What are Bulimia, Anorexia, & Eating Disorders?
Ranging from starvation diets to gluttony, eating disorders refer to eating patterns that are somehow destructive in nature. There are many different forms of eating disorders including well-known anorexia nervosa, bulimia nervosa, binge eating, and eating disorders not otherwise specified (EDNOS). Eating disorders are severe conditions that affect both physical and mental health. Patterns of disordered eating behaviors can quickly become set in the mind.
Symptoms of eating disorders vary significantly with the individual and with the form of eating disorder they have. Negative and distorted self-image is common, as are preoccupations with food, social withdrawal, low self-esteem, depression, and the like. Weight alone cannot be used to gauge whether a person has an eating disorder. Conventional wisdom said that individuals with anorexia were always thin, but research and statistics from the National Institute of Mental Health reveal that an eating disorder relates to the pattern of behavior, not the outward physical results.
Types of Eating Disorders
There are many types of eating disorders, ranging from those with a clinical definition to those that are undefined but are unhealthy and unsafe nonetheless. Some of the most common types of eating disorders include:
Anorexia is one of the most well-known eating disorders and is characterized by self-starvation. People with anorexia typically experience dramatic weight loss and have a strongly distorted self-image where they seem themselves as being fat or overweight even when the opposite is true. For people with anorexia, the idea of being “fat” is torture, and they will do anything to prevent weight gain. People with anorexia are incredibly focused on their body, including their weight, their measurements, and their shape. When a person has anorexia, they often become obsessive about weighing and measuring themselves and tracking their progress. The slightest upward fluctuation in weight can feel like a devastating setback.
In addition to being noticeably thin, there are many other physical symptoms associated with anorexia, some of which are:
- Soft, downy body
- Facial features like the eyes or cheeks that appear to be sunken or hollow
- Dark under eye circles and yellowish skin
- Absence of menstrual periods
- Dizziness and fainting
- Hair loss
- Irregular heartbeat
- Low blood pressure
Bulimia is another commonly known eating disorder. Bulimia is characterized by bingeing eating and either purging afterward (purging bulimia) or extreme starvation and exercise after (non-purging bulimia). A typical cycle of bulimia involves self-starvation followed by extreme binge eating. After bingeing, a bulimic will attempt to undo their actions through self-induced vomiting, abusing laxatives, or intense exercise beyond what is normal. Bingeing often involves eating in secret and consuming excessive amounts of food in a short period. In many cases, bulimics will binge on high-calorie foods that they would typically avoid, like sweets, junk food, and carbohydrates. When a person is bingeing, they feel that their eating is out of control and they will eat until they are uncomfortably full.
Bulimics do not necessarily appear as being abnormally thin. They can fly under the radar because they may look normal and may sometimes eat meals socially with family and friends when in public. However, after eating, a bulimic will attempt to purge or starve themselves even if the meal was healthy or was not a significant binge. Bulimics diet and exercise frequently and have an unhealthy distortion of what they really look like. Eating food and not being able to get rid of it through purging and exercise can be torturous for someone who is obsessed with controlling the calories that go into their bodies.
Constant vomiting and laxative use take their toll on the body, with some of these physical symptoms of bulimia:
- Damaged teeth and gums from stomach acid exposure during vomiting
- Sores on the knuckles of the hands from inducing vomiting
- Swollen cheeks
- Raspy voice or hoarseness
Binge Eating Disorder
Binge eating disorder is also referred to as compulsive overeating. With this condition, a person will go through periods of uncontrollable eating to the point of being painfully full. When bingeing, people will go beyond what’s considered to be an indulgence for most people. Instead of treating yourself to one donut, a person with binge eating disorder will eat the entire box, followed by feelings of shame and guilt.
People with a binge eating disorder do not purge after eating, but they are filled with feelings of deep shame and self-loathing. People with a binge eating disorder do not starve themselves or over-exercise between bingeing episodes, so their weight can fluctuate vastly; at times, they may be very thin and obese at other times. Like other eating disorders, people with binge eating disorder are obsessed with food and may be quick to embrace the latest fad diet, and may spend an abnormal amount of time talking about food, dieting, and their bodies.
Because there is no purging with binge eating disorder, it can go unnoticed by friends and family. Since bingeing is typically done in secret, no one will know the excessive amounts of food that a person with this disorder is really eating.
Orthorexia is an eating disorder that’s on the rise in North America. A person with orthorexia may appear to be very healthy because they will only eat foods that are considered to be “clean.” In fact, family and friends may admire the healthy eating habits of a person with orthorexia, unaware that they have a serious eating disorder. Orthorexics are obsessed with avoiding unhealthy foods, including anything deep fried, fatty foods, sugar, dairy products, genetically modified foods, or foods that contain artificial preservatives. With orthorexia, a person may avoid certain foods and claim an allergy or intolerance. They are typically very knowledgeable about food and its impact on a person’s health. Many people will look at a person with orthorexia as being an expert in healthy eating because of their vast knowledge that comes with their obsession with healthy foods.
