What are eating disorders and what are the signs?

By Cara Murez HealthDay Reporter

MONDAY, March 13, 2023 (HealthDay News) — Eating disorders are on the rise, affecting an estimated 30 million people worldwide, and they can be fatal.

The causes are “like pieces of a puzzle,” according to Amy Ethridge, an occupational therapist and clinical psychiatry specialist in the Adolescent Medicine and Eating Disorders Program at Penn State Milton S. Hershey Medical Center in Hershey.

“It’s also usually a stress response,” Ethridge said in a press release from the center. “The fact is, eating disorders are complex medical and psychiatric conditions that patients don’t choose and parents don’t cause.”

A constant barrage of commercials and TV shows idealizing unattainable body types doesn’t help. Anxiety and depression can be factors, as can heredity.

Ethridge, with the clinical psychologist Jamal Essailidirector of the young adult eating disorders program at the medical center, offered information about eating disorders, their dangers and how someone can get help.

Patients do not wake up one day and suddenly decide to become anorexic, for example. It’s not a choice, they said. All age groups, genders, cultures and backgrounds can be affected, not just adolescent girls.

Anorexia nervosa is one of the most common eating disorders.

With anorexia, a strong fear of gaining weight leads to drastically limiting calorie consumption. Patients often have a distorted body image. Warning signs include an intense focus on body image and weight, weight loss, anxiety, and avoidance of high-calorie or non-diet foods.

In atypical anorexia nervosa, the symptoms are similar, except the person is not underweight. People with eating disorders can come in all shapes and sizes.

“People with higher weight are at increased risk for eating disorders, likely because they are under intense pressure to lose weight,” Essayli said in the statement. “It is critical that providers screen for early warning signs of eating disorders like food-related anxiety in people who are not underweight, as these people often go unnoticed due to their weight.”

In another eating disorder, bulimia nervosa, people also limit their food intake to try to lose weight or prevent weight gain. But they also often have episodes of binge eating, during which they quickly consume large amounts of food.

To compensate for the calories consumed during binge eating, they may vomit, take laxatives, or exercise excessively. People with bulimia nervosa often suffer from poor body image. Early symptoms can include a chronic sore throat, swollen salivary glands, digestive problems, and worn tooth enamel from stomach acid in the mouth.

Binge eating also includes uncontrollable food consumption, often in response to dieting. People with this disorder sometimes eat when they are not hungry, often in secret. They don’t engage in behaviors like vomiting to compensate.

Avoidant/restrictive food intake disorder is another type of eating disorder. In this, people limit and avoid food for reasons unrelated to body image. This may be due to very picky eating, fear of choking or vomiting, or lack of appetite. The disorder can lead to lack of development in children.

Although it takes a medical professional to diagnose an eating disorder, there are warning signs.

You may notice someone is exercising too much, being extremely preoccupied with food and dieting, or worrying about what to eat at a restaurant.

Refusing to eat certain types of food, apart from an allergy, could be a sign. This could include restricting an entire category of foods for weight loss, such as all carbohydrates.

Strict rituals with food, excessive chewing, or being careful not to let two foods touch can be signs of avoidant/restrictive food intake disorder. The same goes for the insistence on eating alone, skipping meals, or eating small portions.

While many people express concern about their body size and shape, if their perception is distorted and it becomes an obsession, it can be a sign.

Going to the bathroom frequently and having tooth erosion can also be indicators.

Ethridge offers tips for sharing your concerns with your loved one.

“The best way is to express concern about the behavior,” she said. “Discuss what you noticed that changed or became difficult. Avoid simplifying the situation by recommending to “just eat”. Prepare for negative reactions and even denial of the problem. The intention is not to diagnose it, but rather to help them seek treatment starting with a medical evaluation.

SOURCE: Penn State Health, press release, March 9, 2023

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