Eating Disorders: Shapes and Sizes
On researching my last post about the eating disorder demographic, I found that the information I gathered was very much centred on Anorexia Nervosa and Bulimia Nervosa. These disorders are a big problem, of course, and are very dangerous- however, I found myself wanting to create a post which explained not just these “well-known” disorders, but other types of ED as well. It seems that the lack of information about the variety of disorders which exist could make sufferers feel more isolated- as well as the common misconception that everyone who is diagnosed with an ED must be dangerously underweight.
ANOREXIA NERVOSA (ANA)
Anorexia Nervosa is characterised by a refusal to or an unwillingness to eat. It can occur in all ages and genders, but disproportionately affects preteen/teenage girls and young women. This is generally considered one of the most dangerous and shocking eating disorders, due to the dramatic weight loss often experienced by sufferers. According to the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, there are four criteria which must be present for a diagnosis of Anorexia Nervosa.
– A refusal to or an inability to maintain minimum “normal” weight for age and height range, resulting in a body weight 15% lower than expected.
– An intense fear of gaining weight or becoming overweight; even if the sufferer is underweight.
– Flawed self-perception and an inability to accept the seriousness of their current condition.
– Amenorrhea must be present (this is the absence of three or more menstrual cycles where they can be expected to occur).
Chances are, when one thinks of an eating disorder, they think of Anorexia- understandably. The condition is very dangerous, with around 20% of cases resulting in death 20 years after onset. However, it is not- as many people are led to believe- the only serious eating disorder.
BULIMIA NERVOSA (MIA)
Bulimia Nervosa is characterized by cyclical bingeing and purging episodes. Bingeing is typically eating more than a person normally would in a very short space of time, accompanied by feelings of guilt or a lack of control over food consumption. Purging can involve induced vomiting, laxative abuse, excessive exercise and fasting. Bulimia Nervosa exists when bingeing and any type of purging behaviour occurs on average 2 times weekly or more for a period of at least 3 months. These tend to be accompanied- as in Anorexia- with flawed self-perception and an intense fear of becoming overweight.
Binge Eating Disorder is newly-recognized and is characterized by recurrent episodes of binge eating that occur twice weekly or more for a period of at least six months. As with Bulimia Nervosa, the sufferer tends to feel a lack of control when eating large amounts of food over a short period. In BED, bingeing episodes are associated with at least three common features- such as eating until uncomfortable, eating when not physically hungry, eating very quickly, eating alone for fear of being embarrassed by how much food is being consumed, or feeling disgusted, depressed or guilty after the episode of overeating. However, although these behaviours still cause distress, they are not associated with compensatory methods of purging. As a result, BED sufferers often present as overweight or obese.
EATING DISORDER NOT OTHERWISE SPECIFIED (EDNOS)
According to the Diagnostic and Statistical Manual there is a category of eating disorders that do not meet the specific criteria for the two defined disorders- Anorexia Nervosa and Bulimia. People with this diagnosis tend to show signs of disordered eating but do not meet all the criteria for Anorexia Nervosa or Bulimia. Over one-half to two-thirds of people diagnosed with eating disorders fall into the category of EDNOS- more people are diagnosed with EDNOS than Anorexia and Bulimia combined. A person meets the definition of having EDNOS if they exhibit all the criteria for Anorexia Nervosa but have regular periods or a normal body weight, or if they exhibit all the criteria for Bulimia but purge less than two times per week or for a shorter duration, if they spit out food instead of swallowing, or if they purge only small amounts of food.
EDNOS is just as serious as the other diagnosed disorders- the only real difference being that they may have features from more than one disorder, show some features of a diagnosed disorder but not all, or their symptoms may vary over time. EDNOS can still be a serious threat to the sufferer’s health, however, and should be taken as seriously as Anorexia or Bulimia.
Although not formally recognised by most medical professionals, Anorexia Athletica is commonly referred to in medical literature as a disorder characterised by compulsive over-exercise. People suffering from Anorexia Athletica may engage in both excessive workouts and exercising as well as calorie restriction. This puts them at risk for malnutrition, even if they are eating their RDA of calories- as the excessive exercise requires an increased calorie diet. Symptoms of Anorexia Athletica may include over-exercising, obsession with calories, fat, and weight, an obsession with phsycial fitness and performance and a lack of pleasure from exercising. It may become more of a compulsion than a conscious decision.
Pica is a disorder characterised by eating non-food items (such as coal, chalk, dirt etc) at an age where it is not generally considered appropriate. Is more common in women and children, and can stem from an iron deficiency or chemical inbalance- although it can be a compulsion with no rational explanation. It can be potentially dangerous, as ingesting some items can lead to parasites, stomach tears and intestinal obstructions. Many cases of pica have been tied to the obsessive-compulsive spectrum, but this is not exclusively the case. If you experience pica, it may be an idea to see your doctor- as you could be suffering from a lack of important minerals, or could damage yourself internally in several ways.
I hope that this post serves to open your mind to the idea of there being more than two serious eating disorders- and if you’re a sufferer, that people understand that you exist no matter what your ED is. Someone can be fat, thin, or anything in-between- but anyone can have an eating disorder, and it’s an important thing to remember.
Would you like to share your story? Is there anything I have missed? If so, please leave a comment below. If you need to talk to someone about your eating disorder, see your doctor or contact a charity such as Young Minds to discuss your problem.
IMAGE CREDIT: Wikimedia Commons