Eating disorders are behavioral problems marked by extreme and prolonged changes in eating habits, as well as distressing feelings and emotions. They can be life-threatening in that they can impair physical, neurological and social functioning. Anorexia nervosa and bulimia nervosa are the major types of eating disorders. Eating disorders have onsets during adolescence and young adulthood. Anorexia nervosa and bulimia nervosa are more prevalent in women, but they can affect anyone at any age.
Eating disorders are often linked to food, weight, and people with eating disorders tend to form obsessions and paranoia over eating or the effects of eating certain foods. Restrictive consumption, binge-eating, purging of food by inducive vomiting or laxatives, and compulsive exercise, are all behaviours associated with eating disorders. Excessive incorporation of these behaviors can become addictions.
Are Eating disorders considered a mental health issue?
Since the 1980s eating disorders have been recognised by the Diagnostic and Statistic Manual (DSM). The most recent edition (DSM V), describes eight different types of eating disorders. Eating disorders are multifaceted mental health issues that are both psychological and medical in nature. As a result, they often necessitate therapies and treatments that target both the body and mind.
Eating disorders co-exist with other psychological disorders, the most common of which are mood and anxiety disorders, OCD, and struggles with alcohol and drugs. Evidence shows that genes and heritability play a role in whether certain individuals are more likely to have an eating disorder, but eating disorders can affect anyone including those with no family history of such disorders.
Many of the habits associated with any eating disorder can be harmful to one’s physical and mental health. As a result, someone suffering from an eating disorder should seek treatment from professionals, including psychiatrist, dietitian, doctor, etc. Eating disorders are psychological disorders that necessitate specialist treatment by a team of experts. They will assist you in the healing process by using a blend of treatments that focus on mental health improvement and physical health stabilisation.
Incidence of eating disorders
Between 2000 and 2018, the global prevalence of eating disorders rose from 3.8% to to 7.8% (The American Journal of Clinical Nutrition). Eating disorders affect approximately 70 million people worldwide (NEDA). In Asia, eating disorders are most common in Japan, followed by Hong Kong, Singapore, Taiwan and South Korea (International Journal of Eating Disorders). Furthermore, 13% of women over the age of 50 have eating disorders. For binge-eating disorder, the average age of onset is 21 years, while anorexia and bulimia is seen in as early as 18 years. The 17-18 years age demographic has the greatest incidence of eating disorders among adolescents.
Although the overall incidence rate has remained constant over the past decades, the high-risk population of 15-19 year old girls has increased. Anorexia, bulimia, and binge eating disorders are diagnosed in more than 5% of girls. When non-specific eating disorder signs were included, more than 13% of the girls had undergone an eating disorder. An eating disorder claims the lives of approximately one person every hour according to the Eating Disorders Coalition (EDC). Eating disorders have the highest death rate out of all mental disorders.
Symptoms of Eating Disorders
An individual suffering from an eating disorder is unlikely to exhibit all the signs and symptoms simultaneously, however, the following signs provide a general understanding of the habits that could signify an eating disorder.
- Weight loss, dieting
- Preoccupation with food, weight, calories, etc.
- Controlling food consumption or restricting eating certain foods.
- Apprehensive about eating in public.
- Skipping meals or eating small portions.
- Withdrawal from social circles.
- Excessive concern about body image, and frequently inspecting one’s reflection in the mirror.
- Stomach cramps and other stomach problems.
- Menstrual anomalies, like missing periods.
- Concentration disturbance.
- Maintaining a strenuous workout routine.
- Evidence of binge-eating, such as huge quantities of food disappearing in a brief span of time.
- Evidence of purging, such as the use of laxatives, or induced vomiting.
Types of Eating Disorders
Self-starvation and weight loss characterize anorexia nervosa, resulting in a low weight for a person’s height and age. Anorexia has the highest death rate of any psychiatric illness and can be a life-threatening illness. An overwhelming fear of gaining weight or being overweight drives the dieting behaviour in anorexics. Symptoms are:
- Strict dieting, such as obsessively counting calories in food or avoiding certain foods.
- Hiding food, lying about eating, avoiding eating in front of people.
- Excessive exercise
- Social withdrawal
- Feeling sluggish, muscles are not as strong as they used to be.
- Inability to concentrate.
- Feeling dizzy.
- Bloating, constipation, and abdominal pain
- Trouble sleeping
- Irregular periods.
Uncontrollable eating, binge-eating are the characteristics of bulimia nervosa. Binge-eating is described as consuming large amounts of food in a short period of time while feeling out of control of what and how much food one consumes. Binge eating is hidden and is accompanied by feelings of guilt or humiliation. They are usually followed by “compensatory habits” in order to avoid weight gain. Fasting, vomiting, and the use of laxatives are examples of these habits. Symptoms are:
- Eating large amounts of food.
- Feeling guilty or embarrassed after binging.
- Having a lot of food-related thoughts.
- Distorted body-image
- Prone to mood swings
- Disappearing shortly after eating
- Hand is covered with calluses.
People with binge-eating disorder have periods of binge eating in which they eat a huge amount of food in a short span of time, feel out of control , and are upset by their binge eating. However, unlike bulimia nervosa, they do engage in compensatory behaviors like vomiting, exercising or use of laxatives. Binge eating is a chronic condition that can lead to severe health problems like obesity, diabetes, hypertension, and heart disease.
Otherwise Specified Feeding or Eating Disorder (OSFED)
This includes eating disorders or eating behaviour disturbances that cause anxiety and affect family, social, or work functioning but does not fall into either of the other groups of eating disorder. An individual may experience a mixture of symptoms from a variety of eating disorders.
This is a newly identified eating disorder characterized by a disruption of eating that leads to a chronic inability to fulfill dietary needs and excessive pickiness of food.
Pica is an eating disorder in which a person consumes foods that are not food items with no nutritional value, on a regular basis. If the behaviour persists for at least a month, then it may be severe enough to require medical attention. Paper, paint chips, soap, thread, chalk, metal, pebbles, charcoal, clay are some of the common substances consumed.
Rumination disorder is characterized by the voluntary regurgitation and re-chewing of food after eating, in which ingested food is willingly brought back into the mouth and re-chewed, re-swallowed, or spat out. Rumination disorder can develop at any age, including infancy, childhood, adolescence and adulthood.
Receiving an eating disorder diagnosis is the first step towards treatment. Eating disorders are usually treated with a combination of psychological and dietary therapy, as well as medical and surgical supervision. Nutritional therapy is very important as it provides nutritional education as well considering the preferences and choices of the patient. Eating disorders can be treated by a range of therapies that have been proven to be successful.
Sources:
- https://www.waldeneatingdisorders.com/blog/are-eating-disorders-mental-illnesses/
- https://www.rethink.org/advice-and-information/about-mental-illness/learn-more-about-conditions/eating-disorders/
- https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409365/
- https://www.singlecare.com/blog/news/eating-disorder-statistics/