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Help With Eating Disorders

Curated and updated for the community by APA

Eating disorders are illnesses in which the people experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become pre-occupied with food and their body weight. Eating disorders affect several million people at any given time, most often women between the ages of 12 and 35. There are three main types of eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder.

People with anorexia nervosa and bulimia nervosa tend to be perfectionists with low self-esteem and are extremely critical of themselves and their bodies. They usually “feel fat” and see themselves as overweight, sometimes even despite life-threatening semi-starvation (or malnutrition). An intense fear of gaining weight and of being fat may become all-pervasive. In early stages of these disorders, patients often deny that they have a problem.

Read more on symptoms, & treatment

  • Oct 31, 2019
Body Dysmorphic Disorder and a Culture of Perfection

Body dysmorphic disorder is an obsessive-compulsive related disorder that has garnered some media attention recently. Contrary to the offhand way it sometimes referred to in the media, body dysmorphic disorder is a serious mental health condition with potentially severe consequences.  Individuals with body dysmorphic disorder are preoccupied with what they see as flaws in their physical appearance. They believe they look ugly or abnormal. These flaws are not noticeable to others or only seem to others as very minor.

  • Oct 02, 2019
Overtraining and Under Eating: Athletes at Risk of RED-S Syndrome

Regular exercise typically improves mood, promotes better sleep, and prevents health problems such as high blood pressure. However, if people exercise too much, as Katie Kirk did, they can experience a wide range of negative health effects. 

  • Feb 01, 2019
Eating Disorders, Weight-Shaming and “Clean” Eating

Eating disorders affect all kinds of people: women, men, young and old and from all racial and ethnic backgrounds. Many factors likely contribute to developing eating disorders, including a range of biological, psychological, and sociocultural factors. Having a close relative with an eating disorder or a history of dieting are risk factors. High levels of body image dissatisfaction and setting unrealistically high expectations for oneself (perfectionism) also increase the risk

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Are there some common warning signs of eating disorders?

There is no one sign of an eating disorder, however there are red flags. These can include excessive “fat, weight or calorie talk,” a pattern of eating a limited choice of low-calorie food or a pattern of occasional binge eating of calorie-dense foods. People with anorexia nervosa may excessively exercise or excessively stand, pace or fidget. Affected individuals may severely limit the amount of calories they consume or may avoid weight gain following meals by inducing vomiting or abusing laxative, diuretic and diet pills. Feeling self-conscious about one’s eating behavior is common. Affected individuals often avoid social eating settings and eat alone. More

What causes an eating disorder?

There is no single cause of an eating disorder. We know that genetics play a large role, but genetic vulnerability is only part of the story. Environment plays a role too, especially in triggering onset, which often occurs in adolescence. Pressure to diet or weight loss related to a medical condition can be the gateway to anorexia nervosa or bulimia. For those who are genetically vulnerable to anorexia nervosa, once they lose the first five to 10 lbs, dieting becomes increasingly compelling and rewarding. Looked at another way, if eating disorders were the result solely of social pressure for thinness we would expect eating disorder rates to have increased as obesity has in the past few decades, yet anorexia nervosa and bulimia remain relatively rare and often cluster in families. More

How can I best help and support someone who has been diagnosed with an eating disorder?

Treatment for an eating disorder is challenging. It involves interrupting behaviors that have become driven and compelling. Recovery takes a team, which includes family, friends and other social supports, as well as medical and mental health professionals. Be empathic, but clear. List signs or behaviors you have noticed and are concerned about. Help locate a treatment provider and offer to go with your friend or relative to an evaluation. Be prepared that the affected individual may be uncertain about seeking treatment. Treatment is effective, many are able to achieve full recovery and the vast majority will improve with expert care. Treatment assists affected individuals to change what they do. It helps them normalize their eating and reframe the irrational thoughts that sustain eating disordered behaviors. Food is central to many social activities and the practice of eating meals with supportive friends and family is an important step in recovery. More

We tend to hear about young women and eating disorders, but are there other groups of people that are more often affected by eating disorders?

Eating disorders do not discriminate and can affect anyone. Although they are most common in young women, it is not unusual for older women to have an eating disorder. Some have had one all their life, others were only mildly affected until some life event triggers clinical worsening – a stressor, physical illness or a co-occurring psychiatric illness, such as depression or anxiety. Recent evidence strongly suggests that anxiety disorders, especially social anxiety disorder, and obsessive compulsive personality traits increase individual vulnerability to an eating disorder. Eating disorders occur in men too. An estimated 10 percent of people with anorexia nervosa and bulimia and a third or more of people with binge eating disorder are male. More

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About the Expert:

Angela Guarda, M.D.
Associate Professor of Psychiatry and Behavioral Sciences
Director, Johns Hopkins Eating Disorders Program
The Johns Hopkins University

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Helena’s Story

Helena was a 16-year-old girl who lived at home with her parents and younger sister. Throughout her teenage years, she had been a normal weight but she worried a great deal about her body weight and shape. She often compared her body weight with that of other girls and women she met or saw — and then judged herself as too heavy.

Read More 

Editor's Choice

JUNE 25 2020

Among people facing food insecurity, researchers find a hidden health issue: eating disorders
Stat News

After finalizing the results of her first major study on the issue, conducted among clients of a food bank in San Antonio, the data were striking: In addition to seeing high levels of food restriction — the deliberate effort to reduce amount of food one eats — she and her colleagues reported high rates of binge eating and purging, such as self-induced vomiting or laxative misuse. Those rates increased depending on people’s level of food insecurity, from 2.9% among people who were only mildly food insecure to 37.6% among people who had so little food even the children went hungry. 

JUNE 14 2020

Coronavirus: Living with eating disorders in lockdown

BBC

For people with eating disorders, the increased time spent with family, lack of gym facilities and an upset to routine can intensify issues. "Eating disorders thrive in secrecy so when you're left alone with your own thoughts and no other distractions, they can take over, which is what I feel happened to me," said the 24-year-old from Belfast..

JUNE 3 2020

UNC Researchers Study Effects of Eating Disorders During a Pandemic
Chapelboro.com

To understand how people with eating disorders were being impacted by the pandemic, Bulik and Peat surveyed people with eating disorders in the U.S. and the Netherlands. Survey results found that study participants in the U.S. with anorexia nervosa are reporting increased dietary restriction and fears about being able to find foods consistent with their meal plan. People with bulimia or binge-eating disorder reported increases in binge-eating episodes and urges to binge. Additionally, Bulik said three things stood out when it came to what was currently concerning people with eating disorders the most: lack of structure, living in a triggering environment and lack of social support..

Resources

Additional Resources and Organizations

National Eating Disorders Association

Mental Health America

National Alliance on Mental Illness

National Institute on Mental Health

Screening for Mental Health, Inc.

Overeaters Anonymous

Physician Reviewed

Ranna Parekh, M.D., M.P.H.
 January 2017