While it may not seem like a bad thing to have an interest in healthy eating, orthorexia is characterized by some of the same abnormal thoughts involving food and body image that other eating disorders are. A person with orthorexia will feel extreme anxiety and panic if they consume food that isn’t on their acceptable list, they have a distorted view of their body, and they will spend an unnecessary amount of energy obsessing and worrying about food.
Symptoms of Eating Disorders
While each type of eating disorder has its own set of symptoms, there are some that are common across most types, including:
- Social withdrawal
- Taking great pride in comments about their weight loss
- Obsessive focus on weight, clothing size, measurements, and body shape
- Idolization of the bodies of others who also have eating disorders or obsession with “Pro-Ana” websites that offer eating disorder tips and encouragement
- Self-loathing and overly-critical self-talk
- Distorted body image
- Irrational fear of weight gain, even in the smallest amounts
- The need to exercise extreme control of your diet, or the excessive loss of control when eating
- Avoiding eating in public or socially
- Anxiety or panic over food, sometimes just from thinking about it
Why You May Need Therapy for an Eating Disorder
Eating disorders are not just a matter of self-control or dieting. They have far deeper roots than that, and there are few individuals who can truly handle all the issues that arise from an eating disorder alone. Additionally, eating disorders frequently coexist with other disorders and mental illnesses like anxiety disorder, depression, or substance abuse. One of the problems with eating disorders is that they seem deceptively easy to handle until they have taken over a person’s life completely.
In many cases, a therapist will also work in conjunction with a doctor. Eating disorders have a profound physical effect on the body, and in some severe cases, malnourishment or suicide may also be an issue.
Goals of Eating Disorder Therapy
For a person with an eating disorder, distorted body image and thoughts of self-hatred are deeply ingrained and cannot be easily solved. Much like an addiction to drugs or alcohol, a person with an eating disorder may never be fully “cured,” but instead they can learn to manage their condition and minimize its effects on their self-worth.
In counseling sessions for eating disorders, a therapist will encourage the patient to dig deep to uncover where their negative thoughts and self-perceptions are coming from. For many people, the self-loathing that contributes to eating disorders goes back to childhood or a time where they were made to feel insecure or unworthy. In discovering where a person’s distorted thoughts come from, they can begin to change their perceptions and learn to see themselves with more compassion.
The goal for a person in therapy for an eating disorder is to be able to live a relatively normal life, free from their obsession with food and their bodies. In our society, it’s impossible for these concerns to go away completely, but when a person with an eating disorder can develop a healthy relationship with food, they are succeeding at their treatment.
Another important goal is self-acceptance, rather than self-hatred and judging yourself in an excessively harsh way. Through therapy, a person with an eating disorder can learn to change their thoughts and behaviors over time.
Methods Typically Used in Therapy for Eating Disorders
A wide number of treatments can be used to treat eating disorders. The severity of the patient’s condition and the patient’s desire to deal with the issue are the primary factors in determining the method. Often, an eating disorder therapist will use some form of accountability whether in single or group sessions to ensure that healthy habits are being implemented. In situations where health changes needed to be incorporated, the therapist will also help to develop a plan for the patient to use.
Another commonly-used type of therapy for treating eating disorders is cognitive behavioral therapy (CBT). CBT involves teaching a person to notice their negative or distorted thoughts and self-talk. In learning to catch your destructive thoughts, you will then learn strategies for challenging and changing them. This does not mean putting an unnecessarily positive view onto your life but instead aims to teach people to see themselves more realistically.
There is no “quick-fix” for eating disorders. Instead, recovery takes time, dedication, and hard emotional work, but it is worth it when you can find freedom from an unhealthy self-perception and a lifetime of being obsessed with food. When a person is committed to making the positive change towards recovery from an eating disorder, they have already taken the first step in healing. Deciding to work with a therapist and acknowledge that you have a problem takes courage and is a major accomplishment on its own. Through therapy sessions, you can learn to increase your inner strength and continue to make positive progress on your journey to overcoming disordered eating.
How to Find an Eating Disorder Therapist
The primary treatment forms require replacing negative behaviors with positive ones as well as understanding the roots. To get the most benefit from your sessions, look for a therapist with experience in eating disorder treatment. They will be the most effective at giving you the guidance you need to work through the deep-seated issues that cause eating disorders.
It’s not uncommon for a therapist who handles eating disorders to push clients. You should expect this. The pushing is intended to challenge you to address the underlying issues of your eating disorder and to deal with it rather than let the negative behaviors continue. You should still feel comfortable and a certain level of trust with the therapist, but do not be surprised if some of the sessions make you feel anxious or uncomfortable about your ability to succeed. Search the TherapyTribe directory for a therapist that specializes in eating disorders.