Eating disorders -- such as anorexia, bulimia, and binge eating disorder -- include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating Disorders are serious emotional and physical problems that can have life threatening consequences for females and males.

What Causes an Eating Disorder?

Eating disorders are complex conditions that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors. Scientists and researchers are still learning about the underlying causes of these emotionally and physically damaging conditions. We do know, however, about some of the general issues that can contribute to the development of eating disorders.
While eating disorders may begin with preoccupations with food and weight, they are most often about much more than food. People with eating disorders often use food and the control of food in an attempt to compensate for feelings and emotions that may otherwise seem overwhelming. For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one's life, but ultimately, these behaviors will damage a person's physical and emotional health, self-esteem, and sense of competence and control.

Psychological Factors that can Contribute to Eating Disorders:

• Low self-esteem
• Feelings of inadequacy or lack of control in life
• Depression, anxiety, anger, or loneliness

• Troubled family and personal relationships
• Difficulty expressing emotions and feelings
• History of being teased or ridiculed based on size or weight
• History of physical or sexual abuse

• Cultural pressures that glorify "thinness" and place value on obtaining the "perfect body"
• Narrow definitions of beauty that include only women and men of specific body weights and shapes
• Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths

• Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be imbalanced. The exact meaning and implications of these imbalances remains under investigation.

Anorexia Nervosa

Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self starvation and excessive weight loss.
Anorexia Nervosa has five primary symptoms:

• Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level.
• Intense fear of weight gain or being "fat."
• Feeling "fat" or overweight despite dramatic weight loss.
• Loss of menstrual periods in girls and women post puberty.
• Extreme concern with body weight and shape.

Warning Signs of Anorexia Nervosa:

• Dramatic weight loss.
• Preoccupation with weight, food, calories, fat grams, and dieting.
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (i.e., no carbohydrates, etc.).
• Frequent comments about feeling "fat" or overweight despite weight loss.
• Anxiety about gaining weight or being "fat."
• Denial of hunger.
• Development of food rituals (i.e., eating foods in certain orders, excessive chewing, rearranging food on a plate).
• Consistent excuses to avoid mealtimes or situations involving food.
• Excessive, rigid exercise regimen -- despite weather, fatigue, illness, or injury, the need to "burn off" calories taken in.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Anorexia nervosa involves self starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This "slowing down" can have serious medical consequences.

• Abnormally slow heart rate and low blood pressure, which means that the heart muscle is changing. The risk of heart failure rises as heart rate and blood pressure levels sink lower and lower.
• Reduction of bone density (osteoporosis), which results in dry, brittle bones.
• Muscle loss and weakness.
• Severe dehydration, which can result in kidney failure.
• Fainting, fatigue, and overall weakness.
• Dry hair and skin, hair loss is common.
• Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

• Approximately 90-95% of anorexia nervosa sufferers are girls and women (Gidwani,1997).
• Between 1-2% of American women suffer from anorexia nervosa (Zerbe, 1995).
• Anorexia nervosa is one of the most common psychiatric diagnoses in young women (Hsu, 1996).
• Between 5-20% of individuals struggling with anorexia nervosa will die. The probabilities of death increases within that range depending on the length of the condition (Zerbe, 1995).
• Anorexia nervosa has one of the highest death rates of any mental health condition.
• Anorexia nervosa typically appears in early to mid-adolescence.

Bulimia nervosa is a serious, potentially life threatening eating disorder characterized by a secretive cycle of bingeing and purging.
Bulimia Nervosa has three primary symptoms:

• Eating large quantities of food in short periods of time, often secretly, without regard to feelings of "hunger" or "fullness," and to the point of feeling "out of control" while eating.
• Following these "binges" with some form of purging or compensatory behavior to make up for the excessive calories taken in: self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
• Extreme concern with body weight and shape.

Warning Signs of Bulimia Nervosa:

• Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen -- despite weather, fatigue, illness, or injury, the need to "burn off" calories taken in.
• Unusual swelling of the cheeks or jaw area.
• Calluses on the back of the hands and knuckles from self-induced vomiting.
• Discoloration or staining of teeth.
• Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can impact the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

• Electrolyte imbalances that can lead to irregular heartbeats and possible heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
• Potential for gastric rupture during periods of bingeing.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Tooth decay and staining from stomach acids released during frequent vomiting.
• Chronic irregular bowel movements and constipation as a result of laxative abuse. Peptic ulcers and pancreatitis.

• Bulimia nervosa affects 1-3% of middle and high school girls and 1-4% of college age women.
• Approximately 80% of bulimia nervosa patients are female (Gidwani, 1997).
• People struggling with bulimia nervosa will often appear to be of average body and weight.
• Often, people struggling with bulimia nervosa will develop complex schedules or rituals to provide opportunities for binge-and-purge sessions.
• Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.

Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified or characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.

Binge Eating Disorder is characterized by:

• Frequent episodes of eating large quantities of food in short periods of time.
• Feeling out of control over eating behavior.
• Feeling ashamed or disgusted by the behavior.
• There are also several behavioral indicators of BED including eating when not hungry and secretiveness.

The health risks of BED are most commonly those associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:

• High blood pressure
• High cholesterol levels
• Heart disease
• Diabetes mellitus
• Gallbladder disease

• The prevalence of BED is estimated to be approximately 1-5% of the general population.
• Binge eating disorder affects women slightly more often than men--estimates indicate that about 60% of people struggling with binge eating disorder are female, 40% are male (NIH, 1993).
• People who struggle with binge eating disorder can be of normal or heavier than average weight.
• BED is often associated with symptoms of depression.
• People struggling with BED often express distress, shame, and guilt over their eating behavior.

Information on this site was taken from The National Eating Disorders Association web site.

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