How to Get Help for Different Types of Eating Disorders
Experts provide advice if you or someone you know needs support.
Warning: This article discusses eating disorders, anorexia, bulimia, binge eating disorder, and body dysmorphic disorder.
Despite what the name suggests, eating disorders are more than just having an unhealthy relationship with food. Eating disorders are mental health conditions that are nuanced and complex. There are several types of eating disorders, and the causes for having one are different for each individual. Ahead, find out more about the common types of eating disorders, their symptoms, and the types of treatment available, according to professional doctors.
What is an eating disorder?
"An eating disorder is a mental health condition characterized by chronically severe ways in eating with distressing emotional and thought patterns," California-based clinical psychologist and author of the book Joy from Fear, Dr. Carla Marie Manly, tells HelloGiggles. She further explains that eating disorders involve persistently focusing and worrying about food, body weight, body image, calories, and at times, exercise.
Someone with an eating disorder will engage in a particular eating pattern, while their concern with food can have negative impacts on other areas of their life, such as at work or in relationships. "The individual is often aware of the unhealthy pattern of consuming food but unable to alter the pattern without professional help," says, clinical psychologist, Dr. Joshua Klapow.
There are different types of eating disorders, but generally speaking, the physical ramifications of eating disorders can harm the heart, digestive system, bones, teeth, mouth, and lead to other diseases, reports the Mayo Clinic. "In eating disorders, food is not viewed as a source of healthy nutrition and sustenance; food becomes a devilish friend-turned-enemy," says Dr. Manly.
What causes an eating disorder?
According to Dr. Manly, eating disorders are thought to be a result of a combination of genetic and environmental factors. "Eating disorders may be triggered by stressful or traumatic life events and often co-occur with other mental health disorders such as OCD (obsessive-compulsive disorder), substance abuse, and anxiety," she says.
Dr. Klapow also explains that one can have a genetic predisposition for an eating disorder. Similarly, how your family interacts with food in your own home can offset a negative relationship with food. For example, he says, parental modeling of unhealthy eating patterns, the use of food by parents as punishment or rewards in a highly restrictive manner, or unrealistic expectations about weight and physical appearance placed by family or society, can all trigger an eating disorder.
What are the types of eating disorders?
1. Binge Eating Disorder (BED)
Binge eating disorder is characterized by chronic episodes of consuming large amounts of food in a short period of time, says Dr. Manly. "The individual may eat normally and then have a night a week where they binge either to satisfy a compulsion or as a form of self-punishment for other factors in their life," adds Dr. Klapow. Typically, someone will hide the fact that they binge and when they do, they'll eat to the point of physical discomfort, which is then followed by feelings of guilt and regret. Unlike other eating disorders, there is no compensatory behavior after the binge, such as self-induced vomiting, exercising, or fasting.
The symptoms of binge eating disorder can include binges at least once per week, eating large quantities of food even when you aren't hungry, eating in private to avoid feeling embarrassed or guilty, eating quickly, and being overcome with feelings of guilt, disgust, or depression after an episode. According to the National Eating Disorders Association, almost three million people have binge eating disorders, making it the most common eating disorder in the United States.
In terms of treatment for binge eating disorders, there is no one approach. "In all eating disorders, a multidisciplinary approach is ideal," says Dr. Manly. "This involves a team of professionals including a medical doctor, psychologist, dietician, and psychiatrist." The therapies used can range from cognitive behavioral therapy, interpersonal therapy, family therapy, and psychopharmacology, which uses antidepressants or appetite suppressants in its approach.
2. Anorexia Nervosa
According to Dr. Manly, anorexia nervosa involves self-starvation resulting in weight loss that is 15 percent or more below the normal weight expected for height, developmental stage, and age. There are two types of anorexia nervosa, including a restricting type, which involves weight loss via fasting, dieting, or compulsive exercise. Then, there's the binge-eating/purging type, which involves occasional purging or binging behaviors. There's a fear of food and weight gain, explains Dr. Klapow. "Without intervention, the condition can cause permanent physical damage and in some cases be lethal," he says.
Physically, anorexia can cause issues like abnormal blood counts, irregular periods and heart rhythms, teeth erosion, dehydration, insomnia, and more. "Treatment is usually a combination of inpatient hospitalization to help restore the individual's physiological health and monitor for metabolic consequences. Once stabilized, intensive behavioral and cognitive therapy to help the individual regain normal eating habits ensues," says Dr. Klapow.
3. Bulimia Nervosa
"Bulima nervosa involves intermittent, low-calorie dieting followed by binging on higher-calorie or 'off-limits' foods," explains Dr. Manly. "Binging is followed by compensatory behaviors such as vomiting, laxative misuse, fasting, or excessive exercise in hopes of preventing weight gain or reducing weight."
Similar to anorexia nervosa, an individual dealing with bulimia will be very concerned with their perception of body image and shape. Those who suffer from bulimia may weigh differently, ranging from average weight to obesity, which is why many families or friends may not be aware of the disorder. Key symptoms of bulimia include recurrent diarrhea, misuse of diuretics, laxatives, or diet pills, bathroom use directly after eating, chronic sore throat, dental decay, heartburn or acid reflux, missing food, and periods of restricted eating or dieting, explains Dr. Manly.
Dr. Klapow says there is a lesser-known subcategory of bulimia called exercise bulimia, which is when someone will endure extreme exercise to work off a binge. For example, "an individual may work out for hours at a time after eating dessert or work out every day for three hours a day because they feel guilty about eating," he says. "Treatment for these disorders focuses on restructuring the individual's relationship and perspective on food and gives them healthier intake targets to not restrict them, but also not to overindulge," says Dr. Klapow.
4. Body Dysmorphic Disorder
Body dysmorphic disorder is a mental health condition where a person can't stop thinking about their perceived flaws and body image. "The person literally sees themselves as physically different than the rest of the world, despite all objective indicators suggesting this is not the case," says Dr. Klapow. The intense focus on body image can cause significant distress and prevent you from functioning in your daily life.
According to the Mayo Clinic, some other symptoms of this disorder are a strong belief that you have a defect in your appearance that makes you ugly or deformed, engaging in repetitive behaviors that "fix" your flaws, constantly comparing your appearance to others, and having perfectionist tendencies. "Learning to redefine their food requirements and judge them based on an image they see is the main focused of intervention," says Dr. Klapow.
What's the first step in getting help for an eating disorder?
"As a leading, often-ignored mental health issue, eating disorders are costly to individuals' psychological and physical health," says Dr. Manly. The first and best thing one can do if they're dealing with a disorder is seek professional help. "It can be wise to begin the process by having a full physical examination with your primary care provider followed by a referral to a skilled psychotherapist," she says. Once you find a psychotherapist, they will diagnose you with a disorder depending on the symptoms shown and then work with you to find the best treatment option for you.
If you or someone you know is struggling with an eating disorder, please visit the National Eating Disorder Association (NEDA) for more information and support, or text "NEDA" to 741-741.