University of Minnesota Eating Disorder Research Program

Eating Disorders

Eating disorders are serious illnesses that result in psychological, social, behavioral, and physical problems. One to ten percent of the estimated three million Americans with eating disorders die from these illnesses.

The majority of individuals with eating disorders are female. Eating disorders involve disturbances in weight, eating patterns, and body image.

People with eating disorders often suffer from depression and low self-esteem. Sometimes their quest for an elusive "perfection" becomes, at best, destructive to good health and mental well-being and, at worse, deadly. Some individuals may be suicidal. For many, their eating disorder symptoms persist on for many years.

The specific types of eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia Nervosa

Approximately one out of 200 females ages 12 to 18 will develop anorexia nervosa. This disorder is characterized by self-imposed starvation that leads to severe weight loss. A person with this disorder is often driven to avoid food. In spite of hunger and a preoccupation with food, people with anorexia nervosa fear gaining weight so intensely that they refuse to eat.

Other signs that a person may have anorexia nervosa include three or more missed menstrual periods in a row, fasting, obsession with dieting, frequent self-weighing, problematic relationships with friends and family, preoccupation with exercising, and an unrealistic view of oneself as overweight or "fat." People with this disorder may complain of feeling bloated after eating a light meal, and they may purge by vomiting or laxative abuse after eating. About half of those with anorexia nervosa also develop binge-eating behavior. Death rates from anorexia nervosa are approximately 1 to 15 percent, depending on the severity of illness.

Bulimia Nervosa

In contrast to anorexia nervosa, bulimia nervosa is characterized by binge eating on large amounts of food and then purging it by vomiting, using laxatives or water pills, fasting and/or exercising excessively. A person can suffer from bulimia nervosa for many years without others knowing because most maintain a relatively normal weight. Bulimics may binge up to 20 times per day. Individuals with bulimia nervosa often evaluate their self-worth according to how closely their body's shape and weight matches their ideal size and weight.

Additional signs that a person may have this disorder include preoccupation with food and eating, preoccupation with body shape and weight, large financial expenditures on food, guilt feelings, depression, anxiety and a desire to eat alone. Some steal food or other items.

Binge Eating Disorder

Binge eating disorder is characterized by recurrent episodes of binge eating without the use of any compensatory behaviors, such as vomiting, taking laxatives or diuretics, fasting, or exercising excessively. During the binge episodes, individuals with binge eating disorder feel a sense of loss of control over their eating, and often experience feelings of disgust, depression or guilt after overeating. Individuals with binge eating disorder may seek treatment for weight loss as weight gain or obesity is likely to result from frequent binge eating.

Why?

Health professionals speculate that a number of factors contribute to eating disorders. Society and often our own families place tremendous pressure on people, particularly women, to be high achievers, to be "pleasers," and to strive for perfection in appearance and other areas, no matter how mythical that ideal really is. One possibility is that people with eating disorders are acutely affected by these societal and familial pressure, yet they attempt to exert independence by controlling what they eat. Also, they may believe that through controlling their eating and weight, they can achieve perfection.

There is considerable pressure on Americans (again, particularly women) to be thin. Most people are of normal weight when their eating disorders start. Some research shows that 70 percent of American women think they are overweight; 38 percent of these women state they have abused laxatives and have severely limited their diets for weight-loss purposes.

Many people with eating disorders have low self-esteem and do not view their bodies as others see them. Their depression and poor self-image become a circle of misery: feelings of unworthiness lead to the eating disorder, which in turn leads to further feelings of guilt and unworthiness about the eating disorder symptoms.

Another possible cause is that a person feels unable to cope with some life-changing event, such as puberty. In some cases, the person is attempting to deny his or her sexuality by remaining in a small, childlike body.

Some studies have suggested that genetics play a role in the development of eating disorders. In addition, a family history of alcohol abuse and eating disorders appears to place a person at risk for eating disorder symptoms. Many children of alcoholics are believed to suffer from bulimia nervosa. There may be biological factors that also contribute to the onset of eating disorders and perpetuate them once they develop.

The Consequences

It is important to understand the physical and psychological results of an eating disorder, which can be severe and potentially deadly.

Risks include dehydration, heart attack, irregular heartbeat, low blood pressure, menstrual problems, depression, anxiety, suicidal thoughts and behaviors, susceptibility to drug and alcohol abuse, impulsive behavior, and decreased bone density that can lead to broken bones.

In addition, people with anorexia nervosa often bruise easily and feel uncomfortably cold because of the loss of body fat that results from their self-imposed starvation. The skin becomes dry, and hair and nails become brittle. As the person becomes abnormally thin, a new layer of hair may form on the skin to protect it.

With bulimia nervosa, the repeated vomiting of food can cause life-threatening tears in the stomach and throat. Serious chemical imbalances may occur because the body loses essential electrolytes and minerals during this purging process. Mouth and tooth problems, swelling of the parotid glands (near the ear), and muscle cramps can occur.

Some of these conditions may return to normal once the eating disorder is stopped; some of these problems, however, may persist.

Treatment

Treatment from a qualified health professional is essential to address these disorders and their physical and psychological consequences.

Inpatient and outpatient treatment is available. Individual and/or group therapy and counseling, with family involvement, are often part of the treatment process. Nutrition information and healthy eating patterns are also emphasized. Antidepressant medications have proven helpful for some people. Many find cognitive therapy (learning to think more accurately) and behavioral techniques useful in helping them develop a healthy weight, healthy eating habits, and a healthy view of themselves.


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Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder

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