An eating disorder is a mental illness that is characterized by irregular eating behaviors and patterns coupled with concern and distress over body shape and weight.1 People struggling with an eating disorder may use starvation, purging, or other behaviors to control their physical appearance. Although eating disorders typically develop during adolescence, anyone can develop one at any time in their life. Additionally, the stereotype that all people with eating disorders are extremely thin or frail is a misconception. There is a spectrum of different weights that people suffering from eating disorders can be. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) recognizes four disorders as eating disorders.
Table of Contents
DSM V Eating Disorder Categories
The DSM V recognizes the following eating disorders:
- Bulimia Nervosa
Bulimia Overview
Bulimia Nervosa, often times referred to as bulimia, is an eating disorder categorized by a cycle of eating an abnormally large amount of food in a short period of time, or binging, followed by a compensatory behavior.2 Compensatory behaviors may consist of self-induced vomiting, or purging, excessive exercising, fasting, or laxative use to avoid gaining weight from binge eating.2 Individuals with bulimia may participate in compensatory behavior due to overwhelming feelings of guilt after eating. Bulimia affects people of all ages, races, genders, and sexual orientations.
Anorexia Nervosa Overview
Anorexia nervosa, commonly referred to as anorexia, is a life-threatening eating disorder characterized by significant weight loss due to the restriction of calorie intake.3 This extreme weight loss is accompanied by an intense fear of gaining weight, denial of the seriousness of the weight loss, and body dysmorphia.3 Anorexia affects all people regardless of class, age, sex, or race.
Binge Eating Disorder (BED) Overview
Binge Eating Disorder (BED), also referred to as extreme overeating is an eating disorder that involves eating abnormally large amounts of food in short periods of time. The inability to fight the urge to eat is one of the defining aspects of BED. In addition, those who suffer from BED often seek emotional comfort in food for a variety of reasons. Unlike bulimia, those with BED do not purge following a binge. This eating disorder can affect anyone regardless of age, sex, race, or class.
Eating Disorder Not Otherwise Specified (EDNOS) Overview
It is important to note that not everyone has a specific, definable eating disorder such as anorexia, bulimia, or binge eating disorder. Many people suffer from an eating disorder not otherwise specified (EDNOS). EDNOS is a category of eating disorders in which the person does not completely meet all the criteria of a specific eating disorder. It is possible to experience symptoms from more than one disorder and/or experience all but one symptom of an eating disorder. For example, many patients experience the symptoms of anorexia without having a body mass index (BMI) below 15%, which is necessary to diagnose anorexia.4 Many people with eating disorders do not look frail, sickly, or skeletal. There is a wide weight spectrum for people with eating disorders, and therefore you may not be able to know if someone is suffering from an eating disorder simply based on their physical appearance.
Signs of An Eating Disorder
No two people’s experiences with eating disorders are the same, and because of this, each person’s signs and symptoms may vary. That being said, there are some commons signs of eating disorders. Using this list can be helpful for evaluating if you think you may have an eating disorder. Common indicators of an eating disorder include:
- Dramatic or frequent fluctuations in weight
- Preference to make one’s own meals,
- Eating something different from the rest of the family
- Extreme food restrictions
- Excessive body dissatisfaction
- Secretive exercise
- Feelings of guilt after eating
- Frequently weighing self
All of these signs can be an indication that you, or someone you care, about may be dealing with an eating disorder.5 Different eating disorders all have different signs that can help a person to evaluate their own symptoms and behaviors to better understand the disorder they may be dealing with. Seeking professional help will allow a person to receive a medical diagnosis and
professional guidance on how to overcome their eating disorder.
Signs of Anorexia Nervosa:
The following symptoms and behaviors are common in people with anorexia:
- Low body weight – may have dramatic weight loss
- Feels as though they are overweight, even when that is clearly not the case
- Denial of hunger
- Preoccupation with body weight and shape (frequent weighing and comments regarding weight and shape)
- Obsession with food and its nutrients (calories, fat, carbohydrates, etc.)
- Food rituals (cutting into very small pieces, excessive chewing, etc.)
- Excessive exercise and dieting
- Anxiety regarding weight, meal time, and social activities or gatherings
- Frequent fatigue and overall weakness
- Dry, thinning, or loss of hair
- Dry skin and brittle nails
- Frequently cold, wearing multiple layers to hide body or to stay warm
- Downy hair covering body, called lanugo
- Amenorrhea (loss of menstruation in people with uteruses)
A person with anorexia may not show all these signs initially, but instead gather more as their disorder progresses. As the disorder progresses, a person’s preoccupation with their weight intensifies. It creates a cycle: the more weight the person loses, the more that person worries and obsesses about weight.6
Signs of Bulimia
The following signs and symptoms are common in people with bulimia:
- Frequent fluctuations in body weight
- Frequent episodes of binging followed by purging
- Hiding food to eat in private
- Feeling of loss of control during binge episodes
- Feelings of shame and guilt when eating
- Preoccupied with body weight and shape
- Preoccupied with exercise and dieting
- Signs of purging include frequent trips to bathroom (especially after meals), swollen cheeks, cuts or scabs on knuckles and back of hands, discolored teeth and tooth decay
- Withdrawal from social activities and gatherings
Unlike a person with anorexia, a person with bulimia may maintain a normal body weight and appearance despite having an eating disorder.6 Despite this, people with bulimia have similar fears regarding gaining weight and dealing with body dysmorphia. Because people with bulimia may feel ashamed of their disordered behavior, they can become very good at hiding the signs and behaviors of bulimia.
