Eating disorders are serious mental health conditions that are can be life-threatening if left untreated. In fact, they have the highest mortality rate of any mental illness, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD). Getting help for an eating disorder is therefore critically important for anyone affected by the illness. It starts with knowing when to seek help, including the signs and symptoms to watch for…
The Early Signs of an Eating Disorder
An eating disorder is a condition that is marked by an unhealthy relationship with food. The National Institute of Mental Health outlines three main types of eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder.
Anorexia nervosa is a condition associated with weight loss due to excessive food restrictions and exercising, sometimes to the point of starvation. Generally speaking, those with this condition see themselves as overweight, even after extreme weight loss. According to statistics published by the NIMH, females are three times more likely than males to have this condition.
Common signs of anorexia include:
- Extreme food restrictions
- Intense fear of weight gain
- Unwillingness to maintain a healthy body weight
- A distorted body image; many with anorexia believe that they have more body fat than they actually do
Anorexia nervosa has the highest mortality rate of the three most common eating disorders. Many who live with this condition die as a result of complications associated with starvation, while others die of suicide.
Bulimia nervosa is a condition marked by cycles of extreme overeating, followed by behaviors to compensate for overeating, including forced vomiting, fasting, extreme exercising or using diuretics or laxatives. This condition may be more challenging to identify, as those living with it may be underweight, normal weight or overweight. Females are about five times more likely than males to have this disorder.
Common signs include:
- Acid reflux
- Dehydration resulting from excessive use of laxatives and/or diuretics
- A chronically sore throat
- Swollen salivary glands in the jaw and neck
- Electrolyte imbalance
The NIMH reports that about 1.2% of the U.S. population lives with binge-eating disorder, about two-thirds of whom are females, making it the most common eating disorder in the nation. It’s marked by a person’s inability to control their food intake, but unlike with bulimia, periods of binge-eating are not followed by purging. As a result, those with this condition are typically overweight or obese.
Common signs include:
- Eating an uncommonly large amount of food in a short period of time
- Eating past the point of fullness
- Eating alone or in secret
- Hoarding food in unusual places
- Feelings of guilt, shame or distress in association with eating
- Frequent dieting, with or without weight loss
Disordered Eating vs. Eating Disorder
Recognizing an eating disorder in oneself or someone else can be a challenge. After all, most people have experienced overeating and then making up for it later by skipping a meal or spending a few extra minutes on the treadmill. Restrictive fad diets that encourage followers to lose or maintain their weight by omitting entire food groups crop up on a seemingly annual basis, and it’s not uncommon to hear people casually mention “eating their feelings” as a means of coping with emotions they perceive as negative.
Habits like these may indicate disordered eating, and they are in contrast to non-disordered eating in which one eats only when they’re hungry, stops when they’re full and incorporates a variety of food in their diets.
However, there’s a difference between disordered eating and an eating disorder. According to the National Eating Disorders Association, identifying the difference between disordered eating and an eating disorder comes down to three factors: patterns of behavior, obsession and ability to function.
Someone with an eating disorder generally exhibits certain behavioral patterns on a regular basis. Binge-and-purge cycles, for example, are more likely daily occurrences rather than rare or occasional. Secondly, many people with eating disorders are mentally consumed by calories, where to buy food, when their next meal will come or what foods they should avoid, even to the point of it interfering with their everyday life. Finally, a person’s inability to function due to eating patterns may point to an eating disorder. For example, someone may avoid certain social situations, such as dining out with friends or colleagues, if they are afraid of being judged for what they do or don’t eat.
The Consequences of Ignoring the Signs of an Eating Disorder
The sooner an eating disorder is diagnosed, the greater the chances are for recovery. Left untreated, eating disorders can lead to serious health problems.
Without receiving treatment, those living with anorexia nervosa may eventually experience serious problems like anemia, organ failure and infertility. Those with bulimia nervosa are likely to experience cardiac complications, ulcers, edema, tooth decay, organ damage and peripheral neuropathy. While those living with binge-eating disorder are unlikely to have problems associated with malnutrition, their risks are just as significant and include high cholesterol, heart disease, Type II diabetes and high blood pressure.
Eating disorders are serious mental health disorders and generally don’t go away on their own. Without treatment, they can lead to poor quality of life, including a lifelong battle with the disorder and in extreme cases, early death.
Eating Disorders and Co-occurring Conditions
Eating disorders are rarely about the food; in most cases, eating disorders serve a purpose, providing the one living with the disorder with a way to cope with stressors or emotions. Many who have eating disorders have a co-occurring condition, such as substance abuse, anxiety, depression or post-traumatic stress disorder. Co-occurring mental disorders may precede an eating disorder, begin around the same time as the eating disorder or emerge after it’s already begun. This can present significant challenges when pursuing self-help for eating disorders.
According to a national survey, 56 percent of respondents with anorexia nervosa, 79 percent of respondents with binge-eating disorder and 95 percent of respondents with bulimia disorder met the criteria for at least one co-occurring disorder. There is an increased risk of depression among those with these eating disorders, as well as a markedly elevated risk for obsessive-compulsive disorder among those with anorexia nervosa and bulimia nervosa.
In order to experience recovery, one must learn healthier ways to cope with stress and negative feelings, and if necessary, receive treatment.
How to Get Diagnosed for Eating Disorders
Eating disorders are diagnosed based on eating habits, signs, and symptoms. If a doctor suspects their patient has an eating disorder, they may perform an exam or request tests to confirm the diagnosis. To be diagnosed, someone may see either their primary healthcare provider or a mental health professional.
Assessments and tests typically include a physical exam and/or lab tests to rule out other medical causes for an eating issue, and a psychological evaluation, including self-evaluation questionnaires and additional tests to check for complications arising from the disorder.
Addressing the Fears of Being Diagnosed
While eating disorders are associated with serious short- and long-term complications, for many, the idea of being diagnosed and receiving treatment is more intimidating than the disorder itself. Common fears related to being diagnosed include:
- Fear of gaining weight
- Fear of losing control
- Needing to buy bigger clothes
- Fear of losing an important part of their identity
- Losing the eating disorder as a coping mechanism
Many with eating disorders question whether they’re “sick enough” to receive treatment. They may compare themselves to others living with the disorder and determine that their condition isn’t as advanced, making it difficult for them to know when to seek help for eating disorders.
For those facing these fears and roadblocks, it’s important to recognize that they deserve to receive the help and support they need for a healthy life. A physician or mental health professional who specializes in treating eating disorders can help patients identify their personal roadblocks to recovery and address their fears.
A Better Life Is Possible
There isn’t a one-size-fits-all approach to recovering from an eating disorder, and treatment may be provided in a variety of forms and settings. It usually involves a combination of nutritional and psychological counseling, as well as treatment for co-occurring conditions. Factors generally addressed include:
- Life-threatening medical symptoms
- Unhealthy behaviors such as excessive exercising, binge eating, purging and restrictions
- Establishing normal eating patterns
- Challenging thoughts and behaviors that contribute to the disorder
- Addressing ongoing medical issues
- Creating an aftercare plan
Whether or not someone begins therapy or medication, help for eating disorders is available, and their life can be improved with intervention from a medical professional.