Signs & Symptoms of Eating Disorders

Eating Disorder

Signs and Symptoms of Eating Disorders

Approximately 24 million Americans suffer from eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorders.  Although the media, celebrity culture, and the advertisement industry are often blamed for promoting unrealistic beauty ideals, there are much more complex factors involved in the development of eating disorders.  Genetic factors, personality traits, mental health, and sociocultural influences all contribute to the development of the three main categories of eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder (BED).

Genetic Factors:

Research studies have shown that people are 10 times more likely to develop an eating disorder if there is a family history of eating disorders.  85-90% of those diagnosed with an eating disorder are adolescent girls or young women, in their early-mid 20’s.

Personality Traits/Disorder:

Over 50% of those with a clinical diagnosis of an eating disorder also fit the diagnostic criteria of obsessive-compulsive personality or borderline personality.

Mental Health Factors:

Research suggests that eating disorders are closely related to serotonin activity in the brain; serotonin dysfunction is a common feature of depression, anxiety, schizophrenia, bipolar disorder, and borderline personality disorders.  Mental illness and personality traits are hereditary genetic factors strongly correlated to eating disorders.

Sociocultural Influences:

Participating in sports and extracurricular activities that promote thinness and low body-fat or weight (gymnastics, dance, modeling, etc.) increases the chances of developing weight-preoccupation and increases the potential of developing an eating disorderEmployment in stressful environments can lead to disordered eating behaviors; jobs that are heavily based on appearance and image (modeling, acting, performing arts, etc.).

Anorexia Nervosa

Anorexia nervosa is one of the most common eating disorders diagnosed among adolescent and young women.  Individuals diagnosed with anorexia are irrationally afraid of gaining weight and believe that they are fat, despite often being underweight by medical standards.  Anorexia has the highest mortality rate of any mental illness, although only .5-1% of Americans are diagnosed with anorexia.  Approximately 22% of those with anorexia also fit the diagnostic criteria for obsessive-compulsive personality disorder.  Anorexia nervosa is progressive in nature; they develop over time from preoccupation with food and weight to persistent actions focused on weight loss.

Warning Signs:
  • Infrequently eating; denying hunger; restricting calories and eliminating food groups
  • Preoccupation with food, body weight, and appearance and with the body weight and appearance of others
  • Engaging in behaviors to lose weight, such as using diet pills, vigorous exercising despite injuries or fatigue; constant dieting
  • Preoccupation with nutritional content of food; preoccupation with dieting behaviors, including the use of food cleanses, liquid diets, etc.
  • Development of abnormal eating behaviors, such as rearranging food on plates, not allowing food groups to overlap or touch, counting bites and chews when eating
Symptoms of Anorexia Nervosa
  • Very low body weight
  • Visible muscle loss, general weakness
  • Mood swings, increased irritability
  • Headaches
  • Fainting and fatigue
  • Constipation
  • Severe dehydration, leading to electrolyte imbalances, urinary tract infections, and possible kidney infections or failure (severe anorexia)
  • Dry hair and skin, hair loss
  • Early onset osteoporosis
  • Growth of downy-like hair called lanugo, on face, arms, and other areas of the body
  • Slow heart rate, low blood pressure, and low body temperature—making the person feel constantly cold

Individuals with anorexia develop ritualistic behaviors, very similar to those of individuals with obsessive-compulsive disorder.  Panic attacks and panic disorder can become a by-product of rigid food and eating rituals.  Without early interventions, these behaviors become resistant to change and treatment becomes increasingly difficult.  Comprehensive treatment typically involves cognitive-behavioral therapy, nutritional management, group support, and nutritional counseling.

Bulimia Nervosa

Bulimia nervosa is characterized by binge-eating, followed by feelings of shame and guilt, which leads the individual to compensate by eliminating the food, either through self-induced vomiting, improperly using laxatives and diuretics, and compulsive exercising.  Many people with bulimia have a normal body weight.  Many people with bulimia are not preoccupied with thinness.  People with bulimia often feel out of control during a binge; for many, purging is a coping strategy aimed at regaining control over their eating behavior.  Approximately 28% of individuals with bulimia also fit the diagnostic criteria of borderline personality disorder.

