Mayuri Bhakta
FNP-BC Medcor Provider

Eating disorders affect people of all walks of life. According to national surveys, about 20 million women and 10 million men will experience an eating disorder at some point in their lives. Eating disorders are serious; if unrecognized and untreated, eating disorders can cause severe health problems and even death. While there are many types of eating disorders, the three most common types of eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. Let’s look at their common features as well as their important distinctions.

What are Risk Factors for Developing an Eating Disorder?

  • Family history of eating disorder
  • Family history of mental health disorders such as anxiety, depression, or addiction
  • Personality traits such as perfectionism (anorexia) or impulsivity (bulimia)
  • Low self esteem
  • History of strict dieting and focus on weight loss
  • Weight stigma and/or teasing or bullying about weight
  • Limited social support
  • History of trauma from abuse, rape, or death of a loved one
  • Depression, anxiety disorders, or substance abuse

What is Anorexia Nervosa?

Anorexia nervosa is a potentially life-threatening disorder in which a person has an abnormal body image and fear of weight gain. People who suffer from anorexia severely limit their food intake to prevent weight gain. This “self-starvation” can cause people to be deprived of nutrients the body needs to function.

Signs and symptoms of anorexia include:

  • Weight loss
  • Feeling cold
  • Obsession with food, weight, dieting and calorie-counting
  • Cutting out whole food groups
  • Lack of hunger
  • Constipation or reflux
  • Lack of energy
  • Headaches
  • Lack of concentration
  • Significant fear of becoming “fat”
  • Loss of menstrual cycles
  • Dizziness or fainting
  • Dry skin and nails and thinning, dry, brittle hair
  • Fine hair on the body
  • Poor immune system function
  • Low blood pressure and heart rate
  • Abnormal lab findings such as anemia, low thyroid levels, low blood counts, and abnormal electrolytes
  • Cavities or abnormal teeth

What is Bulimia Nervosa?

Bulimia nervosa is also a potentially life-threatening disorder; it is characterized by binge eating and purging episodes. People may eat unusually large amounts of foods and then purge by vomiting, taking laxatives, fasting, exercising excessively, or combining one or more of these behaviors. People who are bulimic may be underweight, normal weight, or overweight.

 Signs and symptoms of bulimia nervosa include:

  • Recurrent episodes of binge eating
  • Eating large amounts of food in a two-hour period which is more than most people would eat in that timeframe
  • Lack of control of eating during a binging episode
  • Recurrent purging behaviors such as self-induced vomiting, taking laxatives, fasting, taking diuretics, or exercising excessively
  • Disappearing after meals, usually to the restroom
  • Episodes of this behavior occurs once a week for at least three months
  • Shows real concern about body weight and shape
  • Discolored or stained teeth, from vomiting
  • Excessive use of mouthwash or mints
  • Developing food rituals such as chewing too much, not allowing foods to touch, eating only certain food groups
  • Development of calluses to the backs of the hands and knuckles from vomiting
  • Fluctuations in weight
  • Difficulties concentrating
  • Dry skin, hair, and nails
  • Poor immune system function

What is a Binge Eating Disorder?

Binge eating disorder is the most common eating disorder in the United States. It occurs when someone repeatedly eats large quantities of food. They may feel a loss of control while eating and may experience shame or guilt after binging. People with binge eating disorder do not purge. Binge eating  is potentially life-threatening.

Signs and symptoms of binge eating disorder include:

  • Eating large amounts of food in a two-hour period which is more than most people would eat in that timeframe
  • Loss of control while binge eating
  • Eating faster than normal
  • Eating until uncomfortable
  • Eating alone
  • Eating large amounts of food when not hungry
  • Feelings of disgust, guilt, or depression after binging
  • Binge eating episodes occurring at least once a week for three months
  • New practices with food such as cutting out food groups or fad dieting
  • Fear of eating in public or around others
  • Concern about body weight and shape
  • Changes in weight
  • Low self-esteem
  • Developing food rituals such as chewing too much, not allowing foods to touch, eating only certain food groups
  • Difficulty concentrating
  • Clinical obesity

What Kind of Health Problems Can Result from Eating Disorders?

