Eating Disorders

Posted by Frank Gillespie MA

Anorexia, bulimia, Eating Disorder Not Specified, muscle dysmorphia and orthorexia are diagnostic names for sufferers of eating or body image disorders. However, many can also suffer from symptoms of these disorders which can also impair one’s self-esteem and well-being.

What is an eating disorder?

Both eating disorders and body image disorders involve a distorted perception of the one’s body image. The person, male or female, develops harmful habits (such as binge eating, self-induced vomiting, excessive exercising or refusal to eat etc.) to compensate for trying to achieve an ideal body. This is not without negative consequences and these people are never satisfied with themselves.

Facts about eating disorders

The number of cases in eating and body image disorders is constantly growing. According to eating disorder statistics, approximately 24 million people in the U.S. struggle with some kind of eating problem. Among U.S. females in their 10s and 20s, the prevalence of clinical and subclinical anorexia may be as high as 15%. More severe data is that a mere 10% of people with eating disorders receive treatment, and of those only 35% seek treatment from a facility that specializes in eating disorders. Untreated eating disorders raise the risk of mortality.

The more they lose weight or achieve the muscle texture they want, the worse they feel. Partly, it has to do with the fact that the need to lose weight or for better muscle tone is only symptomatic of the real underlying issue. People suffering from eating disorders and body image have low self-esteem. For example, an anorexic feels that restricting their food intake is what they can control when their life feels out of control. A bulimic may initially purge to control their weight. It eventually takes on a secondary function which alleviates bad feelings, but she/he can’t express them. These are just a few examples why an eating disorder can develop. It is complex and the reason why each individual develops and maintains these behaviors is unique to each individual and influenced by their external environment. This includes family, friends, and societal norms. Most individuals with eating disorders or body image distortions have a history of trauma, affective problems (e.g. anxiety and depression), and the desire to ‘fit in’.

What are the different types of eating disorders?

1. Anorexia nervosa

People suffering from anorexia nervosa are the most identifiable because of low body weight. They deny food in extreme ways to maintain their body weight at a very low level. They usually don`t consider fasting as a negative thing, in fact they are expressly proud of their diet. Therefore, the most difficult challenge in treating anorexia for professionals is to raise awareness of the issue, if the affected people make contact with them at all. There are two types of anorexia. The restrictive type and purging type. Although both consume insufficient calories, the restrictive type will ‘restrict’ their caloric intake and exercise excessively. The purging type will consume more, but compensate with vomiting, laxatives, or excessive exercise. In the United Sates, ipecac, usually found in first aid kits, has been known to be a way to induce vomiting amongst anorexics. However, this is life threatening as it remains in the heart and can cause coronary complications.

People with anorexia view themselves as fat; even in the final stages. They have a fear of gaining weight and every single bite is followed by a painful remorse. Anorexia has the highest mortality rate of any eating disorder.

What are the symptoms of anorexia?

As a consequence of serious weight loss the early symptoms of anorexia soon appear, as a result of nutrient deficiency. Symptoms include:

  • dry or yellowish skin
  • deterioration of teeth
  • hair loss
  • digestion problems (e.g. constipation)
  • fatigue
  • insomnia
  • tiny hairs on face, legs, arms, neck, and back to compensate for lack of fat (lanugo)
  • dizziness or fainting
  • dehydration

And in the final stage the symptoms continue with:

  • osteoporosis
  • impairments in the tissues and nervous system
  • absence of menstruation in women

How to help someone with anorexia?

If you think a loved one may have symptoms of anorexia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to go along.

It may be hard to notice signs of anorexia sometimes, because people often disguise their thinness, eating habits or physical problems. If you're concerned that a loved one may have anorexia, watch for these possible symptoms:

  • complaining about being fat
  • repeated weighing or measuring of themselves
  • covering up in layers of clothing to hide weight loss or because they are cold
  • making excuses for not eating or skipping meals
  • lying about how much food they have eaten
  • running to the bathroom after or during a meal
  • changes in eating habits such as
    • eating only a few or certain `healthy` foods (low fat, low calorie food)
    • adopting rigid meal or eating rituals
    • refusing to eat in public or with others

2. Bulimia nervosa

Bulimia nervosa was recognized about 20 years ago, but today is one of the most common eating disorders. Patients suffering from bulimia nervosa are hard to identify based on external characteristics. They are usually a ‘normal’ weight or 10 pounds thinner or heavier than their normal body weight. Bulimia and the so called Yo-yo effect go hand in hand in many cases.

People with bulimia eat a little and only a few times during the day, but they secretly consume large amounts of food, then they get rid of it with so called purging techniques (such as self-induced vomiting and laxatives). Binge eating is not in connection with feeling hungry, the periodical attacks usually have psychological causes. People with bulimia do not enjoy the flavor of their food, they eat big amounts as fast as possible for which they feel guilty later. At this time they turn to the above mentioned techniques. Those who suffer from bulimia have a distorted body image and very low self-esteem. Treatment of bulimia is usually easier because patients are generally aware of their problems and are also willing to change.

What are the symptoms of bulimia?

Symptoms of bulimia may include:

  • eating large amount of food until the point of discomfort or pain
  • forcing vomiting or using other techniques (e. g. laxatives, ipecac, dietary supplements or herbal products) to get rid of calories
  • excessive exercising to avoid gaining weight
  • fear of gaining weight
  • being preoccupied with own body shape and weight

How to help someone with bulimia?

If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to go along.

Since most people with bulimia are normal weight or slightly under or overweight, it may not be obvious to others that something is wrong. If you're concerned that a loved one may have bulimia, watch for these possible symptoms:

  • refusing to eat in public or with others
  • repeatedly eating unusually large quantities of food at once
  • going to the bathroom right after or during eating
  • having sores, scars or calluses on the knuckles or hands
  • having damaged teeth and gums (from excessive vomiting)
  • having a distorted, extremely negative body image
  • constantly worrying or complaining about being fat
  • excessive exercising

Men with body image disorders

3. Muscle dysmorphia

The two aforementioned disorders mainly affect teenage girls and young women, however they are observed in a growing number of boys too. Muscle dysmorphia or `exercise addiction` is a more typical body image disorder in men. Men with muscle dysmorphia perceive their body too powerless, or too thin and therefore they begin to rigorously workout. In spite of this, they still find their muscles underdeveloped, so they take the workout to the extremes, often to the point of injury. Besides this, they are constantly ashamed of their appearance; they rarely live a normal social life and start dedicating most of their lives to working out. The illegal mass building supplements only make the situation worse because anabolic steroids can cause serious side effects such as: osteoporosis, sexual dysfunction, skin lesions, liver dysfunction and mood disorders. Exploring the root of self-esteem problems is the most effective way in treating muscle dysmorphia.

4. Orthorexia

Another disorder called orthorexia has appeared in the recent decades. People with orthorexia simply want to avoid eating disorders and unhealthy lifestyle, but they become compulsive and obsessed with healthy eating. They concentrate on quality instead of quantity. As is the case with all the other eating disorders, orthorexia is also characterized by obedience to strict rules and tremendous guilt when failing to keep them. The biggest problem is that these people slowly isolate themselves from their friends by despising everybody who they consider unhealthy. An orthorexic parent in the family can seriously endanger the children`s health since the constant reduction of nutrients leads to deficiency conditions.

What are the causes of eating disorders?

We don`t know the exact causes of eating disorders. There are many factors that are interconnected in the background of the disorder as is the case of many mental illnesses. These factors may include:

  • Genetic factors: Certain genes may increase the risk of developing an eating disorder. People with close relatives (parents, siblings) with an eating disorder or an addiction (e.g. alcoholism or drug abuse) may be more likely to develop an eating disorder, too.
  • Psychological and emotional factors: People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may have low self-esteem, perfectionism, impulsive behavior and troubled relationships.
  • Social factors: Being thin is often associated with being successful, beautiful or worthy in popular culture. Peer pressure and what people see in the media may fuel this desire to be thin.

Treating eating disorders

Treatment depends on the specific type of eating disorder, but in general, it typically includes psychotherapy, nutrition education and medication. If your life is at risk, immediate hospitalization may be needed.

Treatment depends on the specific type of eating disorder, but in general, it typically includes psychotherapy, nutrition education and medication. If your life is at risk, immediate hospitalization may be needed.

Frank Gillespie MA

Frank Gillespie has a Master's Degree in Counseling from LaSalle University in Philadelphia. He is a nationally Certified Counselor (NCC). He has provided therapy for over 23 years. During his career, he has helped more than 10,000 people move past their obstacles towards reaching their potential and fulfillment in their lives. He practices Cognitive Behavioral Therapy with a warm and nurturing approach. In addition to being a therapist, Frank has been an adjunct college professor teaching social work, a clinical consultant, a clinical director, and a seminar speaker. Frank has recently retired from his full time practice to focus on a part time online practice. He is married. He enjoys listening to music, watching sports, power walking, swimming, reading and writing.


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