So, with so many grey areas pertaining to body type and symptoms, how do you know if someone is truly in the throes of an eating disorder?
Anorexia Nervosa
Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior. Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or misusing laxatives, diuretics or enemas.
Many people with anorexia see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions. A person with anorexia typically weighs herself or himself repeatedly, portions food carefully, and eats only very small quantities of only certain foods. Some who have anorexia recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic form of anorexia, in which their health deteriorates over many years as they battle the illness.
Ten Warning Signs
• Deliberate self-starvation with weight loss
• Intense, persistent fear of gaining weight
• Refusal to eat or highly restrictive eating
• Continuous dieting
• Excessive facial/body hair because of inadequate protein in the diet
• Compulsive exercise
• Abnormal weight loss
• Sensitivity to cold
• Absent or irregular menstruation
• Hair loss
• Intense, persistent fear of gaining weight
• Refusal to eat or highly restrictive eating
• Continuous dieting
• Excessive facial/body hair because of inadequate protein in the diet
• Compulsive exercise
• Abnormal weight loss
• Sensitivity to cold
• Absent or irregular menstruation
• Hair loss
Anorexia Nervosa Symptoms Explained
1. Weight
15% below ideal body weight. Refusing to maintain a normal weight or above-normal weight for height and age. Not everyone who is of a low weight is anorexic; it is important to recognize that it is the REFUSAL to maintain a normal weight that is the key factor.
It is sometimes difficult to identify anorexia in children because their height appears to be in proportion to their weight. A possible complication of an eating disorder is stunted growth in children. A pediatrician will need to carefully monitor him/her with a growth chart. Also, young children may not talk about weight but rather may describe physical complaints such as nausea or feelings of fullness.
2. Intense Fear of Gaining Weight or Becoming Fat, Even if Underweight
This intense fear is powerful enough to cause individuals to diet to the point of starvation. While the term anorexia means loss of appetite, this is not true of anorexia nervosa. A person with anorexia is hungry but he or she is afraid to eat because of the fear. Often specific foods are avoided, especially those that are high in fat and calories. Often individuals will become vegetarians and want to eat healthily when indeed the issue is the fear of gaining weight.
A person with anorexia constantly thinks about food – how many calories, how many fat grams, how much exercise is needed if you eat a cookie? How many times do you check the scale?
There is always the attempt to try to control eating because of the fear of gaining weight. Often meals are avoided or eaten very slowly, pondering each bite, fearing that eating will surely make one fat.
These thoughts begin to control a person’s mind 24 hours a day, 7 days a week. A person’s entire life can be centered on this one issue, depriving that person of joy in friends, fun and family.
3. Body Image Problems
When a person with anorexia looks into a mirror he/she does not often see an accurate reflection. A person with anorexia sees him/herself as fat, even if he/she is dangerously thin. This is a very frightening experience and feels very real – driving the person to diet.
Sometimes a person with anorexia can accept that he/she is very thin but cannot accept how dangerous the situation really is. It is difficult for him/her to understand that a very low weight and dangerous dieting habits can actually be fatal. The death rate for anorexia is higher than for any other psychiatric illness.
4. Amenorrhea or Absence of Menstruation
Missing 3 periods is usually the criteria for this state. Of course, these criteria are not applied to males, young females who have not started their periods, or females who are on birth-control pills.
Types of Anorexia
Many individuals with anorexia will severely restrict their calories sometimes taking in only a few hundred calories a day or just water. This is called the RESTRICTING TYPE. Our bodies do not like to starve. Remember, the individual with anorexia has an appetite; he/she just tries to control it. It is very difficult when a person is starving not to want to eat. What happens to many individuals is that they lose control, they eat, or eat something they feel they should not have eaten. For these individuals, this might mean something as simple as a cookie, a normal meal or even a binge. With the fear of gaining weight, they may vomit or exercise. This type of anorexia is called the BINGE-EATING/PURGING TYPE, one of the most dangerous forms of an eating disorder.
Bulimia Nervosa
Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise.
Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week. Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.
Seven symptoms of Bulimia Nervosa:
Preoccupation with food
Binge eating, usually in secret
Vomiting after bingeing
Abuse of laxatives, diuretics, diet pills
Denial of hunger or drugs to induce vomiting
Compulsive exercise
Swollen salivary glands
Broken blood vessels in the eyes
Binge eating, usually in secret
Vomiting after bingeing
Abuse of laxatives, diuretics, diet pills
Denial of hunger or drugs to induce vomiting
Compulsive exercise
Swollen salivary glands
Broken blood vessels in the eyes
Bulimia Nervosa symptoms explained
1. Binge Eating
All of us will overeat now and then; doing so is pretty normal behavior. For instance at Thanksgiving, we all sit down at the dinner table and probably overindulge. Binge eating in bulimia has certain characteristics that make it much different.
A binge is defined by several characteristics, including consuming a larger amount of food than most people would eat during the same time period (potentially thousands of calories) within a short period of time (typically 2 hours or less). It is also characterized by a feeling that one CANNOT STOP or CONTROL one’s eating, accompanied by physical or emotional distress.
2. Purging
Following a binge, an individual may feel consumed with fear, guilt or shame and the need to try to undo his/her behavior. Purging is a way to compensate for binging. Purge behaviors come in many forms: vomiting, taking laxatives or water pills, starving or excessive exercise.
It is important to recognize that purging rarely works well for weight loss. Laxatives and diuretics make a person lose water not weight. Even vomiting seems to be ineffective; it has been reported that 50-75% of the calories have already been absorbed.
3. Bingeing and Purging occurs more than 2 x a week for at least 3 months
4.Body Image: Self evaluation and self esteem is overly influenced by weight and shape
Many people in our culture are concerned with how they look, what they weigh or how to change the body parts they don’t like. In bulimia, there is an intense connection between self respect and the way the body looks. We can be great in a lot of things, but if our thighs are too big, well then, we are just not good enough.
What about weight in bulimia nervosa?
Weight can be normal, underweight or overweight. Unlike anorexics who can be often identified by their low weight, it is more difficult to identify bulimics. Weight can also dramatically shift, and large swings might be an indicator that someone is developing an eating disorder.
Weight can be normal, underweight or overweight. Unlike anorexics who can be often identified by their low weight, it is more difficult to identify bulimics. Weight can also dramatically shift, and large swings might be an indicator that someone is developing an eating disorder.
Binge Eating Disorder
Binge-eating disorder is characterized by recurrent binge-eating episodes during which a person feels a loss of control over his or her eating. Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating.
In 1997, binge eating disorder (BED) was included into the DSM-IV as a provisional diagnostic category requiring further study. About 30% of the participants in weight loss programs meet criteria for BED. The prevalence of BED in the general population is 2%; BED is 1.5 times more common in women than men. In treating obese patients with BED there are several potential goals of treatment, including cessation of binge eating and improvement of eating-related psychopathology (e.g. concerns about weight and shape, restraint eating), weight loss or prevention of further weight gain, improvement of physical health, and reduction of psychiatric comorbidity. Contrary to expectations, weight loss programs do not appear to worsen the eating disorder, and successful treatment of binge eating does not automatically promote weight loss. Controlled treatment studies have shown that psychotherapeutic approaches and drug treatment may successfully reduce binge eating episodes in patients with BED. Remission rates are generally high (e.g. 50% and more following cognitive behavioral therapy), and the overall prognosis is better than for patients with bulimia nervosa
*All information above is obtained through the National Association for Anorexia Nervosa and Associated Disorders.
