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Eating Disorders — Anorexia, Binge Eating, and Bulimia

eatingdisorders571Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food.

The most common eating disorders include:

Anorexia Nervosa

Anorexia nervosa is an eating disorder that makes people lose more weight than is considered healthy for their age and height.

Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much, or use other methods to lose weight.

Causes

The exact causes of anorexia nervosa are not known. Many factors probably are involved. Genes and hormones may play a role. Social attitudes that promote very thin body types may also be involved.

Family conflicts are no longer thought to contribute to this or other eating disorders.

Risk factors for anorexia include:

  • Being more worried about, or paying more attention to, weight and shape
  • Having an anxiety disorder as a child
  • Having a negative self-image
  • Having eating problems during infancy or early childhood
  • Having certain social or cultural ideas about health and beauty
  • Trying to be perfect or overly focused on rules

Anorexia usually begins during the teen years or young adulthood. It is more common in females, but may also be seen in males. The disorder is seen mainly in white women who are high academic achievers and who have a goal-oriented family or personality.

Symptoms

To be diagnosed with anorexia, a person must:

  • Have an intense fear of gaining weight or becoming fat, even when she is underweight
  • Refuse to keep weight at what is considered normal for her age and height (15% or more below the normal weight)
  • Have a body image that is very distorted, be very focused on body weight or shape, and refuse to admit the seriousness of weight loss
  • Have not had a period for three or more cycles (in women)

People with anorexia may severely limit the amount of food they eat, or eat and then make themselves throw up. Other behaviors include:

  • Cutting food into small pieces or moving them around the plate instead of eating
  • Exercising all the time, even when the weather is bad, they are hurt, or their schedule is busy
  • Going to the bathroom right after meals
  • Refusing to eat around other people
  • Using pills to make themselves urinate (water pills or diuretics), have a bowel movement (enemas and laxatives), or decrease their appetite (diet pills)

Other symptoms of anorexia may include:

  • Blotchy or yellow skin that is dry and covered with fine hair
  • Confused or slow thinking, along with poor memory or judgment
  • Depression
  • Dry mouth
  • Extreme sensitivity to cold (wearing several layers of clothing to stay warm)
  • Loss of bone strength
  • Wasting away of muscle and loss of body fat

Binge Eating

Binge eating is when a person eats a much larger amount of food in a shorter period of time than he or she normally would. During binge eating, the person also feels a loss of control.

Considerations

A binge eater often:

  • Eats 5,000–15,000 calories in one sitting
  • Often snacks, in addition to eating three meals a day
  • Overeats throughout the day

Binge eating by itself usually leads to becoming overweight.

Binge eating may occur on its own or with another eating disorder, such as bulimia. People with bulimia typically eat large amounts of high-calorie foods, usually in secret. After this binge eating they often force themselves to vomit or take laxatives.

The cause of binge eating is unknown. However, binge eating often begins during or after strict dieting.

Bulimia

Bulimia is an illness in which a person binges on food or has regular episodes of overeating and feels a loss of control. The person then uses different methods—such as vomiting or abusing laxatives—to prevent weight gain.

Many (but not all) people with bulimia also have anorexia nervosa.

Causes

Many more women than men have bulimia. The disorder is most common in adolescent girls and young women. The affected person is usually aware that her eating pattern is abnormal and may feel fear or guilt with the binge-purge episodes.

The exact cause of bulimia is unknown. Genetic, psychological, trauma, family, society, or cultural factors may play a role. Bulimia is likely due to more than one factor.

Symptoms

In bulimia, eating binges may occur as often as several times a day for many months.

People with bulimia often eat large amounts of high-calorie foods, usually in secret. People can feel a lack of control over their eating during these episodes.

Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include:

  • Forcing yourself to vomit
  • Excessive exercise
  • Using laxatives, enemas, or diuretics (water pills)

Purging often brings a sense of relief.

People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person’s weight is often normal, other people may not notice this eating disorder.

Symptoms that other people can see include:

  • Compulsive exercise
  • Suddenly eating large amounts of food or buying large amounts of food that disappear right away
  • Regularly going to the bathroom right after meals
  • Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics
Source: MentalHealth.gov | Eating Disorders, https://www.mentalhealth.gov/what-to-look-for/eating-disorders | public domain, last updated: 03/2019

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