What is an eating disorder?

An eating disorder is a mental disorder that affects your relationship with food and with how you see yourself (the body image). Eating disorders affect a person's physical and emotional wellness and can be life-threatening.

The symptoms of eating disorders vary from one individual to another and differ depending on the specific type. You may count calories or limit how much and what kinds of foods you eat. You may also consume large amounts of food, eat non-food items, or throw up after eating. It makes you feel guilty or ashamed rather than satisfied with your eating.

Food is a necessity to survive. Everyone has a connection with food — your favorite things to eat (or avoid) are unique. It can be hard to notice an eating disorder because you may have gotten used to it. You might feel trapped in a cycle of unhealthy eating, but treatment is available to help you feel better when you are ready.

What are the types of eating disorders?

There are several other types of eating disorders, such as:

• Anorexia nervosa: Avoiding food and calorie consumption (self-starvation), fearing to gain weight and distorted self-image.
• Bulimia nervosa: Eating large amounts of food in a short period (binging) or believing that the food intake was large, followed by eliminating the food (purging) through vomiting, the use of laxatives, which are medications that help you poop, or by exercising excessively.
• Binge Eating Disorder: This means eating a large amount of food in a short time (binging) and then feeling shame, regret, guilt, or depression afterward.
• Pica: This involves compulsively eating non-food items, like chalk, dirt, or paint.
• Rumination Disorder: It occurs when undigested food comes back into a person's mouth after swallowing. The person then rechews, re-swallows, or spits out the food.
• Avoidant/Restrictive Food Intake Disorder (ARFID): This is when someone limits the amount or type of food they eat for reasons unrelated to body image or weight loss.

It is possible to have more than one type of eating disorder at the same time.

What are the symptoms of eating disorders?

These can vary by type but may include mood swings, fatigue, fainting or dizziness, thinning hair, or hair loss. Other signs can be unexplained weight changes, excessive weight loss, excessive sweating, or red flushes.

Behavioral signs of eating disorders can include restrictive eating or eating a lot of food in a short time.

• Avoiding food, especially certain types of food
• Compulsive vomiting after each meal or laxative misuse.
• Exercising compulsively after meals.
• Frequent use of the bathroom during meals.
• Avoiding one's friends or social activity.
• Hiding foodstuffs or throwing them away
• Food rituals include keeping food in the mouth beyond what is necessary and secretly eating.

It can be challenging to spot an eating disorder in someone you care about because it often looks like regular changes in diet or lifestyle aimed at improving health. You cannot tell just by looking at someone if they have this condition.

What does it feel like to have an eating disorder?

If you have an eating disorder, you might feel that:

• Food is the enemy, or it hurts you.
• You did wrong or shameful after consuming food
• You are not of your right weight or body scale
• You are "Failure" if you don't reach the correct weight/food requirement
• People do bad things to you
• People view you negatively
• Your food and how you eat this is the only thing within your life that you own.
• You do not spend time with other people for fear of being judged.

These feelings are not a choice. An eating disorder affects your health and makes it hard to make decisions, feel emotions, and interact with others as you usually would.

What causes eating disorders?

The exact cause is not known. However, research points to several possible factors, including:

• Genetics: Studies show that anorexia nervosa, bulimia nervosa, and binge eating disorder can run in families. You may inherit traits that make you more likely to develop an eating disorder.
• Brain biology: Chemicals in your brain, like dopamine and serotonin, affect how you feel pleasure and happiness. Research suggests these chemicals may be involved in the behaviors linked to eating disorders.
• Cultural and social ideals: Pressure to fit in can harm your mental health and change how you act to meet unrealistic goals set by others. In today's digital world, social media, TV, and movies can harm your self-esteem if you don't look like the people you admire.
• Underlying mental health conditions: You may use extreme measures about food when you feel as though other aspects of your life are hard to deal with. An obsession with food becomes an unhealthy approach to coping with painful emotions or feelings. As a result, some eating disorders occur among other mental health conditions.

Anyone at any age can develop an eating disorder, but they are most common in adolescents and teenagers. You may be more at risk if:

• You have a family history of eating disorders or other mental health issues.
• You have experienced trauma, such as physical, emotional, or sexual abuse.
• You have a mental illness such as obsessive-compulsive disorder, depression, or anxiety.
• Engage in activities in which body weight or size plays a part (such as gymnastics, wrestling or swimming).
• Undergo significant life transitions such as starting a new school or work, a divorce or a change of place.
• Have Type 1 diabetes. Research revealed that almost 25% of girls and women living with Type 1 diabetes developed an eating disorder.
• Be someone who is a perfectionist and strives for excellence.

