Eating Disorders are treatable psychiatric conditions characterized by these main patterns: restricting food intake, binging, or rapidly consuming large amounts of food, and purging or eliminating calories through vomiting, laxatives, excessive exercise, and other harmful means. An eating disorder can involve any one or combination of these behaviors.[1]
You cannot tell if someone has an eating disorder from their weight alone, and you cannot get rid of these disorders simply by eating differently. While there is no definitive cause of eating disorders, growing consensus suggests there are a range of biological, psychological and sociocultural factors that contribute to the development of an eating disorder.
At their core, eating disorders involve a disruption to someone’s self-perception. Social factors such as weight stigma, exposure to bullying, racial and ethnic assimilation, and limited social networks [1] can increase the risk of eating disorders. Psychological factors such as perfectionism, body image dissatisfaction, anxiety disorder and behavioral inflexibility [2] can also increase the risk of an eating disorder.
Common Symptoms
These symptoms are intended as a general overview. Someone struggling with an eating disorder will not typically exhibit all of these signs and symptoms. [3]
- Preoccupation with weight, food, calories, macros, or any other similar behavior or attitude that puts weight loss, dieting, and food control as a primary concern
- Skipping meals or regularly taking small portions. General discomfort in eating around others
- Feelings of disgust, depression, or guilt after overeating
- Withdrawal from usual friends an activities
- Frequent dieting and extreme concern with body size and shape
- Significant mood swings
- Noticeable weight fluctuations, both up and down
- Maintaining an excessive and rigid exercise schedule - despite weather, illness, or injury
- Non-specific gastrointestinal complaints
- Menstrual irregularities when not on hormonal contraceptives
- Difficulty concentrating
- Fainting, feeling dizzy upon standing
- Sleep problems
- Muscle weakness
- Dry skin and hair, brittle nails
- Fine hair on body
Anorexia
A person with anorexia has a distorted self-image of their body and is driven by an intense fear of gaining weight. This leads to limiting the number of calories and types of food they eat, exercising compulsively, and/or purging the food eaten through intentional vomiting or laxative misuse until they lose weight. A person with anorexia typically cannot maintain an appropriate body weight based on height, age, stature and physical health. [4]
Bulimia
A person with bulimia has a distorted self-image of their body, judges themselves harshly based on this view, and has self-esteem struggles linked to their body image.[5] This leads to eating an excessive amount of food in a short period of time (binge eating) followed by self-induced vomiting, misuse of laxatives, fasting or exercising excessively.[4] A person with bulimia typically maintains a weight that is appropriate for their height, age, stature and physical health.
Binge-eating Disorder
A person with binge-eating disorder has lost control over their eating and as a result experiences recurring episodes of consuming excessively large amounts of food. [6] These episodes are not followed by self-induced purging, extreme exercise, or fasting. A person with binge-eating disorder is often overweight or obese.
Emerging Trends
Men
Masculine body image has led to an increased focus on diet and exercise for men, but the inaccurate belief that associates eating disorders primarily with women prevents many men from speaking up or seeking help.[7] One-third of people with an eating disorder are men [8], and the prevalence of men engaging in unhealthy diet behaviors such as binge eating, purging, fasting, excessive working out, and supplement or steroid misuse is on the rise.
LGBTQ+ Community
Sexual minority adults have two to four times greater risk of developing anorexia, bulimia, or binge eating as compared to cisgender heterosexual adults.[7] Initial research suggests that some of the unique stigmas and microaggressions individuals within the LGBTQ+ community are faced with may be a contributing factor to poor body image, which increases their risk of disordered eating behaviors. Overall, body dissatisfaction is shown to be an underlying key stress experienced by transgender people.[9] Interventions such as gender dysphoria treatment and creating feelings of belonging and connection within the LGBTQ+ community have been shown to help increase body satisfaction.
