All about eating disorders

All About Eating Disorders

In this article, you will learn all about eating disorders. For example, we will discuss the main types, share some common signs and symptoms, and learn how you or someone you care about can get help. At Anderson’s Nutrition, we have a team of specialized Registered Dietitians who work with eating disorder patients through our Nourish Program.

What is an Eating Disorder?

Eating disorders are serious but treatable mental and physical illnesses. It is a common myth that you can tell a person has an eating disorder just by looking at them. Eating disorders actually can affect any person. In fact, an individuals can have an eating disorder regardless of gender, age, race, ethnicity, religion, sexual orientation, socioeconomic status, or body weight and shape.

When someone is suffering from an eating disorder, they engage in irregular and/or harmful eating patterns. They also exhibit an unhealthy preoccupation with food, weight, and body shape.

What are the most common eating disorders?

The most common types of eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. Increasingly, we are seeing patients who exhibit another type of eating disorder known as avoidant restrictive food intake disorder, or ARFID. There are also other less common eating disorders such as orthorexia, pica, and other specified feeding or eating disorder (OSFED). Below we focus on the most common types of eating disorders that we see in the general population.

Anorexia Nervosa

Anorexia nervosa is often known simply as “anorexia”. It is characterized by weight loss caused by self-imposed starvation, a fear of gaining weight, and extreme distorted body image. Someone suffering from anorexia might restrict calories or certain types of food or food groups, and might also engage in compulsive exercise, bingeing behaviors, and purging by vomiting or using laxatives.

Bulimia Nervosa

Bulimia nervosa involves a cycle of bingeing, followed by compensatory behaviors. For example, a person with bulimia might engage in self-induced vomiting, compulsive exercise, and laxative and/or diuretic use. Individuals tend to feel a lack of control during the bingeing period, and then engage in behaviors to compensate. These behaviors are used to prevent weight gain and to control the body. They tend to occur at least once per week for months on end.

Binge Eating Disorder

Binge eating disorder is characterized by recurrent episodes of consuming large amounts of food in a short period of time. Furthermore, the individual often consumes the food very quickly, and to the point of significant discomfort. As a result of binging, a person may experience negative emotions such as guilt, shame, feeling a loss of control, and extreme distress.

Avoidant Restrictive Food Intake Disorder (ARFID)

Avoidant restrictive food intake disorder (ARFID) was only recently identified and named. It is characterized by persistent and extreme avoidance or restriction of certain foods or food groups. As opposed to the eating disorders described above, ARFID is not driven by body image concerns, or a desire for weight loss. Rather, it stems from other motivating factors. These factors may include avoidance of some sensory aspects of food; lack of interest in eating; and concern about the potential consequences of eating (ie. choking, throwing up, chewing, etc).

Eating disorder statistics

Eating disorders can have serious physical, emotional, and social consequences. Because they are so serious in nature, they require comprehensive treatment that includes medical, psychological, and nutritional intervention and support. While the cause of eating disorders is unknown, a growing consensus suggests that it includes a range of biological, psychological, and sociocultural factors.  

Here are a few statistics from the National Eating Disorders Association (NEDA) and National Association of Anorexia Nervosa and Associated Disorders (ANAD):

  • 28.8 million Americans (9% of the population) will suffer from an eating disorder at some point in their lives.
  • Binge eating disorder is the most common eating disorder in the United States.

  • Less than 6% of people with eating disorders are medically diagnosed as “underweight.”

  • Eating disorders are among the deadliest mental illnesses, second only to opioid overdose.

How to identify an eating disorder  

Identifying an eating disorder can be, above all, a complex process. That’s because these disorders can present in various ways and are often accompanied by secretive behaviors. For more information about the physical and emotional signs and symptoms of eating disorders, read this article on our Nourish blog.

