While anorexia and bulimia are two of the best known eating disorders, they are not the only ones. Binge eating, muscle dysmorphia and the latest, orthorexia, are other examples.
Understanding eating disorders
Eating disorders are characterized by severely disturbed behaviour around food, weight and body image. They also include issues involving self-image, impulse control, mood and interpersonal relationships.
People with an eating disorder often suffer from another problem, such as depression , anxiety or alcohol or drug abuse. Some may also have symptoms of more than one eating disorder.
Who is affected?
In Quebec, eating disorders affect about 3 percent of girls and women between the ages of 13 and 30. If partial manifestations of the disorders are taken into account, this figure can easily be tripled.
As a general rule, eating disorders:
- Start in adolescence or young adulthood
- Occur in developing countries, but are more prevalent in the industrialized world
- Affect all socioeconomic classes equally
- Are experienced by people of all cultures
- Women are more likely than men to develop anorexia and bulimia (by a ratio of 9:1)
- Binge eating disorder affects approximately two men to three women, who, on average, are in their forties.
Eating disorders are caused by a combination of different factors. Here is a summary.
Biological factors. Weight problems, genetics, family history of anxiety, depression and eating disorders.
Social factors. Ideal of beauty, cultural fixation on thinness and the promotion of miracle diets contribute to strong societal pressure to be thin. While not the single cause or the trigger, family influence can also be involved.
Psychological factors. Low self-esteem, fear of not measuring up, need for control, solitude, anger, fear of growing up, perfectionism and extreme sensitivity to the opinions of others.
Anorexia and bulimia
Anorexia, as we know, is characterized by a refusal to maintain a healthy body weight for one’s age and height, a fear of getting fat, a distorted body image and, for some women, the absence of menstruation. Some people suffering from anorexia will have a bulimic phase involving laxative use or induced vomiting.
Bulimia involves recurring episodes of binge eating, whereby excessive amounts of food are consumed in a very short period of time – amounts much greater than anyone would normally eat in a single sitting. Due to the subsequent sense of shame and loss of control experienced by those with bulimia, the binge eating is then followed by compensatory behaviour, such as self-induced vomiting, misuse of laxatives, exercise or fasting. This explains why most sufferers have a normal weight or are only slightly overweight.
Lesser-known eating disorders
The American Psychiatric Association (APA), which authored the Diagnostic and Statistical Manual of Mental Disorders (DSM), has long classified anorexia and bulimia as eating disorders. It has also recently added binge eating disorder to the list. Additional disorders not yet recognized by the APA are emerging and appear to stem from certain trends in society.
Binge eating disorder. Similar to bulimia, binge eating disorder also entails periods of excessive food consumption followed by guilt and shame. Unlike bulimia, however, it is not accompanied by compensatory behaviour (vomiting, laxative use, exercise, fasting, etc.). An estimated 10 percent of the general population – approximately 30 to 50 percent of people suffering from obesity – are believed to have this disorder.
Orthorexia. Orthorexia begins with an interest in healthy eating but becomes a growing fixation on nutrition and healthy foods, deeming some “good” and others “bad.” People with this eating disorder are obsessed with meal planning and the nutritional content of food, even refusing to eat anything if they judge the food unhealthy.
Anorexia athletica. Similar to classic anorexia, this eating disorder involves fear of weight gain, distorted body image, significant dietary restrictions and compensatory behaviour associated with excessive exercising.
Muscle dysmorphia. More common in men, muscle dysmorphia is an abnormal preoccupation with being muscular. It entails an unrealistic body image, leading to excessive physical training, an exaggerated focus on diet and an intake of supplements to increase weight and muscle mass.
Eating disorders are treated with a variety of therapeutic approaches: psychoeducation, behavioural or cognitive therapy, relaxation techniques, medication, etc.
Since eating disorders can have severe consequences for a person’s physical and mental health, it is important to obtain a diagnosis and treatment in a timely manner. If you think you or someone you love suffers from an eating disorder, consult your doctor.
In some cases, pharmacists are able to detect an eating disorder in one of their patients and refer them to the appropriate resource for help. Your family pharmacist is always there for you!