What are Eating Disorders?
Currently, eating disorders are classified into three groups:
- Anorexia Nervosa (AN)
- Bulimia Nervosa (BN)
- Eating Disorder Not Otherwise Specified (EDNOS), which currently includes Binge Eating Disorder (BED)
These definitions were created by a task force for the DSM-IV – a manual for clinicians to aid in diagnosis and treatment of different psychiatric disorders.
Anorexia Nervosa is characterized by fear of being overweight and gaining weight, which often results in severe restriction of food intake and at times the use of other weight-loss strategies including excessive exercise, purging behaviors and use of diet pills. Individuals with AN typically have a distorted view of their bodies, such that they view themselves as overweight, despite the fact that they are extremely underweight.
Oftentimes, girls and women with AN stop menstruating (experience amenorrhea) as a result of the toll starvation takes on the body. While some individuals with anorexia may also purge, their low body weight (85% or below what is considered a healthy weight for their height and age) is what distinguishes them from an individual with BN.
Bulimia Nervosa involves a pattern of binge eating followed by use of a method to compensate for eating a large quantity of food. For example, some individuals may purge after they binge eat, exercise excessively, take laxatives or diuretics. Binging is defined as eating a large quantity of food in a short period of time during which a feeling of loss of control is present. While traditionally, binging is defined in this way, some individuals may experience this sense of being unable to control their eating even when the quantity is not considered objectively large.
Eating Disorder Not Otherwise Specified includes different types of symptoms that together, do not meet the full criteria for AN or BN. For example, individuals who binge eat, but do not purge would fall into this category. It is often the case that this diagnosis is given to patients who may be in the early stages of anorexia or bulimia, and warning signs are identified before the problem progresses further.
Regardless of what diagnosis an individual receives, many of the behaviors and symptoms associated with eating disorders in general pose many psychological and physical health risks. Having a diagnosis of EDNOS may be no less severe than a diagnosis of AN or BN and treatment will often be necessary in these cases as well.
How do I know if someone I know and love has an eating disorder?
There are a number of signs and symptoms that one can watch for to assist in determining whether it is time to get help. These include:
Warning Signs
- Diet books
- Dieting behavior (e.g., restricting carbohydrates or fats)
- Increased “picky” eating
- Immediately going to the bathroom after eating
- Increased episodes of upset stomach
- Skipping meals
- Large amounts of food missing
Alerting Cues
- Fasting or regularly skipping meals
- Avoidance of eating with others
- Evidence of binge eating
- Evidence of purging
- Use of diet pills, laxatives or diuretics
- Calorie counting
- Excessive or rigid exercise routine
- Absolute refusal to eat certain types of food
While eating disorders have a huge impact on one’s emotional and social well-being, they also can cause a number of very serious health problems. These include:
- Low blood pressure
- Low heart rate
- Loss of menstruation
- Low body temperature
- Erosion of tooth enamel among those who purge
- Osteoporosis
- Hormonal changes
If you feel that you or someone you love may be exhibiting signs or symptoms of an eating disorder, it is important to act now and get help.
Please call (650) 723-5511 for child and adolescent services, or (650) 498-9111 for adult services.
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