In the meantime here are a few identifying factors that healthcare providers, parents, teachers, and loved ones can look for if they have concerns:

For providers:

  • Dramatic changes in weight
  • Menstrual irregularities (ie. missing periods)
  • Abnormal lab findings such as anemia, low thyroid and hormone levels, irregular potassium, sodium, calcium, magnesium, and phosphorus
  • Lanugo (fine hair on the body)
  • Muscle weakness
  • Low blood pressure and/or heart rate
  • Obsessive or avoidant of seeing weight
  • Unusual eating patterns/habits

For parents/teachers/loved ones:

  • Extreme concern with body size/shape/weight
  • Preoccupation with food, calories, portion sizes, dieting
  • Refusal to eat certain foods or food groups
  • Evidence of purging behaviors such as: frequent trips to the bathroom after eating, signs of vomiting, laxative or diuretic packages
  • Evidence of binge eating such as: disappearance of a large amount of food in a short amount of time, large amounts of wrappers or containers of food indicating the food was consumed in a short amount of time
  • Limited range of preferred foods becoming more narrow over time (i.e picky eating that gets worse over time)
  • Drinking excessive amounts of fluids before or after a meal
  • Maintaining an excessive and rigid exercise routine despite the weather, illness, injury, etc.

If you are a parent/teacher/loved one and notice any of these signs and symptoms, or if you have concerns about yourself or someone else, then reach out to your healthcare provider or contact the NEDA Helpline to seek professional help.

Eating disorder prevention

Eating disorder prevention involves various strategies aimed at promoting a healthy relationship with food, body image, and overall well-being. Below we outline some of the different approaches that can help with awareness and prevention of eating disorders.

1. Education and awareness

Promoting eating disorder education and awareness is a key component in prevention. There are various approaches such as:

  • Encouraging open discussions about body diversity
  • Educating on the harmful effects of dieting and restrictive eating
  • Discussing common signs and symptoms of eating disorders
  • Talking about harmful messages in the media regarding body image and dieting
  • Promoting physical activity for enjoyment and health rather than to change one’s body
  • Cultivating supportive environments at home, school, and work
  • Discouraging weight stigma, bullying, and discrimination based on body size or appearance

2. Cultivating food neutrality

Food neutrality refers to the concept of approaching all food without judgment or moral implications. With food neutrality, no food is inherently “good” or “bad.” This leads to a balanced and non-diet and non-restrictive approach to eating. It also promotes a healthy relationship with food. In order to cultivate food neutrality, one needs to adopt a balanced approach to eating without judgement of one’s food choices.

Some steps to help develop food neutrality include:

  • Practice mindful eating
  • Avoid restrictive and fad diets
  • Focus on personal preference and enjoyment of food
  • Reject labeling foods as “good” or “bad”
  • Challenge strict food rules
  • Incorporate a variety of foods into meals and snacks
  • Practice self-compassion and challenging negative thoughts about food and body image

Check out this article on our Nourish blog to learn more about the concept of “mindful eating,” which can help you connect with you body’s overall needs and preferences.

3. Fostering positive and/or neutral body image

Body image is a topic that is often very complex and tied to one’s self-esteem and mental well-being. Meanwhile one’s body image can be influenced by various factors including:

  • Societal standards
  • Social media influences and portrayals
  • Peer comparisons
  • Personal experiences

Fostering a positive body image is important throughout every stage of growth and development. In addition, challenging societal norms can improve one’s self-esteem and feelings of self worth. Encouraging self-acceptance regardless of body shape or size, and discouraging unrealistic beauty standards, are two ways to help promote positive body image.

4. Creating supportive environments

Creating a supportive environment plays a crucial role in the prevention of eating disorders and disordered eating. Above all, prioritizing a loved one’s mental and emotional well-being over appearance is key. It is also important to foster open conversations about body image, self-esteem, and mental health.

Some ways to help create a supportive environment in the home are:

  • Encourage open communication
  • Avoid diet talk and body shaming
  • Incorporate family meals
  • Limit social media influence
  • Support individual and personal food preferences
  • Model a healthy and balanced relationship with food
  • Provide education about the signs and symptoms of eating disorders

Fostering a supportive environment requires ongoing effort and understanding. It is important to remember that eating disorder prevention is a shared responsibility within the family unit. Furthermore, modeling a healthy and compassionate approach to food and body image can make a significant difference in the well-being of all family members.

5. Challenging diet culture and social media

Challenging diet culture norms and addressing the impact of social media are key components in the prevention of eating disorders and disordered eating. Diet culture perpetuates harmful messages about food, body image, and weight and often promotes extreme and unsustainable approaches to eating.

Meanwhile social media tends to showcase carefully curated images and videos. These distort reality and foster unrealistic body and beauty ideals, which can lead to immense pressure to look a certain way.

