Eating Disorders

Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia nervosa generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

NEDA notes the following common symptoms, however not everyone with anorexia nervosa displays all of these emotional and behavioral symptoms:

• Dramatic weight loss
• Has disturbed experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight
• Dresses in layers to hide weight loss and/or stay warm
• Is preoccupied with weight, food, calories, fat grams, and dieting
• Refuses to eat certain foods, and often eliminates whole food groups (carbohydrates, fats, etc.)
• Makes frequent comments about feeling “fat” or being a higher weight despite weight loss
• Has intense fear of weight gain, even though underweight
• Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
• Denies feeling hungry
• Develops food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)
• Uses excessive amounts of condiments, spices, and artificial sweeteners
• Consumes large amounts of water, diet beverages and caffeine drinks to fluid load and reduce hunger.
• Cooks meals for others without eating
• Makes excuses to avoid mealtimes or situations involving food
• Expresses a need to “burn off” calories taken in
• Maintains an excessive, rigid exercise regimen despite weather, fatigue, illness, or injury
• Withdraws from friends and previously pleasurable activities and becomes more isolated and secretive.
• Has limited social spontaneity
• Resists or is unable to maintain a body weight appropriate for their age, height, and build
• Displays rigid and inflexible thinking style and has difficulty adapting to change

Bulimia Nervosa

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.

• Preoccupied with weight, shape and appearance leading to restriction/dieting behaviors to promote weight loss
• Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating 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
• Appears uncomfortable eating around others
• Develops food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
• Skips meals or takes small portions of food at regular meals
• Engaging in fad diets, the elimination of whole food groups, vegetarianism/veganism in service of weight loss.
• Engages in episodes of binge eating large amounts of food in a short period of time, often in secret
• After episodes of binge eating, frequently engages in compensatory behaviors such as self-induced vomiting, diuretic/laxative use, fasting/restricting, excessive exercise or manipulation of insulin dosage
• Withdraws from friends and previously pleasurable activities and becomes more isolated and secretive
• Fear of eating in public or with others
• Steals or hoards food in strange places
• Drinks excessive amounts of water or non-caloric beverages
• Uses excessive amounts of mouthwash, mints, and gum
• Hides body with baggy clothes
• Maintains excessive, rigid exercise regimen – despite weather, fatigue, illness, or injury—due to the need to “burn off ” calories
• Creates lifestyle schedules or rituals to make time for binge-and-purge sessions
• Withdraws from usual friends and activities
• Frequent checking in the mirror for perceived flaws in appearance
• Extreme mood swings
• Evaluates self-worth based on weight, shape and appearance
• Experiences shame, guilt, and despair after episodes of binge- eating and compensatory behaviors
• Frequently experiences low self-esteem

Binge Eating Disorder

Binge eating disorder is characterized by recurrent episodes of binge eating and eating larger amounts of food than most people would in the same situation and discrete period of time. Other associated behaviors include eating very rapidly, eating past the point of being full, eating when not hungry, and eating alone. This behavior is coupled with intense feelings of “loss of control” over eating, shame and guilt. BED is diagnosed when an individual engages in binge eating, on average, at least 1 day a week for 3 months.

• Engages in episodes of binge eating large amounts of food in a short period of time, often in secret
• Avoids eating in public or with others and often feels embarrassed about the quantity of food consumed
• Steals or hoards food in strange places
• Repeated failure to sustain weight loss through dieting, increased activity, or the use of weight loss medications
• Creates lifestyle schedules or rituals to make time for binge sessions
• Withdraws from friends and previously pleasurable activities and becomes more isolated and secretive
• Shows extreme concern with body weight and shape
• Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting
• Manipulation of insulin dosage to accommodate binge episode
• Experiences shame, guilt and despair after binge-eating episodes
• Fluctuations in weight
• Frequently experiences low self-esteem