Hunger and Eating: Learn It 3—Eating Disorders

Eating Disorders

Eating disorders are serious mental health conditions that are associated with a high risk of physical and psychological complications. Three common eating disorders are bulimia nervosa, binge eating disorder, and anorexia nervosa. Each of these conditions is characterized by an intense preoccupation with food, weight, and body shape. Individuals who suffer from bulimia nervosa, binge eating disorder, and anorexia nervosa face many adverse health consequences (Mayo Clinic, 2012a, 2012b). This page will provide an overview of these conditions, including their symptoms and causes.

bulimia nervosa

People suffering from bulimia nervosa engage in binge eating behavior followed by an attempt to compensate for the large amount of food consumed. Purging the food by inducing vomiting or using laxatives are two common compensatory behaviors. Some affected individuals engage in excessive amounts of exercise to compensate for their binges.

Bulimia is associated with many adverse health consequences that can include kidney failure, heart failure, and tooth decay. In addition, these individuals often suffer from anxiety and depression, and they are at an increased risk for substance abuse (Mayo Clinic, 2012b). The lifetime prevalence rate for bulimia nervosa is estimated at around 1% for women and less than 0.5% for men (Smink, van Hoeken, & Hoek, 2012).

binge eating disorder

Since the 2013 release of the Diagnostic and Statistical Manual, Fifth edition, binge eating disorder is a disorder recognized by the American Psychiatric Association (APA). Unlike bulimia, eating binges are not followed by inappropriate behavior, such as purging, but they are followed by distress, including feelings of guilt and embarrassment. The resulting psychological distress distinguishes binge eating disorder from overeating.

anorexia nervosa

Anorexia nervosa is an eating disorder characterized by the maintenance of a bodyweight well below average through starvation and/or excessive exercise. Individuals suffering from anorexia nervosa often have a distorted body image, referenced in the literature as a type of body dysmorphia, meaning that they view themselves as overweight even though they are not.

Like bulimia nervosa, anorexia nervosa is associated with a number of significant negative health outcomes: bone loss, heart failure, kidney failure, amenorrhea (cessation of the menstrual period), reduced function of the gonads, and in extreme cases, death. Furthermore, there is an increased risk for a number of psychological problems, which include anxiety disorders, mood disorders, and substance abuse (Mayo Clinic, 2012a).

Estimates of the prevalence of anorexia nervosa vary from study to study but generally range from just under one percent to just over four percent in women. Generally, prevalence rates are considerably lower for men (Smink et al., 2012).

Who is most at risk?

While both anorexia and bulimia nervosa occur in men and women of many different cultures, White females from Western societies tend to be the most at-risk population. Recent research indicates that females between the ages of 15 and 19 are most at risk, and it has long been suspected that these eating disorders are culturally-bound phenomena that are related to messages of a thin ideal often portrayed in popular media and the fashion world (Smink et al., 2012). While social factors play an important role in the development of eating disorders, there is also evidence that genetic factors may predispose people to these disorders (Collier & Treasure, 2004).

A photograph shows a very thin model.
Figure 1. Young women in our society are inundated with images of extremely thin models (sometimes accurately depicted and sometimes digitally altered to make them look even thinner). Such images may contribute to eating disorders. (credit: Peter Duhon)

Treatment of Eating Disorders

Treatment for eating disorders often involves a multi-disciplinary approach that combines medical, psychological, and nutritional therapies. Cognitive-behavioral therapy (CBT) is commonly used to address the distorted beliefs and behaviors related to eating, body shape, and weight. Medications such as antidepressants may also be prescribed to treat underlying mental health conditions like depression or anxiety, which are often comorbid with eating disorders.

In more severe cases, hospitalization may be required to manage life-threatening health complications. Nutritional counseling and monitored meal plans are also integral to treatment, aiming to restore healthy eating patterns and nutritional status. Family-based treatment is particularly effective for adolescents, involving the family in the patient’s treatment. Support groups and ongoing aftercare provide additional layers of support. It’s crucial to note that early intervention significantly improves the chances of recovery (National Institute of Mental Health, 2021).