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Eating Disorders: Types, Symptoms, Causes, Risk factors, Diagnose, Treatments and Prevention

Eating Disorders
  • Eating disorders are consequential behavioral states which are associated with constant and severe disturbance in behaviors of eating that can affect adversely on person’s health and their emotions associating distressing thoughts and also disturb the functional ability of the person in various crucial life aspects.  
  • Eating disorders are of different types like anorexia nervosa, bulimia nervosa, and binge eating disorders these are main eating disorders that are more common, some uncommon eating disorders are avoidant restrictive food intake disorder, rumination disorder, pica and other specified feeding and eating disorder.
  • A lot of these eating disorders involved in concentrating too much on shape your body, weight and food which then leads to different consequential eating disorders. These behaviors can impact remarkably on your body ability to get proper nutrient. Eating disorders can influence the heart, bones, digestive system, mouth, teeth and can also lead to other diseases.
  • When you get distracted towards weight and food matters, it becomes harder for you to give attention to other life aspects. If left untreated, eating disorders can take charge of person life and can also escort to consequential and potentially deadly medical complications as mentioned above.
  • Eating disorder can affect a person of any gender of any age but its rate is higher in women and is developed often in the teen and young adult years even though they can also evolve at other ages. Its symptoms usually appear in juvenescence and young adulthood.
  • With proper treatment and medical care however, those having eating disorders can get them to their normal eating habit and recover their emotional and physiological complications.

Types of Eating Disorders and Their Symptoms

Following is the list of eating disorders that occurs having different symptoms depending upon the disorder type;

  1. Anorexia nervosa.
  2. Bulimia nervosa.
  3. Binge eating disorder.
  4. Rumination disorder.
  5. Avoidant/restrictive food intake disorder.
  6. Pica.

1. Anorexia Nervosa

  • This is the very prominent eating disorder. It develop mainly during juvenescence or in youth and is seen mostly in women contrasting to men.
  • People having anorexia nervosa call themselves as overweight or fat even though they are very perilously underweight.
  • They are in habit of checking their weight constantly and starts of avoid specific food types also reduce their intake severely.

Symptoms

  • The most common symptoms that occurs in anorexia nervosa are;
  • They are greatly underweighting in contrast to their people of closer age and height.
  • They have severely confined patterns of eating.
  • That have potent fear of gaining weight or have tenacious behaviors in order to keep themselves away from gaining weight in spite of the fact of being underweight.
  • They have a relentless addiction of being thin and are very unwilling to prolong a healthy weight.
  • They have a high impact on themselves because of their weight of their body and its shape perceived greatly on their self-assurance.

Obsessive-compulsive signs are also present time after time.

For illustration, people having anorexia are preoccupied repeatedly with notions like about food or collect recipes or store food obsessively.

Sub-Types of Anorexia

It is categorized suitably into two subtypes – the binge eating and purging type, second is restricting type.

1. Binge Eating or Purging Type

Individuals having this subtype of anorexia may binge on a sizeable amount of food else they eat small amount.

In the both situation, after eating, they do purging through exercising excessively, taking diuretics or laxatives and vomiting.

2. Restrictive Type

  1. Individuals having restrictive type eating disorder lose their weight solely through fasting, dieting or excessive exercise.

Anorexia eating disorder might be very dangerous and damaging to the body.

As the time goes by, individual having anorexia may experience brittle nails and hair, infertility, thinning of the bones and the growth of a fine hair layer all over the body.

In consequential cases, it results in brain, heart or multi-organ loss and eventually death.

2. Bulimia Nervosa

  • This is another familiar eating disorder. Just like anorexia, this disorder also appear during the juvenescence and during early youth and is also appears to more usual in women as compare to the men.
  • People having bulimia eat frequently unusually a large amount of food in a particular time duration.
  • Every episode of binge eating continuous until the individual becomes irritating full. During the binge, an individual having this eating disorder perceive that they just can’t stop eating or they cannot manage how much they started to eat.
  • Binges can happens with food of any type, it occur most frequently with food which they have trying to avoid.
  • Then the person with bulimia strive to purge in order to remunerate the calories munched and mitigate their gut irritation.
  • Those purging behavior includes enemas, diuretics, laxatives, fasting, forced vomiting and excessive exercise.

Symptoms

Symptoms of bulimia is quite closer to those of purging or binge eating.

However, the individuals having bulimia normally have rather than normal weight instead of becoming bony.

