What Are Eating Disorders?
Anorexia Nervosa, often shortened to anorexia, is characterized by infrequent or abnormal eating patterns and, in many cases, self-induced weight loss. Underlying psychological factors often include a fear of gaining weight, an exaggerated view of one’s physical appearance, and low self-esteem regarding body image. In the U.S., roughly one in every 200 women has anorexia; the lifetime prevalence rate for American men is .3%.
Anorexia carries the highest mortality rate among all psychological disorders; roughly 20% of individuals with anorexia die of complications stemming from the disorder. Suicide is responsible for roughly half of all anorexia-related fatalities; other common causes of death linked to the disease include starvation, substance abuse, and cancer.
Bulimia Nervosa, often called bulimia, is characterized by periods of binge eating followed by attempts to purge the excessive calories through self-induced vomiting and/or the abuse of laxatives, diuretics, fasting, and excessive exercise. Roughly 1.5% of women and 0.5% of men in the United States will have bulimia during their lifetime.
Roughly half of all people with anorexia will develop bulimic habits. If left untreated, long-term bulimia can lead to serious dehydration, heart problems, laxative dependence for bowel movements, depression, and irregular menstrual cycles.
Binge-Eating Disorder (or BED) is defined as excessive eating patterns accompanied by feelings of shame, guilt, and/or lack of control. Unlike anorexia or bulimia, BED does not include a purging component and consequently, many men and women with this disease are considered obese. Roughly 2.8% of American men and women will have BED during their lifetime; fewer than half will seek treatment. Long-term BED can lead to poor productivity at work, interpersonal problems, and feelings of isolation, as well as psychiatric disorders like depression, anxiety, and substance abuse. Additionally, medical complications linked to chronic obesity include heart disease, diabetes, joint problems, gastroesophageal reflux disease (GERD), and sleep disorders, including sleep apnea. BED is commonly linked with family history, and individuals are most likely to develop BED-related habits in their late teens or early 20s. BED carries a 5.2% mortality rate.
Orthorexia is a term that was coined in 1998 and means an obsession with proper or “healthful” eating. Orthorexia often begins with a genuine, healthy concern about maintaining a proper diet. Over time, orthorexics eventually become preoccupied or obsessed with food quality and quantity, adhering to a rigid set of standards when it comes to daily meals. Presently, orthorexia is not officially recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5); however, many doctors and mental health professionals today recognize orthorexia as a genuine eating problem that is on the rise.
Myths About Eating Disorders
-
Eating disorders are a choice. FALSE- they are complex medical and psychiatric illnesses that people don't choose.
-
Parents are the cause of their kids eating disorders. FALSE - Eating disorders develop differently for each person affected, and there is not a single set of rules that parents can follow to guarantee prevention of an eating disorder, however there are things everyone in the family/friend system can do to play a role in creating a recovery-promoting environment.
-
Everyone has an eating disorder these days. FALSE - Although our current culture is highly obsessed with food and weight, and disordered patterns of eating are very common, clinical eating disorders are less so.
-
Eating disorders aren't really that serious. FALSE - Eating disorders have the highest mortality rate of any psychiatric illness. Besides medical complications from binge eating, purging, starvation, and over-exercise, suicide is also common among individuals with eating disorders.
-
Eating disorders are a "girl thing." FALSE - Eating disorders can affect anyone, regardless of their gender or sex. Although eating disorders are more common in females, researchers and clinicians are becoming aware of a growing number of males and non-binary individuals who are seeking help for eating disorders.
How do I know if I have a problem?
Take some time to reflect on the following questions. You might choose to write out your answers in a journal.
- Do I weigh myself every day?
- Does the number on the scale affect my mood for the day?
- Do I check my reflection in the mirror constantly
- Do I skip at least one meal per day to save calories (and tell myself “there’s just no time to eat…”)
- Do I count calories, fat grams, carbs?
- Do I eliminate whole food groups?
- Do I exercise because I have to, not because I want to?
If you answer 'yes' to one or many of these, it might suggest that your relationship with food and your body is hurting. Professionals consider a behavior, belief, or thinking pattern a problem if it interferes with your day-to-day life and/or causes you significant mental, emotional, or physical distress. Even experiencing difficulties in one of these areas could have a huge impact on your life. So could making even one thing better.
If you think you might have a problem with food or body image, you can speak with a counselor to find out more about your concerns and what kind of services are right for you.
Do Guys Have Eating Disorders?
Yes! Approximately 10% of people with anorexia and bulimia patients are males.
Contributing factors include:
- Alcoholism
- History of obesity
- Teasing
- Physical abuse
- Anxiety disorders
- Perfectionism
- Feelings of anger and body image concerns can trigger binge eating in males.
NEDA (National Eating Disorders Association) on eating disorders in men:
Despite the stereotype that eating disorders only occur in women, about one in three people struggling with an eating disorder is male, and subclinical eating disordered behaviors (including binge eating, purging, laxative abuse, and fasting for weight loss) are nearly as common among men as they are among women.
In the United States alone, eating disorders will affect 10 million males at some point in their lives. But due in large part to cultural bias, they are much less likely to seek treatment for their eating disorder. The good news is that once a man finds help, they show similar responses to treatment as women. Several factors lead to men and boys being under- and undiagnosed for an eating disorder. Men can face a double stigma, for having a disorder characterized as feminine or gay and for seeking psychological help. Additionally, assessment tests with language geared to women and girls have led to misconceptions about the nature of disordered eating in men.
LGBTQ+ and Eating Disorders
LGBTQ+ people face unique challenges that may put them at greater risk of developing an eating disorder. Research shows that, beginning as early as 12, gay, lesbian, and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers.
Potential factors that may play a role in the development of an eating disorder may include:
- Fear of rejection or experience of rejection by friends, family, and co-workers.
- Internalized negative messages/beliefs about oneself due to sexual orientation, non-normative gender expressions, or transgender identity.
- Experiences of violence and post-traumatic stress disorder (PTSD), which research shows sharply increases vulnerability to an eating disorder.
- Discrimination due to one's sexual orientation and/or gender identity.
- Being a victim of bullying due to one's sexual orientation and/or gender identity.
- Discordance between one's biological sex and gender identity.
- Inability to meet body image ideals within some LGBTQ+ cultural contexts.