What are the complications of eating disorders?

Eating disorders can seriously harm your physical health. If untreated, they may result in significant problems like:

• Heart problems, including arrhythmia and heart failure.
• Acid reflux (also called GERD).
• Stomach and intestinal issues.
• Low blood pressure.
• Organ failure and brain damage.
• Osteoporosis.
• Severe dehydration and constipation.
• Stopped menstrual cycles and infertility.
• Stroke.
• Damage to teeth.

Eating disorders can also affect your mental health. Your feelings about food and body image may increase the risk of suicide or thoughts of suicide.

How do we diagnose eating disorders?

A physical examination is the first step healthcare professionals will take to identify an eating disorder.

• Reviewing your symptoms.
• Obtaining information about your diet, exercise, and other activities.
• Asking for tests, such as blood or urine tests, to assess your health.

For a diagnosis, providers consult the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR), published by the American Psychiatric Association. This guide outlines the symptoms of each type of eating disorder. You don't need to have every symptom to be diagnosed. Even if you don't have a specific eating disorder listed in the DSM, you may still need help with food-related issues.

How are eating disorders treated?

The treatment for eating disorders depends on the type but often includes: 

• Psychotherapy: A mental health professional will find the best therapy for you. This may be in the form of individual, group and family therapy. Most people with eating disorders seek cognitive behavioral therapy.
• Medications: You may have other conditions, such as anxiety or depression, associated with an eating disorder. Medications like antidepressants, antipsychotics, and others may help these conditions.
• Nutrition counseling: A registered dietitian specialized in eating disorders can help enhance eating habits and create nutritious meal plans. This expert can also provide tips for grocery shopping, meal planning, and food preparation.

The best approach is often a combination of treatment options. Your care team will work together to create a comprehensive treatment plan that addresses the condition's physical, mental, and behavioral aspects.

Even if you do not have a diagnosed eating disorder, a medical expert can assist you in addressing and managing food-related issues or any other condition that affects your health.

What are the stages of care for eating disorders?

The different stages of care include:

• Outpatient therapy once a week.
• Intensive outpatient therapy several times in a week.
• Inpatient therapy in a hospital.

Your primary care provider will determine the appropriate level of treatment.

What is the treatment for eating disorders?

Counseling can be incredibly rewarding and challenging at times. You will meet with a mental health professional regularly to help you learn and change the thinking patterns that drive your behaviors and emotions.

It's hard to open up to a new person and be truthful. It's also really tough to accept help, especially when you feel that you are in control. Therapy may make you think and feel things you don't want to.

It's OK and encouraged to discuss these feelings with your provider. While undergoing treatment, know that your care team can help you whenever needed.

How to recover from Eating disorder?

The best part is that recovery is possible, and hope does exist. You will not get rid of an eating disorder overnight. Treatment doesn't happen overnight. That all depends on the level and how long you have had one. You can notice your symptoms improving within a few days of beginning a medication or talking to a professional. You can even feel worse before you feel better. This is all normal.

The best way to get back on track is to stick with the treatment plan set forth by your healthcare providers. Talk over any side effects or barriers that come along with that treatment. Be honest and upfront with them. Your providers can give you customized advice for returning to good health quicker.

Can eating disorders be prevented?

There is no known way to prevent eating disorders completely. If eating disorders or mental health issues are common in your family, being aware of this can help you and your healthcare team notice and treat them early. Early treatment can stop unhealthy behaviors before they become harder to change.

How can I reduce my risk of eating disorders?

You might lower your chances of an eating disorder by receiving treatment for other conditions of general health and psychiatric illness, such as depression, anxiety and obsessive-compulsive disorder, when initial signs or symptoms present.

As a parent or caregiver who can determine that eating disorders can run in families through common genetics, the following reduce risk among children:

• Serve as a good role model.
• Healthy eating does not refer to foods as "good" or "bad."
• Do not discuss "dieting" with children
• Do not make negative comments about bodies

What is the prognosis for eating disorders?

Treatment is available for all types of eating disorders. It is best to recognize an eating disorder early and start treatment immediately for a better prognosis. Recovery does take time, and you will require lifelong support.

Untreated eating disorders can be fatal. If you or a family member is experiencing symptoms of an eating disorder, consult a healthcare professional.

When should I see a doctor?

Call your doctor if:

• You feel that your relationship with food is upsetting you.
• You realize that your relationship with food is interfering with your daily life.
• You have chest pain, difficulty breathing, or palpitations.
• Get dizzy or fainted several times.
• Have a sore throat or acid reflux very badly.

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