The bulimia nervosa common symptoms are;

  • They have binge eating recurrent episodes also having a feel of lack of control.
  • In order to avert weight gain they also have repetitive episodes of unseemly purging behaviors.
  • Their self-assurance is influenced overly on their weight and body shape.
  • Despite having a normal weight, they have a dread of gaining weight.

The individual having bulimia may include aftereffect like sore and inflamed throat, hormonal disturbances, severe dehydration, and irritation of the gut, acid reflux, tooth decay, worn tooth enamel and swollen salivary glands.

In consequential cases, bulimia can also cause a disproportion in levels electrolytes such as calcium, sodium and potassium. This can be the cause to stroke and heart attack.

3. Binge Eating Disorder

  • Binge eating disorder is considered as one of the most usual type of eating disorder. It usually develops during juvenescence or during early youth, it can also evolve subsequently.
  • Individuals having binge eating disorder have indications are quite closer to those of bulimia and the binge eating which is a anorexia subtype.
  • For example, in relatively short period of time, they generally eat oddly a very huge amount of food and during binging they feel a lack of control.
  • Individuals having binge eating disorders do not limit their calories intake or with the help of any purging behavior like doing a lot of exercise or vomiting in order to compensate their binge.

Symptoms

Following are some common types of symptoms that happens to be appear in individual having binge eating disorder;

  • Large amount of food is eaten secretly and rapidly by them and until they become uncomfortably full, despite of the fact of being not hungry.
  • During the episodes of binge, they have feeling of lack of control.
  • They get the distress feeling, such as guilt or shame, when they think about their eating disorder.
  • They do not use the purging behavior i.e. calorie restriction laxative or diuretic use, excessive exercise and vomiting.

Binge eating disorder people are often overly weight or obese.

This can enhance their danger of getting the medical complications related to overweight like disease of heart, type 2 diabetes and stroke.

4. PICA

  • There is another type of eating disorder known as pica but it means eating those stuff that are not reviewed as food.
  • Pica individuals are likely to seek non-food substances like dirt, chalk, soil, ice, pebbles, wool, cloth, paper, hair, and cornstarch or laundry detergent.
  • Pica eating disorder can develop in adults as well as in adolescents and children.
  • But this disorder is regularly seen in women that are pregnant, children and person having mental complications.
  • Pica individuals have an alarming risk of infections, gut injuries, nutritional deficiencies and poisoning.
  • Depending upon the substance which is ingested this eating disorder can be deadly.
  • However, pica is regarded when the eating of the non-food substance must not be considered normal in someone’s religion or culture.
  • Along with it, by a person’s peers, it must not be regarded as a socially admissible practice.

5. Rumination Disorder

  • Rumination disorder is an eating disorder that is newly known.
  • In rumination disorder, there is a condition in which person regurgitates the food that they eaten before and swallowed, and then re-chews it, and then spit it out or re-swallows it.
  • This conditions occurs usually within the 30 minutes after eating the meal. Unlike a condition like reflux which is voluntary.
  • This disorder can be developed in toddlers, in childhood or even in adulthood.
  • This eating disorder develops in infants between the ages of 3-12 months and might disappears in its own.
  • Rumination disorder in children and adult usually need therapy to resolve this eating disorder.
  • In infants, it can result in weight loss if it is left untreated and can also cause consequential malnutrition that can be deadly.
  • Rumination disorder in adults might restrict the amount of they ate when they are in public mainly.
  • This may cause them to weight loss and cause them to get underweight.

6. Avoidant/Restrictive Food Intake Disorder

  • In history, Avoidant/restrictive food intake disorder (ARFID) was known by an old name. The old disorder that was replaced was called as “feeding disorder of infancy and early childhood” which was a diagnosis lately reserved for under 7 years old children.
  • Although this eating disorder usually develops either in infancy or early childhood, it can even remain into childhood. In men and women, it is equally common.
  • Disturbed eating is experienced in individuals having AFRID either because of their interest lack in eating or dislike for some colors, textures, tastes, temperature or smells.

Symptoms

Following are some common symptoms that describes the AFRID patient;

  • Sufficient amount of calories or nutrients are prevented by the individual because of restriction and avoidance of food intake.
  • Social functions that normally occurs disturbs their eating pattern i.e. eating with others.
  • Poor development for age and height or lose of weight.
  • Deficiencies of nutrients or depending upon supplements or tube feeding.

It is also crucial to note that individuals having AFRID usually goes beyond their normal behavior i.e. in toddler’s picky eaters and the intake of food becomes lower in older adults.

Moreover, the avoidance or restriction of food in this disease does not involve due to unavailability or cultural or religious practices.

