Article By Sucharita Desu
This year, the National Eating Disorders Association (NEDA) ran its annual week-long campaign associated with eating disorders (ED) during the week of February 21st to February 27th. NEDAwareness Week highlights the realities of EDs and provides hope, support, and visibility to those directly and indirectly affected by EDs. However, what are eating disorders?
Eating disorders are serious conditions related to persistent eating behaviors. They are complicated and often misunderstood illnesses that can affect people of all ages, genders, and backgrounds. Eating disorders negatively affect health, emotions, and the ability to function in key areas of life. Typically, they involve focusing too much on one’s weight, body shape, and food, significantly impacting the body’s ability to get needed nutrition. Overall, eating disorders can harm the heart, digestive system, bones, teeth, mouth, and even lead to other diseases. Eating disorders are looked at on a spectrum rather than in a “yes or no” manner as they come in many forms.
Different types of EDs also have varying symptoms. Some general symptoms of EDs may include skipping meals or making excuses for not eating, withdrawing from normal social activities, excessive exercise, eating in secret, expressing depression, disgust, shame, or guilt about eating habits, and problems with loss of tooth enamel, which could be a sign of repeated vomiting.
Anorexia nervosa, commonly known as anorexia, is a potentially life-threatening eating disorder characterized by abnormal body weight, intense fear of gaining weight, and disoriented perception of weight or shape. A person with anorexia tends to limit calories or use other methods to lose weight, such as excessive exercise, using laxatives or diet aids, or vomiting after eating. Their efforts to reduce weight can cause severe health problems, to the point of deadly self-starvation. Like with many EDs, someone struggling with anorexia has a tough time identifying the seriousness of their disease and the need for help.
Another type of ED is bulimia nervosa, commonly known as bulimia. Bulimia is a serious and potentially life-threatening eating disorder. It involves feeling a lack of control over one’s eating. People with bulimia experience episodes of bingeing followed by purging. They usually eat a large amount of food in a short time and then try to get rid of the extra calories consumed in an unhealthy way. People struggling with bulimia often feel guilt, shame, and an intense fear of weight gain from overeating. This leads to force vomiting, too much exercise, and/or using laxatives. Some other things they will do are restrict eating during the day, being preoccupied with weight and body shape, as well as judging themselves severely or harshly for self-perceived flaws.
Binge-eating disorder is a condition where a person regularly eats too much food and feels a lack of control over their eating. This is experienced in rounds/episodes, lasting around two hours each, typically occurring at least once a week. People with binge-eating disorders tend to eat quickly/more food than intended and continue long after they are uncomfortably full. This eating disorder causes feelings of guilt, disgust, or shame for one’s behavior and the amount of food they have eaten. The embarrassment they feel may also lead to eating alone to hide their bingeing habits. Unlike with anorexia and bulimia, people with bulimia do not try to compensate for their eating behaviors with purging or a lot of eating.
Other Specified Feeding or Eating Disorder (OSFED) is a term used when someone meets part of the criteria for an eating disorder but not all. There are also many other eating disorders including rumination disorder, pica, body dysmorphic disorder, and more.
The exact cause of EDs is unknown. Some possible causes are mental illnesses, genetics/family history, and biology, like changes in brain chemicals, and/or psychological and emotional health (i.e., low self-esteem, perfectionism, impulsive behavior, and/or troubled relationships). Some other risk factors may include dieting and starvation, as well as stress.
Some experts state that EDs are an outcome of interaction among cognitive, socio-emotional, and interpersonal elements. The excessive focus on the body hides the functional and ego-syntonic nature of these disorders. Unlike with other mental disturbances, EDs may also be experienced positively by those who live with them because the unhealthy eating behaviors are functional within the context of their belief system. They believe their eating behaviors benefit them, making them feel special, gain a sense of control, and feel protected.
Some researchers also think that EDs may be outcomes of dysfunctions in the neuronal processes related to appetite and emotionality. People with anorexia and bulimia share a dysregulation in their anterior ventral striatal pathway which creates vulnerability for dysregulated appetite behaviors. People with anorexia also have a high level of self-control in comparison to people with bulimia because of exaggerated dorsal cognitive circuit functioning. Sometimes, it may be a more complex picture. Eating disorders may start and perpetuate because of multiple factors like obsessive-compulsive features and anxious avoidance, along with precipitating factors like teasing, social comparison, and/or stressful events. EDs may also share a dysfunctional system of evaluating self-worth as core low self-esteem, over-perfectionism, mood intolerance, and/or interpersonal difficulties are maintaining factors for EDs.
Furthermore, one study conducted at the University of California San Diego tested how behaviors across the ED spectrum affect reward response in the brain, how changes in reward response alter food intake control circuitry (specifically the ventral-striatal-hypothalamic circuitry - a neural system with food intake control) and if the changes reinforce eating disorder behaviors. In this study, brain imaging was used to study how the brain responded during a taste reward task and analyze the “prediction error” reward response (measures the deviation or surprise level based on whether the person received a reward or did not). The results concluded that behavioral traits, like food intake behavior, add to eating disorder maintenance and progression by modulating one’s internal reward response and altering their food intake control.
EDs can complicate into suicidal thoughts or behavior, problems with growth and development, substance use disorders, and even death. However, lasting recovery treatments that target and change ED behaviors are still being researched. For these reasons and simply to help people with eating disorders, it is extremely important to raise awareness about eating disorders. Some of the things you could do are attend a local event, share what you learn about EDs with others, avoid commenting on appearance, promote body positivity, check in with friends and family, and most importantly, educate yourself about the topic. Even if you are not asked for help, it will always be beneficial to reach out and try to understand the feelings of those with EDs to support them the best you can externally.
To learn more about eating disorders, check out the links below:
Comments