Eating Disorders

An eating disorder is a medical illness caused by a disturbance in eating or exercising habits or body image that negatively affects a person's overall health.  Eating disorders are often characterized by severely limiting food intake or excessive overeating.  Sometimes exercise, vomiting, laxatives, or diuretics are used to eliminate food and calories from the body after an individual has eaten, or binged.  Although there are other types of eating disorders, the three main types of eating disorders are:

• anorexia nervosa,
• bulimia, and
• binge eating.

More common than eating disorders is disordered eating.  Disordered eating is similarly characterized by ritualistic eating habits, body image issues, and changes in eating habits that are less severe than an eating disorder.  Disordered eating can be a precursor to developing an eating disorder.

What are the signs and symptoms of eating disorders?

Eating disorders are generally kept secret.  A common misconception is that everyone with an eating disorder is visibly skinny or at a low body weight.  Look for these signs and symptoms:

• Seeing dramatic loss of weight in a short period of time
• Being preoccupied with weight which can manifest itself through calorie counting, obsession with exercise, and constant complaining about weight despite weight loss
• Eating food ritually by taking tiny bites, ignoring certain food groups, rearranging food on the plate, skipping certain meals altogether, or pretending to eat the food
• Eating alone, or avoiding meals altogether
• Using laxatives, diuretics, ipecac syrup, enemas, or smoking to purge food and/or suppress appetite
• Wearing big or baggy clothes or dressing in layers to hide body shape and/or weight loss
• Making frequent trips to the bathroom immediately following meals 
• Having low self-esteem
• Fearing a loss of control when eating, and/or inability to stop eating once started

What are the causes of eating disorders?

While there is no one single cause or predisposition that will necessarily lead to an eating disorder, the following are characteristics that many individuals with eating disorders exhibit:

• Low self-esteem
• Stress, leading to a need to be in control of something
• Exposure to friends and family members that criticize weight and body image
• Family members that have had, or currently have an eating disorder
• Internalized societal and media image of beauty as skinny

Treatment

Early diagnosis and intervention are important for recovery from an eating disorder.  Eating disorders can become chronic and life-threatening if not identified or treated in their early stages.  Treatment of eating disorders involves a multi-faceted approach that is often tailored specifically on an individual basis.  Most treatments involve forms of psychotherapy and psychological counseling in connection with supplying medical and nutritional needs to the patient.  Counseling, medical, and nutritional help should always be given by a health care professional.  Relapse rates from eating disorders are estimated at 30 – 50%, so continued attention should be given after the disorder has initially been treated.

Self-Care/Prevention

To help prevent eating disorders in yourself and others, you can:

• Educate yourself about eating disorders including their symptoms and causes
• Do not oversimplify or downplay eating disorders as an addiction to food, a way for an individual to have attention drawn to themselves, or only a woman's issue
• Do not put yourself in situations or spend time with individuals that make you feel uncomfortable about your body or body image
• Understand social and psychological factors in society that influence eating disorders such as media, the idea that skinny is better, etc.

When should I see a health care provider?

It is important that treatment for eating disorders be provided by a health care provider.  If you are constantly preoccupied with food, body image, or exercise, consider contacting a health care provider.

Helping someone that may have an eating disorder

Helping an individual with an eating disorders involves trying to engage them in an open dialogue about the issue at hand with the goal of them getting help from a health care professional.  When deciding whether to discuss these issues with someone, think about your relationship to the individual.  Does he or she consider you a close, trusted, and appropriate person to confront them about this issue?  When confronting someone with an eating disorder, consider these suggestions:

• Educate yourself on eating disorders and available resources beforehand
• Choose a time free of distractions and divorced from the issue at hand (ie. not during meals or exercise)
• Avoid criticism and judgment.  State what you have observed that has led you to believe they may have an eating disorder
• Be prepared for a variety of reactions such as crying, anger, and denial.  Do not take these reactions personally
• If the individual does not want to seek help and/or continues to deny an eating disorder, explain that you are still concerned and are hoping, and available to talk to them about the issue again

Additional resources

• Articles about Healthy Eating (Campus Blues)
• Eating Disorder Survival Guide (National Eating Disorders Association)
• Kids and Eating Disorders (KidsHealth)
• What Should I Say—Talking to a Friend with an Eating Disorder  (National Eating Disorders Association)

University of Washington Resources

• Committee on Eating Disorder Awareness (CEDA)  (ASUW)
• Hall Health Mental Health Clinic
• University of Washington Counseling Center (Schmitz Hall)

Citations

Eating Disorders Can Be Prevented!  National Eating Disorders Association.  2006.  Available at:  http://www.nlm.nih.gov/medlineplus/eatingdisorders.html.  Accessed April 14^th, 2007.

Eating Disorders: Facts About Eating Disorders and the Search for Solutions.  National Institute of Mental Health.  February 2^nd, 2006.  Available at:  http://www.nimh.nih.gov/publicat/eatingdisorders.cfm.  Accessed April 14^th, 2007.

Eating Disorders:  Helping a Friend.  University of Wisconsin-Eau Claire Counseling Services.  April 11^th, 2007.  Available at:  http://www.uwec.edu/Counsel/pubs/helpafriend.htm.  Accessed May 4^th, 2007.

Eating Disorders: Helping a Friend.  Villanova University.  Available at:  http://www.villanova.edu/studentlife/counselingcenter/infosheets/psych_topics.htm?page=friend_eating_disorders.htm.  Accessed May 4^th, 2007.

Know the Signs of Eating Disorders.  Medline Plus, National Institute of Health.  Available at:  http://www.nlm.nih.gov/medlineplus/news/fullstory_44775.html.  Accessed April 14^th, 2007.

What Are Eating Disorders?  Harris Center, Massachusetts General Hospital. 2006.  Available at:  http://www.harriscentermgh.org/.  Accessed April 14^th,  2007.

Authored by:  Jeff Stallman, Peer Health Educator
Reviewed by:  Rebecca Greenberg, PsyD