Warning Signs:
  • Evidence of binge eating, such as empty containers, wrappers, or large quantities of food missing
  • Isolating during mealtimes, eating alone or out of sight
  • Eating large amounts of food to the point of being sick or uncomfortable
  • Evidence of purging behaviors, such as spending long amounts of time in the bathroom immediately after meals.
  • In rare cases, individuals may hoard/ hide large amounts of food in closets, under beds, in shelving and cabinets.
  • Having a rigid, routine set around binge-purge cycles; avoiding social events that involve food
  • Rigid schedule of exercise, regardless of fatigue, injury, illness, or extreme weather
  • Prioritizing food, diet, and exercise over employment, school performance, socializing, and relationships
Symptoms of Bulimia Nervosa
  • Chronic, irregular bowel movements, constipation/diarrhea
  • Tooth pain, staining, and decay
  • Inflammation of the esophagus
  • Dehydration, fatigue
  • Marks on the backs of hands and knuckles, yellowing of the fingernails, from self-induced vomiting
  • Swollen cheeks and jaw from gastric acids
  • Halitosis (chronic bad breath) from frequent purging
  • Preoccupation with food, dieting, and exercise
  • Eating abnormally large portions and combinations of food in one session, immediately followed by feelings of guilt, shame, and remorse

Approximately 80% of individuals with bulimia are female.  Research has shown a strong correlation between depression and bulimia; additionally, individuals with bulimia often report purging behavior to be a coping strategy for social adjustment difficulties (ex. transitioning to a new school, residence, etc.) Most people with bulimia acknowledge that their behaviors are abnormal and dangerous; many who suffer from bulimia report a lower quality of life than their peers.  Bulimia is a treatable illness that responds well to cognitive behavioral therapy, group and individual counseling.  Many treatment plans also incorporate an SSRI antidepressant and/or anti-anxiety medications, which can reduce the compulsive binge-purge cycle.

Binge Eating Disorder

Binge eating disorder (BED) is characterized by the compulsive eating of very large amounts of food; unlike those with bulimia, individuals with BED do not attempt to purge themselves of the food.  The compulsive eating behavior leads to extreme feelings of guilt and shame.  Many people with BED also suffer from depression and anxiety.  Sufferers of binge eating disorder self-report feelings of distress prior to binge eating, leading to the theory that binge eating is a maladaptive coping strategy to alleviate the distress.  40% of those diagnosed with BED are male.  Binge eating disorder affects 1-5% of Americans.

Warning Signs of Binge Eating Disorder
  • Frequent episodes of eating large amounts of food, often with odd combinations that increase the likelihood of feeling stomach sick, flatulent, and uncomfortable
  • A feeling of being “out of control” during eating binges
  • Strong feelings of shame and guilt after binges
  • Eating when not hungry; eating in response to negative emotions, such as sadness, anger, frustration, guilt, or fear
  • Isolating when eating, hiding eating behaviors or evidence of food (wrappers, containers, left-over food)
  • Frequent late-night eating
  • Frequent or visible weight fluctuations during a 3-6 month period
Symptoms of Binge Eating Disorder
  • High blood pressure and cholesterol
  • Type II Diabetes
  • Musculoskeletal problems, such as muscle cramping and joint pains
  • Gallbladder disease

Many individuals with binge eating disorder are a normal body weight or slightly heavier than average. Binge eating disorder is often a difficult diagnosis, as most people hide their behaviors and feel shame regarding their loss of control with food.  The diagnosis of binge eating disorder is commonly incidental, often discovered during the evaluation and treatment of depression and/or anxiety.  Binge eating disorder is a treatable condition when its underlying causes are also treated.  Maladaptive coping strategies, control issues, trauma, family trouble and social stresses are some factors that increase risk of developing BED.  Cognitive behavioral therapy, individual and family therapy, and group support are often effective treatments; by teaching effective coping strategies, individuals can regain control over stressful events or triggers and avoid binge eating behaviors.

If you, or someone you know suffers from an eating disorder, addiction, trauma / PTSD, or a debilitating mood disorder like depression or anxiety, call one of our professional admissions counselors for help at (888) 557-8091 or send us a confidential message on our Contact Us page.  If you are ready to take the next step and you would like us to do a confidential insurance verification, visit our Insurance Verification page.

stefieStefie Dias Ruivo, Staff Writer, B.S. Psy, focused on providing the most current Mental Health and Addiction Recovery Research, Information, and Insight.

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