Other Eating Disorders

In addition to six eating disorders that are mentioned above, some other less-common or less-known eating disorders are also present.

These eating disorders fall under the category of these three disorders;

1. Purging Disorder

Purging behaviors is usually used in individuals having purging disorders i.e. excessive exercising, diuretics, laxatives and vomiting to maintain their body shape and weight. However, they don’t binge on food.

2. Night Eating Syndrome

Usually after awakening from sleep, night eating disorders most of the time eat excessively.

Other Specified Feeding Or Eating Disorder (OSFED)

Those eating disorders having symptoms similar to those of eating disorder but are not fit in any categories that are mentioned above are included in OSFED, while this is not found in the DSM (Diagnostic and Statistical Manual).

One of the eating disorder that fall under the OSFED is Orthorexia. Although being introduced increasingly in the scientific studies and media.

By the current DSM Orthorexia has yet to be separately known as a separate eating disorder.

An obsession with healthy eating is seen in individuals having orthorexia to that level that it starts to disrupt their daily lives.

For an instance, people having orthorexia can eliminate an entire food group from their diet fearing of it as they are unhealthy.

This can lead to weight loss, difficulty in eating outside the home, malnutrition and also have distress emotionally.

Obsession with losing weight is seen rarely in individuals with orthorexia.

The way how they comply with their self-imposed rules of diet affects a lot to their identity, satisfaction or self-worth.

Causes

Complex conditions are caused by these eating disorders and the cause of these disorders are still under consideration of researchers and scientists.

Although eating disorders have one common thing having food and weight issues, most of the expert believe in this fact that people who are trying to manage with profuse feelings and painful emotions have these eating disorders by controlling their intake of food.

Unfortunately, because of this a person’s emotional and physical health, self-assurance and sense of control will eventually get damaged.

Following are some factors that are involved in causing eating disorders;

1. Genetics

Eating disorder in people having first degree relatives, parents or siblings will likely to have an increased danger of developing an eating disorder too.

Genetic link is proved to be part of this. Serotonin which is a brain chemical also as an evident being involved in an eating disorder also point as in contribution of genetic and biological factors.

2. Environment

Pressure of a person’s surrounding or cultural pressure also contribute in eating disorder that idealizes a particular body type or shape that put pressure on people in getting that particular unrealistic standards.

Thin women body and muscular body in case of men is considered ideal in media industries and popular cultures to gain popularity, beauty, success and happiness.

3. Peer Pressure

This can be a very powerful force in developing an eating disorder among young people.

Bullying, teasing, or mocking because of a person’s body size and weight can be the cause of pressure to get an eating disorder.

Physical or sexual abuse in the history of the patient can also contribute in development of an eating disorder in some people.

4. Emotional Health

Impulsive behavior, having difficult relationships and perfectionism can cause lower self-assurance in person and then make them vulnerable in developing any eating disorder.

Risk Factors

All type of people can get affected from and eating disorder.

However, there are some certain risk factors that contribute in developing eating disorder in some people, those risk factors are mentioned below;

1. Age

During teens and early 20s eating disorders are much more common in that age group.

2. Gender

Most of the time eating disorders are diagnosed in girls and women.

However, it is also need to be consider that boys and men can be under-diagnosed because of difference in seeking treatment.

3. Family History

The risk is increased when any of the family member like parent or sibling have eating disorder.

4. Dieting

When dieting is taken too far and person get obsessed with it is also an eating disorder.

5. Change in Conditions

When there is a change in lifestyle of a person like going to college, getting a divorce or starting a new job in which a person face difficulty in start, get stressed and can lead them towards an eating disorder.

6. Activities, Vocations and Job Type

Dancers, wrestlers, wrestlers and gymnasts are especially vulnerable to an eating disorder.

Complications

A wide variety of complications can be caused because of eating disorders, while some of them can be life threatening. When an eating disorder is left untreated for a long, it will get more severe and will cause more serious complications i.e..;

  • Severe health problems.
  • Stress, anxiety and depression.
  • Impulsive behavior and suicidal thoughts.
  • Problems in growth and development of the body.
  • Social, family and relationship problems.
  • Substance use disorder.
  • Issues in school and job work.
  • Death like in case of having pica disorder, when a person consume a lot of non-food substance which can be fatal.

Consulting A Doctor

  • To overcome it by yourself and to manage the eating disorder is very difficult.
  • Seek for medical help as soon as possible, if you are going through the problems that are related an eating disorder.
  • And if you think any of your family member is showing symptoms of any of the eating disorder urge them also to get medical help for their better recovery.

