** This subject may be triggering to some, so please exercise caution before reading. **
What Are Eating Disorders?
According to the American Psychiatric Association eating disorders are defined as behavioral conditions that are expressed by severe and persistent disturbances in eating behaviors and associated with distressing thoughts and emotion.
Some types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica and rumination disorder.
Altogether, eating disorders affect roughly 5% of the population. In many cases signs and symptoms begin in adolescence and young adulthood. Some are more common in women, as with anorexia nervosa and bulimia; however, they can all occur at any time and any age. [i]
A Brief Glimpse of Eating Disorder Definitions
Anorexia nervosa: A condition characterised by deliberate efforts to severely restrict food intake (despite low body weight), often to the point of clinical starvation.
Bulimia nervosa: A condition in which someone eats large quantities of food and then purges it via vomiting, exercising excessively just after a binge, or using laxatives, diuretics, or enemas.
Binge-eating disorder: A condition in which someone eats large quantities of food, often in a very short period of time, to the point of discomfort; they may feel that they “lose control” while this occurs.
What Causes Eating Disorders?
There are many reasons someone might develop an eating disorder, but rarely is it about trying to look thin. Many with eating disorders have low self-esteem, and they struggle with past trauma, lack of control over their lives, and feelings of inadequacy, anxiety, or depression.
Things to be Aware of
If you are worried a loved one may be struggling with this, here are a few things too look for. It can often be difficult to know if someone may actually have an eating disorder or is simply concerned about their weight in a culture that is obsessed with dieting. But you can start with the following:
- Starving themselves or restricting their food intake, like eating significantly below normal daily requirements of calories per day
- Acting extremely controlling around food and/or wanting to eat in private
- Exercising excessively
- Purging, including self-induced vomiting or misuse of laxatives, diuretics or enemas
- Spending long, unexplained amounts of time in the bathroom, or needing to run to the bathroom right after each meal
- Consuming a large amount of food very quickly and being unable to stop
- Exhibiting limited spontaneity around food and/or heightened stress around meal time
- Preoccupation with being thin
- Belief they are fat no matter how thin they are
- Hiding their very thin body with big, bulky clothing
- Negative body image and frequent negative comments about their body
- Rigid rules and beliefs about what foods can be eaten and how they should be eaten
- Setting high standards for how successful they are at controlling their weight
- Exhibiting depression or anxiety
- Becoming defensive or irritable when approached about their eating habits
- Acting controlling about letting others see their emotions, or being very restrained in their emotions
- Feeling guilt, helplessness, or low self-esteem
- Rapid or excessive weight loss
- Constantly feeling cold
- Dry, yellowish skin
- Fine hair
- Brittle nails
- Mouth lesions, chronic sore throat, or “chipmunk cheeks” (when the glands on the sides of the jaw enlarge) caused by frequent purging
- Girls with very low weight may not get their periods
Something important to remember is that this is not “girl only” disorder. It is estimated that 20-25% of the total number of people with eating disorders are male.
- Gay men are seven times more likely to report binge-eating and twelve times more likely to report purging than heterosexual men.6
- Gay and bisexual boys are significantly more likely to fast, vomit, or take laxatives or diet pills to control their weight.6
- Transgender college students report experiencing disordered eating at approximately four times the rate of their cisgender classmates.7
- 32% of transgender people report using their eating disorder to modify their body without hormones.8
- 56% of transgender people with eating disorders believe their disorder is not related to their physical body.8
- Gender dysphoria and body dissatisfaction in transgender people is often cited as a key link to eating disorders.7
- Non-binary people may restrict their eating to appear thin, consistent with the common stereotype of androgynous people in popular culture.7
* BIPOC refers to Black, Indigenous, and People of Color
- BIPOC are significantly less likely than white people to have been asked by a doctor about eating disorder symptoms.3
- BIPOC with eating disorders are half as likely to be diagnosed or to receive treatment.2
- Black people are less likely to be diagnosed with anorexia than white people but may experience the condition for a longer period of time.4
- Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, such as binge-eating and purging.3
- Hispanic people are significantly more likely to suffer from bulimia nervosa than their non-Hispanic peers.3
- Asian American college students report higher rates of restriction compared with their white peers and higher rates of purging, muscle building, and cognitive restraint than their white or non-Asian, BIPOC peers.5
- Asian American college students report higher levels of body dissatisfaction and negative attitudes toward obesity than their non-Asian, BIPOC peers.5
You Are Not Alone
Having an eating disorder is a struggle and one that lasts a lifetime. I struggled with anorexia/bulimia when I was a teenager and I still struggle now, as an overweight adult. But having people I can talk to, even if those people are on social media platforms, has made it much more manageable. Knowing you are not alone in what seems to be an insurmountable obstacle can make all the difference. You may continue to struggle with it after the initial healing, but it won’t be as bad. Have faith, think positive and remember that your body is beautiful and treat it kindly.
[i] Guarda, M.D., A., 2022. What Are Eating Disorders?. [online] Psychiatry.org. Available at: <https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders> [Accessed 26 February 2022].
[ii] The Jed Foundation. 2022. Understanding Eating Disorders | JED. [online] Available at: <https://jedfoundation.org/resource/understanding-eating-disorders/?gclid=CjwKCAiAvOeQBhBkEiwAxutUVGRj1AG-XIjCBhBSC2UZgA6b5ZW3NNMOXZBisKzu3nvbclKqsfBTsRoCl48QAvD_BwE> [Accessed 26 February 2022].
[iv] National Association of Anorexia Nervosa and Associated Disorders. 2022. Eating Disorder Statistics | General & Diversity Stats | ANAD. [online] Available at: <https://anad.org/eating-disorders-statistics/> [Accessed 26 February 2022].
[Eating Disorders in LGBTQ+ Populations. (2018, February 21). Retrieved February 22, 2021, from https://www.nationaleatingdisorders.org/learn/general-information/lgbtq
Lauren Muhlheim, L., PsyD, CEDS. (2020, June 20). Eating Disorders in Transgender People. Retrieved February 22, 2021, from https://www.verywellmind.com/eating-disorders-in-transgender-people-4582520
Duffy, M. E., Henkel, K. E., & Earnshaw, V. A. (2016). Transgender Clients’ Experiences of Eating Disorder Treatment. Journal of LGBT Issues in Counseling, 10(3), 136-149. https://doi.org/10.1080/15538605.2016.1177806]
[v] National Association of Anorexia Nervosa and Associated Disorders. 2022. Eating Disorder Statistics | General & Diversity Stats | ANAD. [online] Available at: <https://anad.org/eating-disorders-statistics/> [Accessed 26 February 2022].
[Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
Becker, A. E., Franko, D. L., Speck, A., & Herzog, D. B. (2003). Ethnicity and differential access to care for eating disorder symptoms. International Journal of Eating Disorders, 33(2), 205-212. doi:10.1002/eat.10129
Sala, M., Reyes-Rodríguez, M. L., Bulik, C. M., & Bardone-Cone, A. (2013). Race, ethnicity, and eating disorder recognition by peers. Eating disorders, 21(5), 423–436. https://doi.org/10.1080/10640266.2013.827540
Uri, R. C., Wu, Y., Baker, J. H., & Munn-Chernoff, M. A. (2021). Eating disorder symptoms in Asian American college students. Eating Behaviors, https://doi.org/10.1016/j.eatbeh.2020.101458]