What is an Eating Disorder?
Unfortunately, eating disorders are very common. According to the National Eating Disorders Association (NEDA), 9% of the US population (30 million Americans) will have an eating disorder in their lifetime. In the State of Michigan, about 879,923 individuals are currently struggling with an eating disorder (Deloitte Access Economics, 2020). Teens and young adults are particularly susceptible as adolescence is a time of identity formation and self-comparison. The use of social media has not helped the matter. Early exposure to body-ideal content, such as the images consumed on popular social media sites, can contribute to unhealthy attitudes toward food and body image.
That said, eating disorders affect people of all ages, genders, races, and body types. There are several different types of eating disorders that can impact someone's daily functioning and quality of life. Listed below are the symptoms and what to look for based on the different types of eating disorders:
Anorexia Nervosa (AN) is what most people think of when they hear the term “eating disorder.” Symptoms of anorexia nervosa include:
Restriction, which could include counting calories, becoming hyper-fixted on the food they are consuming, and limiting their daily intake for the purpose of losing weight.
An intense fear of weight gain or becoming fat. One may engage in this by over-exercising, restriction, engaging in a binge/purge cycle, and/or compulsively weighing themselves.
Significant weight loss resulting in weight that is less than minimally normal.
Due to loss of weight, someone struggling with AN will often complain of being cold, may have blue hands/feet due to lack of blood circulation, and become less interested in participating in daily activities due to extreme fatigue. Atypical Anorexia Nervosa (ANN) occurs when someone engages in the behaviors associated with anorexia nervosa, but without the significant weight loss or if there is weight loss, the individual's weight is within or above the normal range. Those who experience atypical anorexia nervosa may be at even higher risk than someone with anorexia nervosa due to lack of intervention. A meta analysis found that atypical anorexia nervosa (AAN) occurs more frequently than anorexia nervosa in community samples, however fewer individuals with AAN are referred or admitted to special care for eating disorders.
Avoidant Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by significantly restricted food intake or avoidance of certain foods, leading to nutritional deficiencies, weight loss (or failure to gain weight in children), and/or reliance on nutritional supplements or tube feeding. Someone struggling with ARFID does not have a fear of weight gain or concerns related to body image. Alternatively, they may have anxiety about their eating disorder leading to weight loss. Symptoms of ARFID include:
Feeling full before meals or having no appetite
Difficulty paying attention
Limiting how much food is consumed, or lack of variety in food consumed
Being particularly sensitive to certain textures of food
Fear of what could happen after eating like vomiting, choking, or having some sort of adverse reaction.
Bumia Nervosa (BN) is another more common eating disorder. However, unlike anorexia nervosa, BN is looked down upon by culture due to the behaviors associated with BN. Whereas anorexia nervosa is more glorified in culture. While both BN and AN are life threatening disorders, those who struggle with BN tend to struggle with a lot more shame around their behaviors. Symptoms of bulimia nervosa include:
Living in fear of gaining weight and trying to lose weight in unhealthy ways, such as self-induced vomiting, compensatory or excessive exercise, the misuse of laxatives or diuretics, and/or fasting.
Repeatedly eating unusually large amounts of food in one sitting.
Feeling a loss of control during binge eating. You may feel like you can't stop eating or can't control what you eat.
Limiting calories or not eating certain foods between binges.
Using dietary supplements or herbal products for weight loss. These products can be dangerous.
Being very unhappy with your body shape and weight. Letting your body shape and weight guide how you feel about yourself and your worth.
Having extreme mood swings.
Orthorexia Nervosa (ON): Orthorexia nervosa is a newer term used to describe an eating disorder characterized by an excessive preoccupation with eating healthy food. Although this may not sound like an eating disorder to some, as there is a focus on “healthy eating,” someone with ON becomes so fixated on only eating what they term as “healthy”’ that they actually damage their own well-being and experience health consequences such as malnutrition and/or impairment of psychosocial functioning. Symptoms of ON include:
Compulsive checking of ingredient lists and nutritional labels
An increase in concern about the health of ingredients
Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
An inability to eat anything but a narrow group of foods that are deemed “healthy” or “pure”
Unusual interest in the health of what others are eating
A feeling of superiority around their nutrition and intolerance of other people’s food behaviors and beliefs
High levels of perfectionism
Spending hours per day thinking about what food might be served at upcoming events
Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
Obsessive following of food and ‘healthy lifestyle’ blogs on social media
Body image concerns may or may not be present
Psychosocial impairments in different areas of life
There are several other types of eating disorders, including binge eating, pica, rumination, and other specified eating disorders (OSFED). It is important to understand that not all eating disorders are the same and present differently, but eating disorders are the second leading cause of death among mental illness, second only to opioid use disorder.
Written by Hillary Levergood, MA, LPC. Hillary has experience working multiple levels of care in eating disorder treatment. Hillary is passionate about offering hope and healing to those who are struggling with an eating disorder, because Hillary knows firsthand that recovery is possible.