The Signs And Symptoms of Eating Disorders

With the current hysteria over the "Obesity Epidemic" sweeping Western industrialized countries, one gets the impression that the only health problems eating create stem from overweight. But the mirror has two faces. There is another world, sensationalized by a celebrity-obsessed media, and too often overlooked in our own lives: an existence dominated by life-threatening eating disorders.

As many as ten million women and one million men are fighting a life-and-death battle with anorexia or bulimia every day. One out of every four anorexics will die of complications from her disease. Yet, the amount of misinformation about eating disorders continues to grow with their prevalence. Eating disorders can be prevented and treated. The signs and symptoms are easy to recognize; it's just a matter of knowing where to look.

What is Anorexia?

Anorexia is probably the easiest eating disorder to identify. It has a clear definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM). To be diagnosed, a person must exhibit all of the following symptoms:

  1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
  2. Intense fear of gaining weight or becoming fat.
  3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  4. In postmenarcheal, premenopausal females (women who have had their first menstrual period but have not yet gone through menopause), amennorhea(the absence of at least three consecutive menstrual cycles).

However, it is little known that there are actually two types of the disease. The Restricting Type is what one commonly associates with the word "anorexic:" the person who simply eats very little, or only certain "safe" foods, or engages in periods of fasting. The second kind of anorexic is the Binge-Eating or Purging Type, who regularly binge-eats and/or compensates for intake by over-exercising, vomitting, or laxative abuse.

Signs and Symptoms of Anorexia

If you suspect someone you know suffers from anorexia, here are a few things to look for.

Behavioral Signs:

  • Sensitivity to comments about weight or appearance
  • Frequent excuses for not eating, such as a large meal earlier or lack of hunger
  • Obsessive talk about diet, exercise, and food
  • Possible self-harm, suicide attempts, or substance abuse

Physical Symptoms:

  • Rapid or extreme weight loss
  • Slow or abnormal heart rate
  • Loss of menstrual period
  • Constipation
  • Thinning hair
  • Malnutrition headaches
  • Dehydration and mineral deficiency
  • Brittle nails and dry skin
  • Lowered immunity leading to frequent illness
  • Growth of fur-like hair (lanugo) on face and torso

What is Bulimia Nervosa?

Bulimia nervosa is less widely understood, and much harder to identify, than anorexia. Most bulimics are at or even above a healthy weight, and often eat very normally in front of other people, keeping their disordered behaviors successfully hidden from the outside world. One common misconception about bulimia is that anyone who throws up her food merits the diagnosis, but as we saw with the purging-type anorexic, this is not, in fact, the case.

The DSM gives the following diagnostic criteria for bulimia nervosa:

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

    1. Eating, in a fixed period of time (e.g., within any two-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
    2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting; or excessive exercise.
  3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
  4. Self-evaluation is unduly influenced by body shape and weight.
  5. The disturbance does not occur exclusively during episodes of anorexia nervosa.

Once again, we find two main sub-groups under our umbrella diagnosis. The Purging Type involves the use of self-induced vomiting, enemas, laxatives, or ipecac to rapidly rid the body of the calories just consumed. The less-common Non-Purging Type bulimic instead turns to fasting or excessive exercise to compensate for intake over time.

Signs and Symptoms of Bulimia

It can be hard to tell for sure whether or not someone is bulimic, since so many of the disordered behaviors occur in private, but there are several signs that, when seen together, are a fairly good indicator.

Behavioral Signs

  • Fluctuations in weight
  • Frequent "failed" diet attempts
  • Large quantities of missing food
  • Consistantly going to the bathroom just after eating
  • Compulsive exercise

Physical Symptoms

Shown in the chart below:

What to Do Next

So you've gone down the list, with someone in mind, and you're pretty sure your friend or family member (or yourself!) has an eating disorder. What do you do now? Seek help. An eating disorder is a disease, and as a disease, it can be treated. Just as anorexia and bulimia both possess physical and emotional attributes, treatment must be multidisciplinary to address all the aspects of the illness.

The first step is to find resources in your area. The National Eating Disorder Association (http://www.nationaleatingdisorders.org) provides help in locating both psychological and nutritional professionals to aid you or your loved one in regaining health. If inpatient treatment becomes necessary, they also have referrals of the countries top facilities.

Remember: there is no magic potion, no quick fix, for this problem. Just as a diabetic must check blood sugar and take insulin daily, a disordered eater will need to continue to monitor him- or herself, even after he or she no longer meets the diagnosis. Life is a journey, or so it is said. And so is recovery.