Encouraging A Loved One To Get Treatment

Most of the patients having eating disorder, unfortunately, think that they don’t need treatment. If you are anxious about your loved one that you think have an eating disorder then urge them to consult a doctor, if they are not willing to go to a doctor.

Things that can act an indications of eating disorders are;

  • Making excuses for not eating and to skip their meals.
  • Obsession with healthy eating.
  • Avoiding normal social activities.
  • Constantly checking in mirror for observing any flaws.
  • Use of herbal products or laxatives or dietary supplements for weight loss.
  • Knuckles calluses because of forced vomiting.
  • Use of toilet during meals.
  • Expressing or showing guilt, shame, disgust and depression about eating habits.
  • Adaption of a restrictive vegetarian diet.
  • Rather than eating with family they make their own meal.
  • Talking about losing weight all the time and constantly being anxious and complaining about being over-weight.
  • Eating huge amounts of sweets or food having high fat constantly.
  • Excessive exercise.
  • Problems like loss of tooth enamel that is because of repeatedly forced vomiting.
  • Secretly eating.

Diagnosis

  • Best recovery outcome can get if early diagnosis is done in a person having eating disorder.
  • If there is an issue in an eating disorder, physical test is performed by the doctor, interview is conducted and then order some laboratory tests.
  • For the formation of diagnosis this will help and then check for associated medical complications and issues.
  • Among with it, a psychological evaluation is done by the mental health professional.
  • They may ask about the person’s eating habit, beliefs and behaviors.
  • There may be ask information about their dieting history, purging, binging and exercise.
  • For eating disorder authorization, these symptoms must meet the standards in the Diagnostic and Statistical Manual of Mental Disorders (DSM).  
  • Another mental illness can be shown often in a person having eating disorder that needs treatment.

Treatment

Using a variety of techniques, eating disorders can be managed. Depending upon the type of the disorder, treatment can vary, but generally include following treatments in any type;

1. Psychotherapy

It involves the behavioral and talking therapy.

It helps to diagnose the reasons having behavioral changes and might be the cause of the eating disorder.

2. Medicine

Different types of medications are given depending upon the type of the eating disorder such as anti-anxiety and anti-depressants drugs.

Other co-occurring illness are also seen in most of the people having eating disorder like anxiety or depression.

And while there no such as assistance for the treatment of eating disorder themselves many patients these medicines or drugs aids with underlying issues.

3. Nutritional Counseling and Monitoring of Weight Restoration

It is compulsory to take nutritional counseling and monitoring of the weight restoration. Family based treatment is very important because the family members ensure the patterns healthy eating and also it enhance the awareness and support.

Related Conditions/ Additional Illness

People having eating disorder may also have more illness like;

  • Borderline personality disorder.
  • Depression.
  • Obsessive-compulsive disorder.
  • Anxiety disorder substance use disorder/ Dual Diagnosis.

If treatment is done of these illness then it will aid in treating the eating disorder.

Another illness can be cause of eating disorder in some cases.

Prevention

Although there is not any certain way of preventing eating disorders, there are some means and strategies that may be the used to develop healthy eating patterns;

1. Avoid Dieting Around The Child

The family members dining habits can affect the relationship between the children and the food.

Together eating meal can helps in teaching the child about the dangers of dieting and urge them to eat a balanced in a reasonable portions.

2. Interact With Your Child

For an instance, there are many different ideas on websites that encourages dangerous ideas, i.e. considering anorexia as a choice of your lifestyle rather than being consider it as an eating disorder.

Correct any misinformation like this is very important and to tell them about the dangers of having unhealthy eating patterns.

3. Reinforce and Cultivate A Healthy Image of Body

Whatever the child body shape, make them confident about their body.

Talk to your child about that the body shape and size can vary and make them more comfortable about their body image.

In front your child don’t even criticize your own body.

It can aid in building healthy self-assurance and strength that will carry the children through the difficult judgments of the teen years.

4. Help Your Child’s Doctor By Enlisting Different Symptoms or Behaviors

  • At well-child, early indication of an eating disorder can be identify by the doctor.
  • For instance, during routine medical appointments, they question the children about their satisfaction about their appearance.
  • Weight and height percentiles and body mass index should be examined during their visit which can alarm you and the doctor to any notable changes that might occurred.

Written by: Anum Mahmood, BSc (Hons) Agriculture (Food technology), Institute of Food and Nutritional Sciences, PMAS-Arid Agriculture University Rawalpindi.

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