Eating Disorders: What You Need to Know
Warm weather is here, and summer is in full swing! Along with warm weather comes the societal pressure to diet and look a certain way in a swimsuit. For many people, this means fad and crash dieting – and sometimes the development of eating disorders. Fad diets and crash diets are often considered forms of disordered eating. But these seemingly harmless eating plans can threaten our health and well-being & become full-blown eating disorders.
There are three major eating disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (the DSM-5):
- Anorexia nervosa is recognized by the severe restriction of energy intake, intense fear of weight gain or being “fat,” and dysmorphic body image or disturbed self-image.
- Bulimia nervosa is most commonly characterized by consumption of abnormally large amounts of food, termed “bingeing,” followed by inappropriate behaviors in an attempt to compensate for the binge, or “purging.” This can include inappropriate use of laxatives & diuretics, self-induced vomiting, fasting, or over-exercising. Bulimia is associated with feeling out of control while bingeing & feeling shame or guilt following the binge.
- Binge eating disorder is the most common disorder, characterized by bingeing (as mentioned, consuming abnormally large amounts of food within a relatively short time period), with associated feelings of loss of control, shame, guilt, and distress. Sufferers do not have the same compensatory behavior seen with bulimia nervosa.
One emerging disorder that is not yet recognized by the DSM-5 disorder is orthorexia. This is an obsession with “clean” or “pure” methods of eating. This often leads to progressively worsening restriction of foods to those only deemed “safe” by the sufferer’s self-imposed criteria. Commonly seen restrictions today include gluten-free, dairy-free, organic, or low-carb, vegan, etc. There is nothing inherently wrong with consuming these types of foods, but obsession and compulsive behavior around them are potentially dangerous to one’s health.
Here are some common signs/symptoms of eating disorders:
- Making excuses to avoid eating or social situations involving food
- Elimination of entire food categories; refusing to eat certain foods
- Repeatedly starts new diet plans or fasts, skips meals, or exercises excessively
- Disappears after eating meals, i.e. to the bathroom
- Preoccupation with body shape, weight, or appearance
- Feelings of low self esteem
How can we help?
- Learn & research. Be aware that persons can experience symptoms of multiple eating disorders at once.
- Approach the subject with care. Avoid saying “just eat” or “just stop” as this is unhelpful.
- Offer concern through “I” statements, such as “I am worried that you haven’t been eating lunch anymore.”
- Explain that there is no shame in admitting a person needs help with an eating disorder. They are commonly misunderstood conditions.
When we look at a person’s health, it is important to note that it is not only what we eat, but what we experience and endure as a whole person that makes up our physical and mental well-being. If you are concerned for disordered eating within yourself or a loved one, visit www.nationaleatingdisorders.org for more information.
Emily Shaber is a registered dietitian, a graduate of Clemson University and an inpatient clinical dietitian at Sentara RMH Medical Center. Emily has five years of experience working with patients with cardiac and renal disease and specializes in critical care nutrition.