Disordered Eating

In a society that discriminates against people, particularly women, who do not look slender, many people find they cannot – or think they cannot – meet society's standards through normal, healthy eating habits and often fall victim to eating disorders.

Types of eating disorders
There are two common types of eating disorders: 

• Bulimia nervosa — characterized by a cycle of binging and purging. Binge-eating is the uncontrolled consumption of large amounts of food lasting a few minutes to several hours. This is followed by purging, or a ridding the body of food eaten during a binge, either through self-induced vomiting, laxatives, fasting, severe diets, or vigorous exercise. 
• Anorexia nervosa — self-imposed starvation. People with anorexia refuse to eat and consider losing weight paramount in their lives. They may try different methods of purging to further lose weight. People who are bulimic eventually recognize they have a problem. People who are anorexic will deny their behavior is abnormal. People who are bulimic usually maintain a near- normal weight, while people who are anorexic become shockingly thin. A person with anorexia may turn to bulimia as an alternative attempt at weight control. This is called bulimarexia.

Who it affects
While eating disorders affect people of all ages and genders, the typical person with an eating disorder is a woman whose abnormal eating behavior began in her teenage years. She is most likely a perfectionist and a high achiever, concerned about her appearance and how she is perceived by others, but emotionally insecure, often frightened, and lonely. The woman with anorexia may equate being the best with being the thinnest because dieting is something she finds she can do successfully. She may do this in reaction to a fear of growing up or in rebellion against parents or other authority figures. The woman with bulimia binge-eats in response to feelings of loneliness, anxiety, or anger. Feeling guilty over subsequent weight gain, she turns to purging as a way to alleviate those feelings. The cycle of binging and purging becomes a part of her daily life and she may binge just so she can purge. This cycle continues until she recognizes she needs help.

Physical effects
The abnormal eating habits of someone with an eating disorder can seriously affect his or her physical health: 

• Vomiting can lead to erosion of tooth enamel, perforate the esophagus, lead to internal bleeding, and cause infections of the salivary glands and throat. 
• Purging upsets the balance of fluids, hormones, and nutrients needed by the body to function properly, leading to muscle cramps, stiffness in the limbs and joints, ulcers, cramps, an irregular heart rhythm or heart failure, damage to the kidneys and liver, diabetes, and amenorrhea (absence of menstruation). 
• Binging can lead to ulcers and a fatal rupture of the stomach. 
• Excessive use of laxatives can damage the digestive tract and lead to colitis. 
• Severe fasting — as in anorexia — starves the body of needed nutrition, leading to shrinkage of vital organs, irregular heart rhythm or heart failure, and infertility. Some of these effects, if not detected in time, can be permanent or fatal. 
• Anorexia can lead to constipation and difficulty in urination, muscle cramps, swelling of joints, nerve and tendon damage, digestive problems, and loss of concentration. Because people with bulimia use food as an escape, they may turn to other substances, such as alcohol or drugs, to both escape and to break the binge-purge cycle. This practice can lead to substance abuse and addiction.

Warning signs
 Any of the following may be a warning that someone is bulimic or anorexic: 

• Secrecy, especially in bulimia, where a person hides their binging and purging 
• Leaving the table immediately after eating to use the restroom (to purge) 
• Abuse of laxatives 
• Severe weight loss or dramatic fluctuations in weight 
• Depression brought on by a poor self-image 
• Severe dieting and excessive exercise 
• Abnormal interest or obsession with food (in bulimia) 
• Unusual eating habits, such as taking only tiny bites (in anorexia) 
• Absence of menstruation 
• Cavities and gum disease (caused by vomiting or poor nutrition) 
• Hair loss or dull, stringy hair (due to lack of protein) 
• Excessive body hair (to compensate for heat loss) and extreme sensitivity to cold (in anorexia)

Treatment
Both bulimia and anorexia can be treated with a combination of medical and psychological approaches to deal with the physical effects of abnormal eating and the underlying psychological problems that may have caused it.

What else to do
People with an eating disorder or any mental illness also face a stigma attached to these illnesses by society. This stigma causes discrimination against people with a mental illness in employment, housing, health care, and the ability to buy health insurance. By learning more about mental illness and the effectiveness of treatment, this discrimination can end, removing the stigma that acts as a barrier to successful treatment.

Adapted from information from the Missouri Advisory Council for Comprehensive Psychiatric Services.