Eating Disorders-General Knowledge

Eating disorders are psychological illnesses defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Bulimia nervosa and anorexia nervosa are the most common specific forms of eating disorders. Other types of eating disorders include binge eating disorder and OSFED (Other Specified Feeding or Eating Disorders). Bulimia nervosa is a disorder characterized by binge eating and purging. Purging can include self-induced vomiting, over-exercising, and the usage of diuretics, enemas, and laxatives. Anorexia nervosa is characterized by extreme food restriction to the point of self-starvation and excessive weight loss.

The extreme weight loss often causes women and girls who have begun menstruating to stop having menstrual periods, a condition known as amenorrhea, although some women who meet the other DSM-5 (Diagnostic and Statistic Manual of Mental Disorders, 5th editions) criteria for anorexia nervosa still report some menstrual activity. The DSM-5 currently specifies two subtypes of anorexia nervosa: Restricting and binge/purge type. Those who suffer from the restricting type of anorexia nervosa lose weight by restricting food intake and sometimes by over-exercising, whereas those suffering from the binge/purge type overeat and/or compensate through some method of purging. The difference between anorexia nervosa binge/purge type and bulimia nervosa is the body weight of a person. Those diagnosed with anorexia nervosa binge/purge type are well under a healthy bodyweight, while those with bulimia nervosa may have a body weight that falls within the range from normal to overweight and obese. 

Though primarily thought of as affecting females (an estimated 5–10 million being affected in the UK), eating disorders affect males as well. An estimated 10 – 15% of people with eating disorders are males. Although eating disorders are increasing all over the world among both men and women, there is evidence to suggest that it is women in the Western world who are at the highest risk of developing them and the degree of westernization increases the risk. Nearly half of all Americans personally know someone with an eating disorder. The skill to comprehend the central processes of appetite has increased tremendously since leptin was discovered, and the skill to observe the functions of the brain as well. Interactions between motivational, homeostatic and self-regulatory control processes are involved in eating behavior, which is a key component in eating disorders.

The precise cause of eating disorders is not entirely understood, but there is evidence that it may be linked to other medical conditions and situations. Cultural idealization of thinness and youthfulness have contributed to eating disorders affecting diverse populations. One study showed that girls with ADHD have a greater chance of getting an eating disorder than those not affected by ADHD. Another study suggested that women with PTSD, especially due to sexually related trauma, are more likely to develop anorexia nervosa. One study showed that foster girls are more likely to develop bulimia nervosa. Some think that peer pressure and idealized body-types seen in the media are also a significant factor.

Some research shows that for certain people there are genetic reasons why they may be prone to developing an eating disorder. Recent studies have found evidence of a correlation between patients with bulimia nervosa and substance use disorders. In addition, anxiety disorders and personality disorders are common occurrences with clients of eating disorders. People with eating disorders may have a dysfunctional hunger cognitive module which causes various feelings of distress to make them feel hungry. While proper treatment can be highly effective for many suffering from specific types of eating disorders, the consequences of eating disorders can be severe, including death.

Tip of the Day

Dessert? Try the salad bar. Enjoy sliced fruit from the salad bar as your dessert when dining out. This will help you resist other dessert options that may be higher in calories.

Daily Inspiration 

“When he had received the drink, Jesus said, “It is finished.” With that, he bowed his head and gave up his spirit.”

~ John 19:30

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Perfection and Recovery

There is a lot of talk about recovery through helplines, email boxes, and social media pages of non-profits dedicated to the prevention and alleviation of eating disorders (ED).  Many people are starting to realize they want to begin recovery, and some are in the recovery process but struggling. Sometimes they are currently with a treatment team or have just graduated from a program. Sometimes they have been maintaining recovery on their own for several years but are starting to wrestle with old ED thoughts.  Some may describe their doubts, lapses and relapses as:

“Whenever I think I’m doing really well in recovery, I slip up and ruin everything.”

“I want to recover but don’t think I can, so I might as well give up.”

“I’m afraid if I tell anyone that I’m struggling that they will be disappointed/angry/annoyed.”

Recovery can bring up a lot of intense feelings that may have some people wondering if it’s even worth it….well…IT IS! For those struggling with an ED, there may be times when they cannot truly control their feelings, but they can respond to them. They can analyze them, talk about them, and use what they’ve learned to talk back to the feelings that keep them stuck. They can change their behaviors and not let negative thoughts control their actions.

The issue with the thoughts above isn’t that they’re negative. It’s okay to feel discouraged or sad; recovery isn’t always sunshine and kittens and running through meadows. It’s hard work that stretches the mind and truly challenges a person.  The issue here is that those struggling, sabotage themselves when they take the same perfectionist, all-or-nothing thinking from their eating disorders and try to apply it to their recovery.  They judge themselves for being “bad” at recovery, they sell their selves short, and they once again believe that their capacity to be loved comes not from who they are, but from how well they do something.

Recovery isn’t about perfection. It’s not about doing each step correctly or being the best. There is no competition in recovery because those struggling are all running different races. They are all living a different story.

For those with an ED, they may judge everything as good or bad in their head.  For example, they may think there is “good” foods and “bad” foods. Days in which they stuck to their plan was good, but if their plans were thwarted by having to eat at a family outing or their weight went up even a smidge, that day was ruined.  They don’t enjoy any activities or pursue any passions because they felt that if they couldn’t be the best at something, they might as well be the worst.

For those struggling,  it may be difficult to feel positive about anything when they believe that one mistake would destroy all their progress.  And yet that’s what disordered thoughts have them believing. A lapse/relapse doesn’t make them a failure at recovery, and it doesn’t erase the incredible steps they have taken thus far. Relapse can actually be a powerful teacher in helping them map out what they need to adjust in their lives so that recovery can be possible again. That may mean re-evaluating their treatment needs, creating a stress management plan, or revisiting what they’ve learned so that they can keep themselves safe in the future.

There is no “ruined” recovery, and there are no “ruined” days either. Jenni Schaefer once wrote that recovery involves doing the “next right thing.” If those with an ED were unable to stick to their meal plan one morning or one week, they don’t have to give up on recovery.  They just have to pick up where they left off and do the next right thing.

If you or someone you love is struggling with an eating disorder, talk about it. It’s okay to let other people know you’re struggling; we’re all human. Imagine if everyone gave up on something that mattered to them because they got confused, made a mistake, or felt discouraged. No one would be able to do anything! We’d have no authors, musicians, athletes, businesses, you name it.  Not one person on earth has ever done everything perfectly all the time, so don’t expect that from yourself or others.Recovery means letting go of perfection, rigid rules, and harsh judgments about yourself that prevent you from growing. It’s about facing your fears and insecurities head-on instead of letting them define and limit you. Dare to keep fighting and moving forward in recovery; even if you’re not sure what it will look like when you get there.

Anorexia Nervosa and Associated Disorders