What are Eating Disorders?
Anorexia Nervosa
Signs of Anorexia
Bulimia Nervosa
Signs of Bulimia
Binge Eating Disorder
Signs of Binge Eating Disorder
What Causes Eating Disorders
Effects of Eating Disorders
Treatment for Eating Disorders

 

What are Eating Disorders?

Eating disorders and eating disordered behaviours are not rare, they affect thousands of teens (and adults) every year. You may be reading this for information for yourself or a friend. If you are worried about yourself or someone you know, talk to an adult such as a parent (either your own or your friend’s), a teacher, a guidance counselor, a school nurse, or a doctor.

If feel you are not being listened to by the first adult you speak to, don’t give up, listen to your gut instinct and find another adult you trust.

Eating disorders are a group of conditions where you become so focused on food and weight that you have trouble thinking about anything else. People with eating disorders develop extreme behaviours related to eating. These behaviours go beyond dieting or exercising every day to lose weight. They affect every part of your life including your thoughts and feelings and can lead to serious health problems.

Kids and teens who are having trouble with complicated emotional issues such as stress, sadness, loneliness, a sense of unworthiness, depression, insecurity, and pressure to be perfect can develop an eating disorder as a way to deal with the uncomfortable feelings. While it’s more common for females to develop eating disorders, males can too.

The most common eating disorders are anorexia nervosa (or “anorexia”), bulimia nervosa (or “bulimia”) and binge eating disorder. All three of these eating disorders generally start gradually with the intention to lose some weight or get in shape. Unfortunately, the eating behaviours can get out of hand to a point where you feel you can no longer control them.

Anorexia Nervosa

People with anorexia are afraid of gaining weight and see their bodies being much bigger than they really are. Many youth with anorexia limit their food intake by dieting, fasting (not eating at all or eating very little), or exercising excessively. They hardly eat at all and when they do, they obsess over it. These behaviours make it so you can’t maintain a healthy body weight.

Others with anorexia may binge (eat a lot in a short amount of time) and purge (force themselves to vomit), use laxatives (eat foods or take medications that increase bowel movements), use diuretics (medication to increase urination) or exercise excessively, or some combination of these to get rid of the extra calories they consumed from binging.

You may find mealtimes become very stressful since you focus so much on what you can and can’t eat. People with anorexia spend a lot of time thinking about food which makes it difficult to maintain friendships, focus on school work, and other activities they used to enjoy. Relationships with family members also suffer.

Interestingly, anorexia really isn’t about food or weight at all. It is much more complicated than that. Your control over food is a result of something else going on. This could be:

  • depression
  • loneliness
  • insecurity
  • feeling worthless
  • feeling pressure to be perfect
  • feeling out of control

These are all things that won’t go away by dieting or losing weight but some people will try it as a way to take control over something.

Signs of Anorexia

Living with anorexia often means constantly hiding your eating behaviours so others don’t notice something is wrong. There are signs you and people close to you can watch for:

  • weight loss
  • feeling fat even though you are underweight
  • critical of your appearance, always looking for something to criticize about yourself
  • obsessing about eating, food, and weight control
  • obsessing about counting fat and/or calories
  • only eating certain foods and avoiding others for no apparent reason (like an allergy)
  • avoid eating: hiding food, playing with it, throwing it away, or making excuses to get out of meals, for example, “I ate after school” or “my stomach is upset”
  • becoming more irritable
  • weighing yourself repeatedly
  • exercising excessively
  • using diet pills, diuretics (to urinate more), or laxatives (to increase bowel movements)
  • withdrawing from social activities and isolating yourself from friends and family
  • avoiding eating in public
  • depression, no energy, and feeling cold a lot
  • becoming more focused or obsessed with school work

Bulimia Nervosa

Bulimia is a repeated cycle of binging and purging; this means you may eat a lot (often high fat, high sugar foods), and then force yourself to get rid of the food by vomiting, using laxatives, using diuretics or exercising excessively to prevent weight gain. Some people with bulimia may not ‘purge’ or physically get rid of the food; instead they may make up for the binge by fasting (not eating), eating very little, or exercising excessively.

People with bulimia typically feel out of control and can’t stop eating until they are too full to eat anymore. This cycle can be both physically and emotionally dangerous.

Binge eating is different from splurging on pizza and ice cream occasionally then going for a run or to the gym the next day. To be diagnosed with bulimia, an individual must be binging and purging at least twice a week for a couple of months.

Although anorexia and bulimia are similar, people with anorexia are usually very thin and underweight but those with bulimia may be a normal weight or can be overweight. Purging behaviours do not actually prevent weight gain.

Signs of Bulimia:

If you have bulimia, there are likely many things you have done to hide your binging and purging behaviours. Some signs of bulimia are:

  • fear of gaining weight
  • very unhappy with your body size, shape, and weight
  • making excuses to go to the bathroom during meals or immediately after
  • only eat ‘diet’, ‘light’, or low-fat foods (except during binges)
  • regularly use laxatives or diuretics (increases bowel movements and urination)
  • alternate between overeating and fasting
  • spending a lot of time working out trying to work off calories
  • withdrawal from social activities
  • avoid eating in public
  • become irritable
  • eating to the point of physical discomfort
  • wanting to eat alone
  • feel ashamed and anxious after purging episodes
  • “chipmunk cheeks” from repeated vomiting
  • discolored teeth due to repeated exposure to stomach acid from vomiting

Binge Eating Disorder

When someone has binge-eating disorder they frequently eat unusually large amounts of food (usually more than three times per week). We all overeat on occasion, such as having seconds of our favorite meal. But for some people, over-eating occurs regularly, usually done in secret. A person with binge eating disorder does not try to get rid of these calories by purging the food they have eaten like they do with anorexia or bulimia.

