Eating Disorders – An Overview

Our relationships with food and our bodies can be complicated. Many people experience ups and downs when it comes to how they eat and how they feel about their bodies. Eating disorders are a mental illness and actually have to do with much more than food, eating, or appearance. Those are merely symptoms of the disorder and how a person’s distress is manifested, but the root of the problem is usually much deeper.

What are Eating Disorders?

Eating disorders are mental illnesses that involve a pattern of disturbed eating habits and thought patterns that are significant enough to get in the way of living a comfortable life. Eating disorders are potentially life-threatening and have the highest mortality rate of all mental illnesses.

The term “eating disorder” describes a wide range of issues and symptoms, and each person may experience eating disorders differently. Some common eating disorders are listed here, but it’s important to remember that most people don’t fit neatly into a “category”.

What Eating Disorders Are Not

They are not:

• Lifestyle choices or diets.
• A sign or result of low intelligence, weakness, or vanity.
• Something that can be cured by “just eating”.

When someone experiences a prolonged period or pattern of negative or unhealthy thoughts and behaviours related to food, eating or body image, it may be a sign that they have an eating disorder. Even though the symptoms of eating disorders seem to be all about food and body image, they are often more complicated than just wanting to look a certain way. Some common eating disorder symptoms include:

• Extreme dieting or overeating
• Fear of gaining weight
• Body image issues
• Changes in eating habits
• Excessive exercise to burn off calories
• Feeling anxious, depressed, or angry about food or body image.
• Weight loss or gain, feeling tired, dizziness, and hair loss.

There are currently four main types of eating disorders that are most commonly diagnosed:

1. Anorexia Nervosa

People with anorexia nervosa have a pattern of restricting their food intake and other ongoing behaviours that interfere with maintaining a weight that is considered healthy for their age, body type, development, etc. They will also have an intense fear of gaining weight, their self-worth is overly influenced by weight and shape, and they often have trouble recognizing how their body really looks, such as believing they are bigger than they really are. These symptoms occur over a period of at least three months.

2. Bulimia Nervosa

A person with bulimia has a pattern of eating a lot of food in a way that feels out of control (binging), followed by extreme efforts to rid themselves of the food (purging). These binge/purge episodes occur at least once a week for three months or more. In bulimia, weight or shape also overly influences the person’s self-worth.

3. Binge Eating Disorder

Someone with this eating disorder has a pattern of binge eating (eating an unusually large amount of food within a relatively short period of time and feeling out of control over what and how much is eaten), followed by troubling feelings of distress, guilt or shame. These binge-eating episodes are not followed by purging behaviours and happen at least once a week for three months or more.

4. Other Specified Feeding and Eating Disorders (OSFED)

If someone has a pattern of disordered eating, body image issues, and other related behaviours that are impairing their functioning and causing them distress, but don’t meet all the criteria for one particular eating disorder, they might be diagnosed with OSFED.

Eating disorders are sometimes misunderstood by people who don’t have direct experience with them. Some common myths about eating disorders are:

Myth: Only girls have eating disorders.

Fact: Eating disorders can affect anyone and while they are believed to be more common in females, current research is showing that up to one-third of eating disorder sufferers are male.

Myth: You can tell who has an eating disorder by looking at them.

Fact: Not everyone who is very thin has an eating disorder, and not everyone who has an eating disorder is very thin. Eating disorders are identified by medical professionals by assessing how someone is thinking and behaving, not by their weight or body shape.

Myth: Anorexia is the only serious eating disorder.

Fact:  All eating disorders are serious. In fact, sometimes bulimia and OSFED can be more dangerous because the physical effects tend to go unnoticed longer than they do in someone who is visibly “sick”. Binge eating disorder carries many serious health risks too, and severe psychological/emotional distress occurs with all eating disorders.

Myth: Eating disorders are caused by unhealthy and unrealistic images in the media.

Fact: While society and media can contribute to or trigger eating disorders, research has shown that the causes are usually a combination of factors, and not everyone who is exposed to this media develops an eating disorder. Also, eating disorders have been documented as early as the 1800s, long before mass media promoted thin bodies.

Myth: People with eating disorders are just vain and care too much about their looks.

Fact: Eating disorders are a mental illness and at their core actually have very little to do with food, eating, or appearance. Those are merely symptoms of the disorder and how a person’s distress is manifested, but the root of the problem is often much deeper.

Myth: All teenaged girls worry about their weight. Fasting and dieting is a pretty normal phase for them.

Fact: While many young people (of any gender) worry about their weight and body shape, it is not “typical” or healthy for a growing person to engage in fasting or extreme restricting to lose weight. On top of that, eating disorders are not diets and involve symptoms beyond food intake. They are mental illnesses that need to be taken seriously.

Myth: Purging always means self-induced vomiting.

Fact: Purging can take place in different ways, including fasting, over-exercising, misusing laxatives, or self-induced vomiting.

The eating disorder information on this page is a simple overview of a complicated health issue. For more in-depth information, please visit these sources or speak to a medical professional.

Ontario – call ConnexOntario to find out where there are mental health supports in your community.

Crisis – in any situation where someone is at risk of hurting themselves or others, call 911 or a local crisis line. You can find resources near you on the free and confidential Be Safe App.

Please see the Help Section for more information and resources.

References

1. National Eating Disorder Information Centre (NEDIC)
2. National Eating Disorders Association (NEDA)
3. Diagnostic and Statistical Manual of Mental Disorders (DSM) Library
4. Centre for Addiction and Mental Health (CAMH)
5. Canadian Mental Health Association (CMHA)