Eating Disorders (Anorexia, Bulimia, and Binge Eating)
Eating disorders are defined as "a pattern of aberrant food intake that
reduces someone's ability to maintain adequate nutrition." EDs are
some of the most dangerous mental health disorders. Both Anorexia
Nervosa and Bulimia Nervosa are both characterized by "overvalued
beliefs about weight" and "the maladaptive behaviors that follow.", but
are distinctly different disorders. To be diagnosed with anorexia
patients must weigh less than the average for their height and age (BMI
of less than 17.5). These patients are preoccupied with their weight,
believe that they are overweight, and are preoccupied with thoughts and
planning around losing weight. It is "a disorder of distorted
perception". Weight-loss strategies can include excessive exercise,
abuse of laxatives, vomiting, restricting intake of food and calories,
and avoiding eating altogether. These behaviors result in malnutrition
that can affect a person's organ function and lead to disorders
including heart arrhythmias and osteoporosis. Anorexia is similar to OCD
in that it involves obsessive thoughts (about weight) and compulsive
behaviors intended to ease those thoughts, which never happens.
Anorexia is ego syntonic, meaning that the person does not see it as a
problem or as something untrue, and is therefore more like OCPD
(Obsessive Compulsive Personality Disorder) than OCD, which is
ego-dystonic. Also similar to OCPD is the rigidity of the person's
behaviors, and the attachment to ideas such as "being overweight is
bad". Actual Anorexia is rare (less than 1 in 200 people) and affects
about 10 times more women than men. It is believed that social and
environmental factors are major risk factors. Anorexia has a death rate
of around 20%, making it the most deadly mental health disorder.
Bulimia Nervosa is characterized by episodes of binge eating (consuming a large amount of food in a short period of time) in which the person feels little self-control before binging, emotional numbness while binging, then shame and guilt afterwards. The immediate regret the person feels leads them to behaviors to offset the food they just ate including vomiting (purging) and abuse of laxatives. This can lead to complications such as dehydration, damage to the teeth and esophagus, kidney damage, ulcers, and more. Damage to the stomach and esophagus can be severe enough to cause ulcers and rupture of the esophagus (Boerhaave Syndrome). Diagnosis requires that episodes of binging/purging occur at least once a week for at least 3 months. The person with bulimia has low self-esteem, difficulty with relationships, and fear of being rejected and alone, and unlike anorexia they are usually at least average weight. More than half of patients diagnosed with bulimia also meet criteria for Borderline Personality Disorder(BPD). Bulimia can be seen as being a version of BPD that is centered on food and eating. Bulimia occurs in around 1% of the population and is about 10 times more prevalent in women than men.
Binge Eating Disorder is very similar to Bulimia but does not involve the purging/offsetting behaviors. This means that people with this disorder tend to be significantly overweight. It is about equally prevalent in men and women and is also often comorbid with BPD. The most recently recognized eating disorder is Avoidant/Restrictive Food Intake Disorder (ARFID), which involves avoiding eating and eating only a small number of foods, but does not involve fear of being overweight or gaining weight. Reasons for limiting food intake include fear of choking or some other bad experience from eating recurring, sensory discomfort, or low appetite. This disorder usually begins in childhood but can last into adulthood.
To The Parents Of Eating Disorder Sufferers, From An ED Survivor
SavingAmyCymru (Amy discusses what it's like to live with a severe chronic ED, including daily life, common and uncommon symptoms, and the struggle to get medical care. TW- Amy passed recently from the effects of her illness and lack of access to care. R.I.P. Amy and thank you for gracing this world.)
Of Herbs and Altars (YouTuber Dorian gives a lot of in-depth information and perspectives on eating disorders in story form)
