What are eating disorders?

What is bulimia nervosa?

Those with bulimia nervosa experience binge episodes in which they eat an unusually large amount of food and feel out of control. Then they have a strong compulsion to “get rid of it,” usually by self-induced vomiting. Laxatives or diuretics can also be used. Excessive exercise may also be employed to shed the excess calories. The person who has bulimia also has deep concerns about her weight or shape, even though her weight is usually within normal ranges or slightly above normal.

Eating disorder not otherwise specified

Some people show signs of disordered eating yet don’t fit the exact clinical definitions of anorexia or bulimia. These cases are designated eating disorder not otherwise specified, or EDNOS. There may be the unfortunate perception that someone diagnosed with EDNOS doesn’t have a “real eating disorder.” EDNOS does not mean the person does not have an eating disorder. It does mean that the signs don’t fit neatly into the anorexia or bulimia category. EDNOS can be as dangerous as anorexia and bulimia.

Binge eating disorder is a type of EDNOS. While many of us overeat from time to time, binge eating disorder is different. It is compulsive overeating. In binge eating disorder, the person regularly eats unusually large amounts of foods. They usually eat rapidly and feel a loss of control over eating. The binge can also be coupled with feelings of shame, disgust, or guilt. Unlike those with bulimia, someone with binge eating disorder does not purge the food.

Not just for women only

Men and boys are also at risk of developing eating disorders. The National Institute of Mental Health estimates that about one in four cases of anorexia show up in preadolescent males. Binge eating disorder shows up in almost the same number of males as females.

Similar to girls and women with eating disorders, teenage boys and young men sometimes have a distorted body image. Many of them are also extremely concerned about becoming muscular. The strong desire to increase muscle mass or decrease body fat places these young men at heightened risk for using dangerous drugs such as steroids.

Men with anorexia show the same types of emotional and physical signs as females. However, because anorexia is typically thought of as a “girl's illness,” they may be under-diagnosed.

Common misconceptions

I’m not underweight, so I can’t have an eating disorder.
Weight is an unreliable indicator of eating disorders. People with eating disorders range from severely underweight to obese, and everything in between.

Only teenage girls have eating disorders.
Anyone of any age, race, income level, educational achievement, or career success may experience eating disorders. It is true that most cases of anorexia and bulimia develop in late-adolescent females. But eating disorders cut across all cultural and age lines.

I don’t have bulimia because I don’t vomit or use laxatives.
Self-induced vomiting and laxative abuse aren’t the only ways to purge calories. People with bulimia may also engage in compulsive exercise. Or they may binge and then fast.

I can never exercise too much.
We all need exercise, and engaging in physical activity usually boosts mood while doing good things for your body. But too much exercise coupled with too little calorie consumption hurts your body. It can cause chronic pain, menstrual cycle disruptions, or osteoporosis.

An eating disorder won’t kill me.
If an eating disorder is not treated in time, it can kill. Short of death, eating disorders can cause long-lasting health problems.

I eat when I need to. Therefore, I can’t have anorexia.
Not all people with anorexia stop eating. Some restrict certain types of foods, eating only what they perceive as “safe” or “free” foods while keeping calorie consumption below normal. Other people with anorexia fast for a specified number of days followed by relatively normal eating for a few days. Then they begin the cycle again.

This is only a phase. I can quit anytime I want.
It’s not “just a phase.” Eating disorders are serious mental, emotional, and physical health issues. People with anorexia and bulimia often think they can stop anytime they want. But the compulsion that drives an eating disorder can’t be tamed easily. Eating disorders take on a life of their own. In many cases, the desire to stop isn’t enough and professional help is needed.

My child can’t have an eating disorder, because the whole family eats together every night.
A person with an eating disorder can appear to go through the rituals of eating normal meals with loved ones. But they may be hiding or throwing away food or purging through vomiting, laxatives, excessive exercise, or fasting.