors…Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.” If you or someone you know is struggling with their relationship with food and/or exercise, please seek help- eating disorders are not a fad or a phase- they are serious, real, and devastating conditions that require professional help.
Eating disorders are serious, life-consuming, and possibly fatal illnesses that require professional treatment.
Among the many myths, one of the most common she hears is a person feeling that they don’t fully “fit” into one classification of an eating disorder; therefore, they don’t have one and don’t need help. This is far from the truth, according to Claire [Mysko, CEO of NEDA].
In fact, she says many people who are struggling will receive a diagnosis of Other Specified Feeding and Eating Disorders (OSFED). OSFED is an all-encompassing category of various disorders that don’t match the traditional criteria for the more common illnesses, such as anorexia nervosa, bulimia nervosa, and binge eating disorder. via TeenVogue
While scientists aren’t sure what causes eating disorders, they do know that is a combination of “genetic, biological, behavioral, psychological, and social factors.” You can learn more about each of these factors, in detail, from the NEA website. Sometimes, other illnesses can occur simultaneously with an eating disorder, including (but not limited to) PTSD, anxiety, obsessive compulsive disorder, and depression.
To give someone the best chance at recovery, treatment should be obtained as early as possible. For that reason, it’s important to be aware of eating disorder warning signs. According to a UK survey, many adults do not know the signs of an ED. By arming yourself with knowledge, you can help someone who is struggling! This list, provided by the NEDA, is not supposed to be a checklist- someone probably won’t have all the symptoms at once. But, if you notice several of these behaviors in yourself or a friend, it is worth considering seeking professional help.
If you’re unsure, take this free screening from the NEDA.
Emotional and behavioral
- In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns
- Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
- Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
- Appears uncomfortable eating around others
- Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
- Skipping meals or taking small portions of food at regular meals
- Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
- Withdrawal from usual friends and activities
- Frequent dieting
- Extreme concern with body size and shape
- Frequent checking in the mirror for perceived flaws in appearance
- Extreme mood swings
- Noticeable fluctuations in weight, both up and down
- Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
- Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
- Difficulties concentrating
- Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)
- Dizziness, especially upon standing
- Feeling cold all the time
- Sleep problems
- Cuts and calluses across the top of finger joints (a result of inducing vomiting)
- Dental problems, such as enamel erosion, cavities, and tooth sensitivity
- Dry skin and hair, and brittle nails
- Swelling around area of salivary glands
- Fine hair on body (lanugo)
- Cavities, or discoloration of teeth, from vomiting
- Muscle weakness
- Yellow skin (in context of eating large amounts of carrots)
- Cold, mottled hands and feet or swelling of feet
- Poor wound healing
- Impaired immune functioning
Most common EDs via NEDA:
Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.
Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities.
Although the disorder most frequently begins during adolescence, an increasing number of children and older adults are also being diagnosed with anorexia. You cannot tell if a person is struggling with anorexia by looking at them. A person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can also have anorexia, although they may be less likely to be diagnosed due to cultural prejudice against fat and obesity.
Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.
Bulimia can affect people of all ages, genders, sexual orientations, races, and ethnicities.
Other Specified Feeding and Eating Disorders (OSFED) was previously known as Eating Disorder Not Otherwise Specified (EDNOS) in past editions of the Diagnostic and Statistical Manual. Despite being considered a ‘catch-all’ classification that was sometimes denied insurance coverage for treatment as it was seen as less serious, OSFED/EDNOS is a serious, life-threatening, and treatable eating disorder. The category was developed to encompass those individuals who did not meet strict diagnostic criteria for anorexia nervosa or bulimia nervosa but still had a significant eating disorder. In community clinics, the majority of individuals were historically diagnosed with EDNOS.
This is not an exhaustive list of eating disorders. If you or someone you know is struggling with food, eating, and body image, please seek help.
There are many types of professional treatment, including in- and out-patient therapy. Getting a diagnosis is the first step towards recovery. Treatment for an ED usually includes psychological and nutrition counseling, and health monitoring. Treatment must address the ED, medical issues, and psychological/biological/cultural/other forces that contribute to the ED.
The road to recovery may be challenging, but it is WORTH IT. Everyone deserves to life a life free from Eating Disorders.
Does this sound like you or someone you know? Please seek professional help. The sooner an ED is diagnosed, the greater chance of recovery. Here’s a great video from NEDA about helping a friend:
Remember, if you’re bringing up an ED to a friend, it will be a difficult conversation. Try to listen without judgement and to let your friend know that you love and care about them.
Are you worried about your own relationship to food and eating? The NEDA has a short screening tool to help you determine if it’s time to get professional help.
Remember, recovery is always worth it!
Join the movement! Come as you are and sign the NEDA pledge!
The NEDA Helpline is available Monday through Thursday from 9:00 a.m. to 9:00 p.m. ET, and Fridays from 9:00 a.m. to 5:00 p.m. ET to answer any questions you may have, help you or a loved one find treatment, and offer support. February 26-March 4 is National Eating Disorder Awareness Week.
If you are in crisis, text “NEDA” to 741-741, any time, 24/7.
National Eating Disorder Official Website
Myths to Stop Believing This National Eating Disorder Week from Teen Vogue
Eating Disorders from Mayo Clinic
7 Important Facts About Eating Disorders from Mental Health America
Eating Disorders from National Institute of Mental Health