Additionally, many social media platforms discuss nutrition and promote diets and diet products. In many cases these voices lack the in-depth knowledge and expertise required to provide accurate and safe nutritional guidance. Misinformation from social media influencers and fad diets can lead to unhealthy dietary choices or the adoption of extreme and harmful eating behaviors. For this reason, it is essential to critically evaluate the credibility and qualifications of anyone offering nutrition advice on social media and the internet.

It is important to seek guidance from Registered Dietitians who above all are trained to provide evidence-based recommendations tailored to individual needs. To learn more about the differences between a Registered Dietitian and a “nutritionist,” read this article on our blog.

Options for eating disorder treatment 

Treatment for an eating disorders requires a comprehensive and multidisciplinary approach. It often involves a team of health care professionals. For example, a care team might include doctors, dietitians, therapists, and psychiatrists. Of course determining whether an individual is struggling with an eating disorder is not a straightforward process. It is therefore best to seek out professional help, by scheduling an assessment with a team of healthcare providers, or starting a conversation with a primary care provider.

The treatment of eating disorders involves a range of care levels depending on the severity and specific needs of the patient. The appropriate level of care depends on various factors. For example, the severity of the eating disorder, physical health status, psychiatric condition, and the person’s ability to engage in treatment are all considered. It is essential for health car providers to conduct a thorough assessment to determine the appropriate level of care for each individual. Consequently the levels of care can be categorized into five different types:

Outpatient Care

Categorized as the lowest level of care, the outpatient level typically involves seeing multiple health care professionals. For example this might include seeing a therapist and a Registered Dietitian on a regular basis, and seeing a primary care provider for check ups to determine medical stability. The outpatient level of care is suitable for individuals with mild to moderate eating disorder symptoms. These patients can manage their daily routines, are working towards recovery, and do not require constant supervision.

Intensive Outpatient Program (IOP)

The IOP level of care is a slightly more structured version of outpatient care that involves more frequent and intensive sessions in a more structured environment. Individuals attend group therapy sessions multiples times per week while still participating in individual therapy and nutrition sessions at least once per week. The IOP level of care is appropriate for individuals with moderate eating disorder symptoms who require more structure than outpatient care.

Partial Hospitalization Program (PHP)

Partial Hospitalization or a “Day Program” is typically a structured five days per week program whereby an individual spends a significant portion of the day at a treatment facility. Therapy and nutrition sessions, in addition to group work, meal support, and some medical monitoring are main components of PHP treatment. This level of care is suitable for individuals with more severe eating disorder symptoms who still do not require 24/7 medical monitoring/supervision.

Residential Treatment

Residential treatment is the second to highest level of care. It involves living at a specialized treatment facility where a patient receives 24/7 comprehensive medical, therapeutic, and nutritional care and supervision. This high level is appropriate for those with severe eating disorder symptoms, medical complications, and/or someone who has not been successful in lower levels of care.

Inpatient Hospitalization

Inpatient Hospitalization is the highest level of care. Individuals with life-threatening eating disorder symptoms or severe medical complications are most appropriate at this level. Meanwhile a patient at this level is admitted to a hospital and receives around-the-clock medical, psychiatric, and nutritional care.

Eating disorder resources

There are readily available resources that can help individuals struggling with eating disorders and disordered eating behaviors. These exist to raise awareness, provide support, and facilitate the recovery process. Here are some of the resources that we recommend:

  • NEDA website: The National Eating Disorders Awareness (NEDA) website provides help and support information. It also offers community forums that provide a safe space to connect with others who have shared similar experiences.
  • Therapy: Therapy and counseling services are essential in the recovery journey. Above all they help individuals address underlying factors contributing to their disorders.
  • Support groups: Eating disorder support groups foster a sense of community and understanding. They also offer a safe space to connect with others who share similar experiences.

How we can help

Eating disorders are serious medical conditions that require professional help for diagnosis and treatment. Recovering from an eating disorder IS possible however.

If you or someone you love is struggling, know that Nourish by Anderson’s Nutrition can help. The Registered Dietitians who work on our Nourish team are trained and experienced. They work with patients and their families throughout the recovery process. They can serve as an invaluable member of a patient’s support team along with doctors, therapists and psychiatrists. Our dietitians are also in network with most major insurance companies.

Schedule an appointment with one of our Registered Dietitian Nutritionists (RDNs) at one of our locations in Arizona, Pennsylvania, or virtually.