Signs of Binge Eating Disorder (BED):
The following signs and behaviors are common in people with BED:
- Frequent episodes of bingeing (consuming large amounts of food)
- Feeling of loss of control during binge episodes
- Hiding food to eat in private
- Feelings of shame and guilt when eating
- Eating when not physically hungry
- Eating past the point of comfort
- Eating alone
- Unhealthy weight gain
Those dealing with BED, similar to those dealing with bulimia, feel out of control when they binge and feel regret and shame following their binges.6 They can fall into cycles where the more distressed they feel about binging, the more they binge.
You Are Not Alone
If you think you may have an eating disorder, know that you are not alone. Four out of ten individuals have either struggled with an eating disorder themselves or know someone with an eating disorder.1 Eating disorders affect people of all genders, ages, and races. In the United States, nearly 10 million females and 1 million males are currently struggling with an eating disorder.2 It is estimated that 2.7% of adolescents between the ages of 13 and 18 will develop an eating disorder during their adolescence.2
How You Can Seek Help
If you think you may be suffering from an eating disorder, the first and most difficult step is admitting to yourself that you have a disorder. From there, you may reach out to someone and ask for help. Recovering from an eating disorder by yourself can be extremely difficult. It is helpful to begin by confiding in a close friend or family member that you trust and know has your best interest in mind. Admitting that you have a problem to someone else is the first step to recovery and getting help. With the support of this person, the next step is to seek professional medical help. After a thorough evaluation, your doctor can diagnose you and give you resources and advice on the next steps you should take. They can also give you a referral to see another doctor, psychologist, psychiatrist, and other healthcare professionals who are specialized in treating eating disorders. People with severe or life-threatening cases may need to be referred to an in-patient treatment facility or even be hospitalized.
The Recovery Process
The recovery process will most likely require you to change your attitude, thoughts, behaviors, and goals so that you can lead a happy and healthy life. You must be motivated to recover and committed to your recovery. Part of the process includes being able to identify triggers for abnormal eating behaviors and being able to cope with them in a new and healthy way. Support groups have been proven to be effective in aiding in the recovery process. Having the support of family and friends throughout this process can be very helpful in the recovery process. Educating yourself as much as possible about your disorder will also help you on the road to recovery. Reading books, researching on the internet, attending lectures, and speaking to health professionals can all help you educate yourself.. Creating a list of coping mechanisms and activities for difficult times can also be helpful. Some may include:
- Taking a walk
- Taking a bubble bath
- Making a craft
- Writing in a diary/journal
- Reading a book
- Gardening
- Practicing yoga
- Meditating
The journey of recovery will be a very different experience for everyone. Some patients may only take a few months to recover, while others may take years. It has not been shown that the quicker you seek help, the faster your road to recovery will be. Some people are able to fully recover and some never fully recover and instead experience a series of relapses.
Relapse
A relapse refers to a setback in the recovery process. Relapses are a normal part of the process for most people. Although relapses can be incredibly frustrating, you can use them to your advantage by using them to help you identify your triggers. This will help you acquire the skills necessary to help you continue on the journey of recovery. The important thing to remember during a relapse is that you have still come far from where you started; try not to let the relapse make you feel discouraged and give up on your goal of getting healthy. Reflecting back on how far you have come can be helpful in finding the motivation to continue moving forward in the recovery process. Reading other people’s stories about recovery has also been found to be helpful in inspiring individuals to get back on track. Utilize your support system to help you get back on track and keep taking it one day at a time. Eventually you will be back on the road to recovery even farther from where you started.
Resources
If you think you may have an eating disorder there are many resources available. Doctors can provide a variety of resources for you such as referrals, pamphlets, books, websites, and more. Other online help centers and hotlines include:4
Eating Disorders Victoria Helpline Phone Number: 1-(300)-550-236
ANAD Help Line Phone Number: (630)-577-1330
ANAD Help Line Email: anadhelp@anad.org
Support group finder: suportgroups@anad.org
NEDA Hotline: 1-(800)-931-2237
NEDA Crisis Text Line: text “NEDA” to 741741 to connect to a trained volunteer
Concluding Remarks
Many people around the world struggle with eating disorders and not everyone meets all the criteria for a DSM V eating disorder. If you think you have an eating disorder know that you are not alone. There are many resources available to help you on the road to recovery.
References
- “Eating Disorders Victoria.” Eating Disorders Victoria. N.p., n.d. Web. 06 Oct. 2016.
- “Overview and Statistics.” National Eating Disorders Association.
- “About Anorexia: Signs, Symptoms, Causes & Articles For Treatment Help.” Eating Disorder Hope.
- “NIMH » Home.” U.S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 06 Oct. 2016.
- Hudson, Landon. “Warning Signs of Eating Disorders and Proven Treatments to Help”. University of Michigan, Health Blog. 01 Aug. 2018.
- The Eating Disorder Foundation. “About Eating Disorders: Signs and Symptoms”.
- “Eating Disorder Help – Resources for Anorexia, Bulimia & Binge Eating.”Eating Disorder Hope RSS. N.p., n.d. Web. 06 Oct. 2016.
- @anadsupport. “Find Support Groups / Treatment • National Association of Anorexia Nervosa and Associated Disorders.” National Association of Anorexia Nervosa and Associated Disorders. N.p., n.d. Web. 06 Oct. 2016.
Last Updated: March 3, 2022.