Understanding Eating Disorders

Everyone feels uncomfortable about their body or relationship with food at some point. But if these relationships deteriorate or become a source of stress, it can end up spiraling into disordered eating behaviors or a diagnosable eating disorder.

"Disordered eating" is an umbrella term used to describe the way people who feel uncomfortable about food, their bodies, exercise, or a large number of other food-related issues behave around them. While disordered eating isn't always specific enough to merit a mental health diagnosis of an eating disorder such as anorexia nervosa or binge-eating disorder, it often shares the same triggers, patterns, and anxieties. 

It can also be just as serious regardless of diagnosis. Left unchecked, disordered eating can lead to serious physical health issues, and it can even pave the way to a diagnosable eating disorder.

Eating disorders and social media

Because disordered eating develops from a complex combination of genetic, environmental, and individual factors, there's no universally agreed upon or exact cause of eating disorders. One factor that many experts agree on, though, is the power of social media. According to a 2016 study, a strong link exists between social media use and body image issues, including promoting starvation-style diets, encouraging extreme exercise, and fostering low self-esteem.

In our image-centric times, we're frequently exposed to images of "the perfect body" everywhere we turn—from our Instagram feeds to our favorite TV shows. This is obviously a subjective ideal that is designed to be unattainable for the vast majority of people. The comparison to this image, however, can make people try to lose unnecessary weight through extreme dieting, overexercise, and other disordered behaviors. 

There's no denying that there's a link between eating disorders and social media use, particularly in the development of negative body image. This is especially true among young women who are already living with an eating disorder, making them more susceptible to the influence and pressures of social media.

Breaking down the stereotypes of eating disorders

The stereotype of someone with an eating disorder is that of a young woman who’s most likely very thin and most likely white. But that's not always the case. In reality, not everyone with an eating disorder is thin, white, young, female, or even diagnosed. And according to the National Association of Anorexia Nervosa and Associated Disorders, the majority of people with eating disorders are not underweight.

Eating disorders can affect anyone, regardless of their age, gender, color, sexual orientation, or income level. Unfortunately, stereotypes linked to eating disorders often deter people from seeking professional mental health care. Despite similar rates among non-Hispanic white people, African Americans, and Asian Americans in the United States, people of color are less likely to seek mental health treatment.

Common types of eating disorders

Not everyone with an eating disorder has anorexia—and anorexia nervosa is not the most common eating disorder. In fact, the most common eating disorder is OSFED (other specified eating disorder). As its name suggests, there isn't a clear match with any of the other eating disorders, but it's just as serious an illness.

Some other common types of eating disorders include:

Anorexia nervosa

Anorexia nervosa is a serious eating disorder characterized by an intense fear of gaining weight and a distorted body image. People with anorexia restrict their food intake, resulting in severe weight loss and malnourishment, which can have physical, emotional, and social consequences.

The causes of anorexia are multifaceted and can involve a combination of genetic, biological, psychological, and environmental factors. Society's emphasis on thinness, cultural pressures, perfectionism, low self-esteem, and having a history of trauma or abuse can contribute to the development of anorexia. It is important to note that anorexia is not a choice or a lifestyle but rather a serious mental health condition that requires professional help.

Bulimia nervosa

Bulimia nervosa is an eating disorder that involves recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain. During a binge episode, individuals with bulimia consume large amounts of food in a short period and often feel a loss of control. To compensate for the perceived overeating, they engage in behaviors such as self-induced vomiting, excessive exercise, or the misuse of laxatives, diuretics, or other medications. Unlike anorexia, individuals with bulimia may maintain a relatively normal weight or have fluctuations within a normal range.

Treatment for bulimia involves a combination of therapies, including cognitive-behavioral therapy (CBT), nutritional counseling, and sometimes medication. The goals are to address the underlying emotional and psychological factors, establish healthier eating patterns, and promote self-acceptance and body positivity.