Athletes
Athletic competition combined with the pressure to win and the cultural emphasis on thinness has created a high-risk environment where today’s athletes are particularly vulnerable to disordered eating and exercise behaviors. Up to 45% of female athletes, and 19% of male athletes struggle with an eating disorder.[10] The negative impacts of eating disorder behaviors on female athletes are so severe that they often have life-long health implications such as infertility and bone and muscle loss, in addition to many other serious complications.
Body Image
The way you view your body is linked to self-esteem and self image. Our world places a disproportionate amount of validation on physical appearance. You are not alone in feeling the world’s pressure to change the way you look, but the truth is striving for a body “ideal” is an unachievable goal. Your body will continue to shift and change throughout the entirety of your life. Bodies were made to vary in shape, size, and appearance. It is important work to find worth and value in who you are and not how you look. You are worthy of radical, unconditional self-love today, right now, as you are in this moment.
Let's Unpack Our Fear of Fatness with Athena Nair.
Helpful Tips to Tackle Body Image
- Identify and challenge negative self-talk
- Focus on your positive qualities, skills and talents
- Keep a "Top-Ten" list of things you like about yourself
- Say positive things to yourself every day, appreciating and respecting what your body can do (laughing, dancing, creating and more!)
- Wear clothes that are comfortable and make you feel good in your body
- Avoid comparing yourself to others, that includes "unfollowing" people who trigger negative body image thoughts and feelings
- Do something kind for your body (...a bubble bath, a massage, a nap!)
- Invest the time spent thinking about your body on a new hobby, volunteering, or another activity that makes you feel good about yourself
Additional Resources
Sarah Dowd, M.S. Ed., LPC - Director of Student-Athlete Wellness and Clinical Counselor, who specializes in body image, self-esteem, and eating disorders
National Eating Disorders Association (NEDA) Helpline: Call or text (800) 931-2237
Join The Body Positive: Love your body, Live your life!
Listen to the Food Psych Podcast to help you break free from diet culture
Watch to understand The Inaccurate Link Between Body Ideals and Health
Learn how to Cultivate Unconditional Self-Worth
References
[1] Bahji, A. (n.d.) TED-Ed. Why Are Eating Disorders So Hard to Treat? [Video] Retrieved on June 21, 2022, from https://www.ted.com/talks/anees_bahji_why_are_eating_disorders_so_hard_to_treat
[2] National Eating Disorder Association [NEDA]. (2022). Risk Factors. Retrieved on June 21, 2022, from, https://www.nationaleatingdisorders.org/risk-factors
[3] National Eating Disorder Association [NEDA]. (2022). Warning Signs and Symptoms. Retrieved on June 21, 2022, from https://www.nationaleatingdisorders.org/warning-signs-and-symptoms
[4] Cleveland Clinic. (November 17, 2021). Anorexia Nervosa. Retrieved on June 21, 2022, from https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa
[5] Cleveland Clinic. (May 16, 2022). Bulimia Nervosa. Retrieved on June 21, 2022, from https://my.clevelandclinic.org/health/diseases/9795-bulimia-nervosa
[6] National Institute of Mental Health [NIMH]. (December, 2021). Eating Disorders. Retrieved on June 23, 2022, from https://www.nimh.nih.gov/health/topics/eating-disorders
[7] Kumar, N. (November 23, 2021). Eating Disorders in Men Are Not Talked About Enough - and They’re on the Rise. Healthline. Retrieved on June 23, 2022, from https://www.healthline.com/health/eating-disorders/eating-disorders-in-men
[8] National Eating Disorder Association [NEDA]. (2022). Busting The Myths About Eating Disorders. Retrieved on June 23, 2022, from https://www.nationaleatingdisorders.org/busting-myths-about-eating-disorders
[9] Nagata, J. M., Ganson, K. T., & Austin, S. B. (2020). Emerging trends in eating disorders among sexual and gender minorities. Current opinion in psychiatry, 33(6), 562–567. https://doi.org/10.1097/YCO.0000000000000645
[10] Conviser, J. H., Schlitzer Tierney, A., Nickols, R. (2018). Essential for best practice: treatment approaches for athletes with eating disorders. Journal of Clinical Sports Psychology, 12.