Individuals with binge-eating disorder often feel embarrassed and out of control about their eating behaviours. However, the disorder is so strong that they can’t resist the urges and continue binge eating. The feelings associated with these “binges” are often very difficult to cope with.

Signs of binge eating disorder:

Signs to watch for that might indicate a person has binge eating disorder. The individual may:

  • Eat unusually large amounts of food
  • Eat even when they are full or not hungry
  • Eat very fast during binge episodes
  • Eat until they are uncomfortably full
  • Frequently eat alone
  • Feel that their eating behavior is out of control
  • Feel depressed, disgusted, ashamed, guilty or upset about their eating behaviours
  • Experience depression and anxiety
  • Feel isolated and have difficulty talking about their feelings
  • Frequently diet, possibly without losing weight
  • Lose and gain weight repeatedly, also called yo-yo dieting

What Causes Eating Disorders?

Eating disorders are complicated. They stem from a combination of many social, emotional and biological factors. There are many possible contributing factors such as family environment, emotional difficulties, low self-esteem, and previous traumatic experiences.

Many people who develop an eating disorder are between 13 and 17 years old, a time of emotional and physical changes. During these years you are becoming more independent, you may experience peer pressure, pressures to succeed at school, pressures to please others, and pressures to excel in sports or other activities. These pressures can leave you feeling inadequate and worthless inside. Teens often experience a need to feel more in control of their personal freedom and sometimes, their
bodies.

For some, involvement with an activity that requires slenderness such as ballet or gymnastics,feel criticized by others due to the emphasis on appearance. Stressful life events such as puberty, the end of a relationship, or going away to school can also trigger an eating disorder.

There can be societal pressures to be thin. Celebrities portray an unrealistic fantasy where girls are petite and skinny and guys are athletic and muscular. Images are splashed all over television, magazine covers, and social media. As girls and boys go through the normal changes during puberty, it is not hard to see why some teens develop a negative view of themselves.

Family history and biological factors can increase your risk of developing an eating disorder. If a parent or sibling has (or had) an eating disorder, your chances of developing one are higher. Researchers believe there may be a genetic predisposition to developing an eating disorder. Brain chemistry also plays an important role.

Effects of Eating Disorders

Eating disorders are very serious conditions. They often go along with other challenges such as stress, anxiety, depression, and substance use. When your body does not get the fuel it needs to function normally, you can develop serious health problems.

When someone’s body weight is too low, they may not have enough body fat to keep organs and other body parts healthy. In extreme cases, eating disorders can lead to severe malnutrition and even death.

With anorexia, the body goes into starvation mode, and the lack of nutrition can affect the body in many ways including:

  • a drop in blood pressure, heart rate, and breathing rate
  • hair loss and thin fingernails
  • loss of periods or delay of onset
  • lanugo hair (a soft hair that can grow all over the skin)
  • lightheadedness
  •  inability to concentrate
  • anemia (when the level of red blood cells which contain hemoglobin is too low and unable to carry enough oxygen throughout your body)
  • swollen joints
  • brittle bones

With bulimia, constant vomiting and lack of nutrients can cause these problems:

  • constant stomach pain
  • constant sore throat
  • weakness and dizziness
  • damage to the stomach and kidneys
  • tooth decay (from exposure to stomach acids)
  • “chipmunk cheeks,” when the salivary glands permanently expand from throwing up so often
  • loss of periods or delay of onset
  • loss of the mineral potassium (this can contribute to heart problems and even death)

A person with binge eating disorder who gains a lot of weight is at risk of developing the following conditions associated with obesity:

  • diabetes
  • heart disease
  • gallbladder disease
  • high cholesterol (a type of fat in your blood), high blood pressure
  • certain types of cancer
  • osteoarthritis (pain and stiffness of the joints
  •  joint and muscle pain
  • stomach problems
  • sleep apnea (pauses in breathing lasting a few seconds to minutes or shallow breaths while you sleep)

Eating disorders can be emotionally painful as well. It can be exhausting and stressful to focus solely on food, eating, exercise, and how your body looks. This causes your relationships with family and friends to suffer, so too does your school work.

Treatment for Eating Disorders

The longer an individual practices unhealthy eating behaviors the harder it becomes to change them.

The most important thing about treating eating disorders is to address them as soon as possible, if left untreated they can do a lot of damage physically and mentally. It is really important to ask for help as soon as you feel you or a friend is struggling. Fortunately, eating disorders can be treated.

People with eating disorders can get well and gradually learn to eat well again.

Eating disorders involve both the mind and body so doctors, mental health professionals, and dietitians will often be involved in the treatment and recovery process. Therapy or counseling is a very important part of getting better. Family based therapy is one of the keys to developing positive eating behaviors. Support from parents, other family members, and friends is critical for recovery.

The treatment of choice for bulimia is cognitive-behavioral therapy or CBT. CBT focuses on unhealthy eating behaviours and the unrealistic, negative thoughts that are connected to the eating behaviours.

Binge eating disorder is treated with CBT or Interpersonal psychotherapy, IPT. These therapies can teach you to resist the temptation to binge and break the cycle. It will also help you recognize how your eating behaviours are connected with your emotions and develop effective strategies to cope with stress and other emotions.

Learning to be comfortable at your healthy weight is a process. It takes time to unlearn some negative behaviors and relearn some positive ones. Be patient, you can learn to like your body, understand your behaviors related to eating, and figure out the relationship between emotions and eating. It is really important to learn strategies to help you feel in control and to like and accept yourself for who you are. If you want to talk to someone about eating disorders for yourself or a friend but are unable or not
ready to, talk to a parent or close family member, try reaching out to a friend, teacher, school nurse or counselor, coach, neighbor, your doctor, or another trusted adult.