Eating disorders are extreme disturbances in an individual's behavior and feelings related to food, weight, and body image. They are most likely to develop in young women, during adolescence and young adulthood. But children, preteens, adult women, and men also may develop these problems. They are serious problems with life-threatening consequences.
Anorexia Nervosa is characterized by excessive weight loss through self-starvation and sometimes through purging. Purging includes vomiting, using laxatives, and exercising excessively. Symptoms include:
- Refusal to maintain a normal weight
- Intense fear of weight gain
- Obsessive preoccupation with weight and shape
- Loss of menstrual periods
- Distorted body image
Bulimia Nervosa is characterized by cycles of binge eating followed by purging, usually done in secret. The individual's weight may range from below to above average, so it may be harder to detect. Symptoms include:
- Repetitive cycles of bingeing and purging
- Feeling out of control of food intake
- Purging after bingeing via self-induced vomiting, laxatives, diet pills, diuretics, excessive exercise, or starvation
- Obsessive preoccupation with weight and shape
In addition, some people may have a mixture of anorexia and bulimic symptoms without qualifying for either diagnosis. They may engage in compulsive overeating or bingeing without purging. Preoccupied and significantly distressed about their eating habits, they may gradually gain weight to the point of obesity. Many people have both symptoms of anorexia and bulimia. Men are most likely to lose weight or to purge by excessively exercising.
Eating Disorders "Eat Up" Relationships
Eating disorders are consuming. They consume the individual in obsessive, negative thinking and behaviors, and they consume the individual's relationships with family members, loved ones, and life. This is partially due to the effects of starvation. When people are not adequately nourished, they think about food constantly, sometimes even dreaming about it. They also become depressed, isolated, and tired. They avoid relationships because they often feel others pressure them to eat. They are physically depleted, and feel compelled to engage in eating disordered behaviors.
Loved ones find eating disorders extremely difficult to understand and accept. Seeing someone you love starve or damage her or his body is stressful. Often, parents, spouses, and others begin to become intrusive in their efforts to get the person to eat or to stop purging. Soon, the individual may see these loved ones as enemies trying to control her or him rather than help.
Eating disorders may develop if a person has no other way to speak or represent feelings. Frequently family dynamics, problematic communication patterns, losses, or stresses like abuse have contributed to negative feelings the person could not deal with directly. It is never a simple matter that can be solved by just telling the person to eat. The symptoms have become the individual's way to avoid facing problems more directly or are an attempt to feel in control when the rest of life feels out of control.
Defining characteristics of Anorexia Nervosa:Individuals with anorexia nervosa are unwilling or unable to maintain a body weight that is normal or expectable for their age and height (most clinicians use 85% of normal weight as a guide). Individuals with anorexia nervosa typically display a pronounced fear of weight gain and a dread of becoming fat although they are dramatically underweight. Concerns and perceptions about their weight have a extremely powerful influence and impact on their self-evaluation. The seriousness of the weight loss and its physical effects is minimized or denied (women with the diagnosis of anorexia nervosa have missed at least three consecutive menstrual cycles).
Diagnostic criteria of anorexia nervosa include two subtypes of the disorder that describe two distinct behavioral patterns. Individuals with the Restricting Type maintain their low body weight purely by restricting food intake and increased activity (i.e. compulsive exercise). Those with the Binge-Eating/Purging Type usually restrict their food intake but also regularly engage in binge eating and/or purging behaviors (i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas). Binge-Eating/Purging Type of Anorexia Nervosa is also frequently associated with other impulse control problems and mood disorders.
People who suffer from anorexia often have low self-esteem and a tremendous need to control their surroundings and emotions. The eating disorder is often a reaction to external and internal conflicts (i.e. anxiety, stress, and unhappiness can be leading factors).
Profile: Anorexia Nervosa
The person suffering Anorexia is generally extremely sensitive about being fat, or has an intense fear of becoming fat, and of losing control over the amount of food he/she eats. This hyper-sensitivity is accompanied by the desire to control his/her emotions and reactions to these emotions. Low self-esteem and the constant need for acceptance leads to obsessive dieting and starvation as a way to control not only weight, but also feelings and actions regarding their emotions. Many anorexics feel they are not deserving of life's gifts and pleasures. They often deprive themselves of situations that offer pleasure. Starvation or restriction, obsessive exercise, calorie counting, a constant obsession with food and health issues, self-induced vomiting, the use of excessive amounts of laxative, diuretics, and/or diet pills, and a persistent concern with body image can all be some of the physical indications that someone suffers from Anorexia Nervosa. People suffering with Anorexia may also go through periods of Bulimia (binging and purging) as well.
There are numerous ways a person with Anorexia can exhibit their disorder. The anorexic attempts to maintain strict control over food/caloric intake. Periods of starvation, obsessive counting of calories, compulsive exercising, and/or purging after meals are among the most common symptoms. In some cases, an anorexic will seem to eat normal meals with only periods of restriction. They use diet pills to control their appetite, or laxatives to attempt to rid their body of food, both of which are dangerous and useless in producing weight loss results. Anorexics will deny hunger, make excuses to avoid eating, will often hide food they claim to have eaten, or attempt to purge the food away with self-induced vomiting, or by taking laxatives.
Diagnostic Criteria: Anorexia Nervosa
The following definition of Anorexia Nervosa is used to assist mental health professionals in making a clinical diagnosis. The clinical criteria is not always representative of what one living with anorexia feels. Please note, you can still suffer from Anorexia even if one of the below signs is not present. One can not simply read the criteria and think "I don't have one of the symptoms, so I am not Anorexic" or "I don't have a problem with food."
1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. 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 denial of the seriousness of the current low body weight.
4. In postmenarcheal females (the absence of at least three consecutive menstrual cycles.
during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
Binge-Eating Type or Purging Type:
during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
Definition/Review of Anorexia Nervosa:
Anorexia Nervosa is an eating disorder effected by a complex mixture of social, psychological and physical problems.
A. An intense drive for thinness
B. An intense fear of gaining weight or becoming fat
C. A disturbance in body image
D. In women- a cessation of the menstrual cycle for at least three months
E. In men- a decreased sexual drive
Facts About Anorexia Nervosa:
A. There are two types of Anorexia Nervosa:
1. Restrictive type
2. Binge eating/purging type.
B. 90-95% of individuals with Anorexia Nervosa are female.
C. It affects about 1 in 2400 adolescents.
D. It typically develops in early to mid-adolescents.
E. Psychological problems are displaced onto food.
F. It is usually preceded by dieting behavior.
G. Unusual food behaviors are practiced.
H. Need to vicariously enjoy food by cooking it, serving it, or being around it is common.
I. Preoccupation with body weight and image.
J. Dieting becomes increasingly important.
K. Denial of the condition can be extreme.
L. Body image disturbance (misperception of body size and shape) is common.
M. Pronounced emotional changes are common.
N. One-third of anorexics subsequently develop Bulimia Nervosa.
Common purging behaviors include:
A. Self-induced vomiting
B. Diuretic abuse
C. Laxative abuse
D. Emetic abuse
E. Excessive exercise
Both Anorexia and Bulimia
Eating disorders are very complex emotional issues. Though they may seem to be nothing but a dangerously obsessive dietary concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.
Copyright © 2006 - 2021 Eating Disorder Therapy by Barbara J. Rossen, ACSW, LMFT. All Rights Reserved.