Understanding Eating DisordersEating disorders are serious mental and physical illnesses that involve disturbances in eating thoughts and behaviors. This can include restricting one’s food intake and/or compensating for intake through purging, over-exercising, laxative abuse, or other harmful behaviors, with the goal of reducing one’s body shape or size.
This can also involve feeling out of control around food, eating larger amounts of food in one sitting than feels nourishing, and experiencing high levels of guilt and shame for these behaviors. Eating disorders can affect any person– regardless of body size, race, culture, socioeconomic status, or gender identity.
Eating disorders are, unfortunately, one of the deadliest of all mental illnesses, second only to opioid overdose. While the typical image we see in the media of someone with an eating disorder involves being in a thin and frail body, only 6% of people with eating disorders are medically considered “underweight.”
As a result, it is common for people to go without treatment or to experience delayed treatment, despite the fact that the sooner one receives treatment, the better the prognosis. Here are some of the common symptoms to be aware of that may indicate an eating disorder:
Those suffering from eating disorders often experience constant “food noise.” This is when food, eating, or other related concerns – such as how food affects one’s body weight, shape, or size – take up a significant portion of daily thoughts and lead to high levels of distress.
If food or body thoughts are taking you or your loved one away from essential aspects of life, such as focusing on work or school or enjoying hobbies and relationships, this may be a sign focus on food has become excessive.
Some decide to make dietary changes based on values or ethics, for example, becoming vegetarian for environmental or animal rights concerns. However, these dietary changes could also be used to mask abnormal eating behaviors. For instance, avoiding carbs, gluten, or animal products can also make it easier to avoid eating certain foods when in social situations – those deemed “unhealthy” or “bad.” It can be helpful to ask yourself about your intentions before making any sudden dietary changes.
Those suffering from disordered eating may feel uncomfortable eating around others due to fear of judgment (related to their own preoccupations with food and body) or fear of being pressured to eat more than they want or to eat specific foods. If you or your loved one suddenly withdraws from social events involving food, consider this as a potential sign there may be an eating disturbance occurring.
Food has calories, and calories are our body’s main energy source – this can be easy to forget in today’s dieting-focused culture – “calorie” has almost become a bad word! Therefore, if someone is restricting food, this is going to affect their fuel reserves negatively. This can lead to energy conservation – the body’s attempt at saving remaining fuel reserves for essential processes needed to keep them alive. This doesn’t leave enough energy to fuel optimal brain function, which can lead to poor concentration, low mood, and overall inability to carry out one’s usual daily tasks.
When someone isn’t eating enough at meals or isn’t eating regularly (it’s recommended to eat about every 3-5 hours), this can significantly impact digestion. The movement of food through the digestive system will slow down, and the stomach will produce less acid (or overproduce acid when a meal does finally enter the system). This can lead to constipation, abdominal cramping, bloating, acid reflux, and other gastrointestinal-related problems, and these symptoms can cause a lot of distress as well as further hinder eating.
Those who struggle with eating often tend to compensate for perceived transgressions with food to avoid weight gain, to “balance out” energy intake, or to reduce guilt. One way this can manifest is through excessive exercise routines. Some signs of being overly rigid with activity include if it is difficult or impossible to take rest days – or you are riddled with guilt and food thoughts when you do – or if you tend to push exercise despite unsafe weather conditions, illness, or injury.
The recently coined term “orthorexia” has been used to describe an extreme focus on ingredients. It is, of course, okay to want to eat in a healthful manner and to take care of and nourish your body, but this can quickly take an unhealthy turn if it becomes an inability to eat anything except for a narrow group of foods that are deemed “healthy” or “clean.” This could lead to guilt when eating foods that are not deemed clean, not eating enough calories overall, or missing out on key nutrients due to cutting out food groups.
Significant and sudden weight changes can indicate that someone struggles to maintain a consistent eating routine. Not only is criticizing weight gain damaging but so too is complimenting weight loss – you never know what is going on behind the scenes or what has caused those weight changes.
As mentioned above, when energy intake is consistently low, the body slows down all non-essential processes to conserve energy. This can include a reduction in blood pressure or heart rate so that the heart muscle isn’t working as hard (leading to dizziness when sudden changes occur with standing), cold hands and feet due to the body prioritizing keeping your core warm but not the extremities, and hair loss – because protein is more essentially needed in other bodily processes!
Of course, with all these internal battles and physical symptoms occurring, it’s no wonder why someone may become withdrawn from their friends or loved ones. Eating disturbances can also co-occur with other mental health conditions, such as anxiety and depression, making reaching out for help all the more challenging.
Additional References on Eating Disorders:
https://anad.org/eating-disorders-statistics/
https://www.nationaleatingdisorders.org/what-are-eating-disorders
Article by Adrienne Dink, MS, RD, LDN