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Comments 13 comments

KristinaMPitts 2 years ago

Thanks for sharing.


carolyn a. ridge profile image

carolyn a. ridge 5 years ago

This is good; it's educational, and yet, interesting. I've seen movies, documentaries, reality shows. The world is definitely aware of its existence, but for untold reasons, when we discuss improper eating, it usually involves obesity. Great information.


Aficionada profile image

Aficionada 5 years ago from Indiana, USA

Maddie, thanks for this excellent article! Several family members of mine have had eating disorders. One who was hospitalized for anorexia (quite a few years ago) is now - after the right multifaceted treatment - a healthy, thriving mother. [ - just a ray of hope - ]

A different issue that I want to mention is that sometimes people who refuse to eat around others are actually suffering from social anxiety. This is a whole different subject, but I was very interested to learn that this is the reason why a friend of one of my children would never eat meals with us.


shae 5 years ago

Hey

im not sure if i have an eating disorder i don't think i do but latley my friend has said that she is worried because in all the 3 years we have been friends she has never seen me eat.I also don't eat breakfast or lunch because im never hungry and depending on what night of the week it is depends on if i eat dinner because if i have tennis traning i cant eat before or after it as i tend to feel sick.I would talk to my hpe teacher about it because she is like my sister but im not sure if there is anything to even be worried about.

thanks


GarnetBird profile image

GarnetBird 6 years ago from Northern California

I had this disorder before I confronted the sexual abuse in my childhood and resolved it. This was awesome; I hope you have time to read my Hub on Saving Our Children From Sexual Abuse.


infinitenesmith 6 years ago

This is the best thing I've read about eating disorders in a long time. Thanks for being so thorough and informative.


Phoenix54 profile image

Phoenix54 7 years ago

Hey Brandy, my son has the same thing. He is right at a year and has all of a sudden changed his eating habits. He used to eat textures and all times but all of a sudden he spits certain foods out and he has started to throw up late night. He has some stomach issues that I have been trying to figure out for 9 months. Don't get me started on stupid doctors. They don't listen to me. I know Im probablly a crazy parent too! I don't care...its my kid! Im worried for his nutrition intake too. He is small for his age and has low muscle tone they say. He is pretty active but lately he just is off...

I know that toddlers experience weird ways of enjoying their foods. My sisters daughter..(now 5) starting "selecting" her foods around 2 I'd say. She now is so picky its not even funny. She eats maybe 4 kinds of food. grilled cheese, mac and cheese, peanut butter sandwich and ravioli. She wont try any new foods! It horrible. She used to eat butter like it was candy. They didn't let her but it was like candy to her. She still enjoys it now. She is slinder and skinny...weird!

I have been wanting to do research too on eating disorders in infants over 8 months b/c that's when they can eat on real stuff. Its weird how they just "stop" enjoying what they loved.


brandy 7 years ago

I am researching a food texture/taste disorder or phobia, i am the mother of an extremely picky eater (toddler) that pretty much "freaks out" when trying to get him to try new things. He has a very limited diet, I worry about his nutrition and growth. I have followed my pediatricians advise and keep offering small amts of things but I have been doing this for over a year now with no changes. I know; I am the PARENT, but how far will this go, what do I do next? I usually give him what he will eat, or he wakes up in the night crying/hungry.


Eating disorders 7 years ago

Girls need to see their parents and other women who are satisfied with their bodies and appearance. Girls whose mothers are worrying about their own weight and image are most likely to develop the same worries about their bodies and may end up with any of the eating disorders mentioned.


Maddie Ruud profile image

Maddie Ruud 8 years ago from Oakland, CA Author

Hi haylz:

It sounds to me like you probably do have eating problems. If you don't feel comfortable confiding in your teacher, is there another adult you could talk to, like a school counselor, or a family member or friend? I really want to encourage you to speak with someone about your struggles. It's hard to do, but there is help, and recovery is possible.

I wish you all the best.


haylz 8 years ago

my friend and my teacher recently confronted me because they said they've seen a change in me recently and have become worried. i was, at one time, going without food for days then only eating small portions of certain foods. i am a keen dancer and sometimes have rehearsals up to four times a week. i sometimes experience dizziness and sickness and have fainted a lot in the past few weeks. i have been eating small amounts over the past 2-3 weeks but only managing one child-sized meal a day. i'm worried that the teacher may pass information on about me. she's done it before. found this page very helpful, thanks.


Maddie Ruud profile image

Maddie Ruud 9 years ago from Oakland, CA Author

Maria, feel free to contact me via my profile page. I'm so glad you've chosen to find out more about what's troubling you. Information is power, as I found in my own struggle with ED.


Maria 9 years ago

I have an eating disorder can you send me some helpful information via my email. Thank you. p.s your site has really shed light on my problem thanks.

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