Binge-eating disorder

Binge eating disorder (BED) is an eating disorder that includes recurrent episodes of consuming large amounts of food in a short period, accompanied by a sense of loss of control and feelings of distress or guilt. Unlike bulimia, individuals with BED do not engage in behaviors such as vomiting or excessive exercise. Binge-eating episodes often occur in secrecy or as a way to cope with negative emotions, stress, or boredom. People with BED may eat rapidly, to the point of discomfort, and continue eating even when they are physically full. They may also withdraw from social activities and relationships due to embarrassment or fear of judgment.

Treatment for BED focuses on addressing the underlying emotional triggers, developing healthier coping mechanisms, and establishing a balanced relationship with food.

Orthorexia

Orthorexia is not currently recognized as a formal eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it refers to an unhealthy obsession with eating only "pure" or "clean" foods that the individual perceives as healthy. People with orthorexia often become fixated on the quality, purity, and nutritional content of the foods they consume and may set strict rules and restrictions for themselves. They also may spend excessive amounts of time researching, planning, and preparing meals and may experience extreme anxiety or guilt if they deviate from their self-imposed dietary rules.

This fixation on healthy eating can lead to social isolation, reduced enjoyment of food, and disruptions in daily life. The preoccupation with healthy eating can also lead to obsessive thoughts, relationship issues, and impaired social functioning

Rumination disorder

People with rumination disorder regularly regurgitate and re-chew their food. They tend to bring up food from the stomach into the mouth involuntarily and then either swallow it again or spit it out. This regurgitation typically occurs within 30 minutes after eating and can happen multiple times a day. Unlike vomiting, it is not accompanied by feelings of nausea or discomfort. Rumination is often an unconscious reflex, and individuals may find it difficult to control or stop the behavior.

Rumination disorder primarily affects infants, young children, and individuals with intellectual disabilities. The exact cause of the disorder is unknown, but it may be related to a lack of coordination between the muscles involved in swallowing and digestion. The repeated regurgitation of food can lead to weight loss, malnutrition, and other physical complications. Additionally, it can have significant psychological and social consequences, including embarrassment, social isolation, and disruptions in daily functioning.

Avoidant restrictive food intake disorder (ARFID)

Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by a persistent and extreme avoidance or restriction of food intake that results in significant nutritional deficiencies and impaired physical and psychosocial functioning. Individuals with ARFID often have an aversion to certain foods based on their sensory characteristics, such as texture, taste, or smell. This can lead to an extremely limited range of accepted foods and a refusal to try new foods. Unlike other eating disorders, the motivation behind the restriction is not driven by concerns about body image or weight but rather by sensory or other negative experiences associated with eating.

At Charlie Health, our goal is to ensure the effective delivery of care for all clients. As such, we are unable to accept clients with any eating disorder as a primary diagnosis.

Seeking mental health support

Eating disorders stop people from getting the nutrition they need for good health, which directly impacts mental health. The resulting imbalances in the body's metabolism can lead to lifelong gut issues, dangerously low electrolyte levels, and other health problems. While anorexia can lead to low blood pressure and a slowed pulse, bulimia can trigger heartburn, dehydration, and kidney failure. Brain fog, changes in mood, and sleep disturbances are also common for people diagnosed with an eating disorder. 

Of course, the physical problems are further exacerbated by the emotional and psychological toll that accompanies mental health conditions—both for those affected and for their loved ones.

We all know that a balanced, nutrient-dense diet keeps us healthy, but eating disorders are rarely about not knowing what balanced eating looks like. Full recovery isn't about eating a healthy amount of food—it's about coping with stress and anxiety, and overcoming perfectionism.

As a result, treatment needs to tackle the underlying issues driving the eating disorder. Any person with a diagnosed eating disorder needs professional mental health care and support tailored to their individual needs. If you think you have an eating disorder, it's important to talk to your primary care doctor or another trusted health care provider. They can refer you to a specialist for professional support, guidance, and treatment.