When people think of eating disorders, the most common one that comes to mind is anorexia nervosa, but there are several more sub-classifications of eating disorders that can be more difficult to spot. While anorexia nervosa is the most life-threatening of the eating disorders, the other classifications such as bulimia and binge eating can be harmful as well and have very different signs and symptoms.
An eating disorder is any psychological disorder that involves abnormal eating habits that negatively affect a person’s health, either mentally or physically. Approximately 1.6% of women and 0.8% of men will be affected by an eating disorder in their lifetime, but the exact rates are unclear. Most eating disorders develop in early adolescence to early childhood for a variety of reasons that are not fully understood. Causes are thought to be related to societal pressures, genetics, and childhood trauma. Eating disorders are often co-morbid (co-occuring) with depression, substance abuse, and anxiety disorders.
Bulimia is diagnosed in patients who perform purging after meals. Purging can take the form of intentionally vomiting, excess physical activity, or the use of chemical aids such as laxatives. As opposed to anorexia sufferers, sufferers of bulimia often maintain a healthy weight, because some of the food’s nutrients are absorbed before the food is purged. Bulimia may or may not include the presence of binge eating.
Long-term effects of bulimia can include damage to the teeth, mouth, and throat due to frequent contact with stomach acid. Prolonged use of laxatives or dietary aids can cause permanent damage to the intestinal tract causing constipation and other problems. Compulsive exercise can result in overexertion or exhaustion that potentially lead to physical injuries.
Eating disorders are most common among people in professions that put pressure on them to be very thin, such as dancers, jockeys, models, and athletes. Some people in these professions develop an eating disorder to retain their competitive edge as they age.
Anorexia nervosa is the most lethal psychological disorder. Individuals with anorexia severely restrict their calorie count, resulting in very low body weight. This disorder often develops following a significant life event or a time of intense stress. Women with anorexia will often stop having menstrual periods due to their low body weight. About 5% of individuals with anorexia die from the disorder or its complications in a ten year period.
Binge eating is the act of overeating a large amount of food in one sitting, usually as a coping mechanism for emotional distress. Binge eaters tend to be overweight, as they do not purge after binge eating. They also experience a lack of control and feel as though they cannot stop eating until they are uncomfortably full. Binge eating occurs at least once per week to warrant a diagnosis and involves negative physical, emotional, and societal aspects. Sufferers often binge eat alone because they are embarrassed and feel significant guilt afterward.
There are a variety of other eating disorders that are not classified under any of the disorders listed above. “Other Specified Feeding or Eating Disorder” (OSFED) classified a person who does not meet the criteria to warrant a diagnosis of bulimia, anorexia, or binge eating disorder. For example, a person with anorexia who is not technically underweight despite dramatically restricted eating habits and substantial weight loss cannot be diagnosed as anorexia, so they are diagnosed with OSFED.
Other disorders are not yet included in the DSM (Diagnostic and Statistical Manual of Mental Disorders), such as “drunkorexia”, where a person restricts their food intake to offset the calories consumed in alcohol, or orthorexia nervosa, in which a person obsesses over maintaining a “clean” diet and avoiding unhealthy food to the point of affecting social interaction.