Eating disorders can cause life-threatening conditions. They can affect every organ system in the body.

Effects on the heart:

  • If you are not eating enough calories, your body can begin to break down its own tissue as an energy source. This can lead to low heart rate and blood pressure and can increase the risk for heart failure.
  • Vomiting and diarrhea from using laxatives can result in the loss of electrolytes. Electrolyte imbalances can lead to abnormal heart rhythms and possible strokes or heart attacks.

Effects on the gastrointestinal system:

  • Digestion issues including slowed digestion, stomach pain and bloating, nausea and vomiting, and constipation can occur from food restriction and vomiting.
  • Blockage of the intestines can result in infections or perforations and rupture.
  • Lack of caloric intake and purging can lead to pancreatitis (inflammation of the pancreas).
  • Binge eating can cause life-threatening stomach rupture.
  • Vomiting can also cause sore throat and swelling to the salivary glands and jaw. It can also lead to wearing down of the esophagus and rupture of the esophagus.

Effects on the brain and nervous system:

  • Lack of nutrients can decrease the energy the brain needs, resulting in problems with concentration.
  • Difficulty with falling and staying asleep can occur with hunger and being very full.
  • Lack of fat intake can cause numbness and tingling in the feet and hands.
  • Low electrolytes from self-starvation or purging can lead to muscle cramps or seizures.
  • Headaches, fainting, and dizziness can occur when the brain is not getting enough blood flow.

Effects on the endocrine system:

  • Low hormone levels such as thyroid, estrogen, and testosterone can occur because the body may not be getting enough fat and cholesterol to make these hormones.
  • Irregular menstrual cycles or loss of menstrual cycles can occur due to changes in hormone production.
  • Decreased bone loss can occur because of low estrogen and testosterone levels.
  • The body’s metabolism will decrease in order to save energy.
  • Binge eating can cause insulin resistance and increase the risk of diabetes.

Other effects on the body:

  • Skin can become dry and brittle from the loss of nutrients, fat, and proteins.
  • Fine body hair, called lanugo, can form to help conserve warmth during starvation.
  • Severe and recurrent dehydration can lead to kidney failure.
  • Malnutrition can also lead to decreased white and red blood cells.

Treatments and Therapies

It is important to recognize signs and symptoms of an eating disorder and to get help soon. Complete recovery is possible, but the longer a person has an eating disorder, the harder it is to break away from it and the more health risks they face. In addition to the severe medical complications mentioned above, people with eating disorders, especially anorexia, are at high risk for death by suicide. Treatment plans vary from person to person but usually consist of medical care and monitoring, medications, nutrition counseling, and psychotherapy. Treatment with a mental health professional is necessary and may be required long-term as interpersonal issues may contribute to eating disorders. Mental health professionals may ask that family members or significant others be involved in the therapy to help with treatment success.

This article is not intended to diagnose or treat any condition or to give medical advice. Always consult your primary care provider for healthcare instructions. External links are provided as references and do not indicate an endorsement by Medcor. External links are subject to other sites’ terms of use and privacy policies.

References

American Psychological Association, “Eating Disorders,” https://www.apa.org/topics/eating-disorders

National Eating Disorders Association, “Anorexia Nervosa,” https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia

National Eating Disorders Association, “Binge Eating Disorder,” https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

National Eating Disorders Association, “Bulimia Nervosa,” https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bulimia

National Eating Disorders Association, “Common Health Consequences of Eating Disorders,” https://www.nationaleatingdisorders.org/health-consequences

National Eating Disorders Association, “Risk Factors,” https://www.nationaleatingdisorders.org/risk-factors

National Eating Disorders Association, “Warning Signs and Symptoms,” https://www.nationaleatingdisorders.org/warning-signs-and-symptoms

National Institute of Mental Health, “Eating Disorders,” https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml