Types of Eating Disorders

San Jose Counseling and Psychotherapy

While the modern diagnoses of anorexia nervosa, bulimia nervosa, and binge eating disorder were first recognized as major health problems in the 1950s, many of the behaviors that characterize the types of eating disorders have been practiced for centuries.

Research suggests that up to 5 percent of Americans have some type of eating disorder that would qualify for eating disorder therapy. Those suffering with an eating disorder are often able to hide their illness until outward signs result, such as severe weight loss or gain.

Eating Disorder Treatment for Anorexia Nervosa

Of off the types of eating disorders, anorexia has the highest mortality rate. A person with anorexia does not eat enough to maintain a healthy weight. They believe that they weigh too much no matter how thin they get. The thought of gaining any weight creates anxiety.

The onset of anorexia is usually during adolescence. Although it primarily affects females, males can also become anorexic. The most distinguishing feature of someone with anorexia is the fact that the person weighs less than 85 percent of the normal weight for a person their age and height.

Extreme use of exercise, vomiting, and laxatives/diuretics use is also common. Severe anorexia can be life threatening, with the gravity of problems including gastrointestinal disease and cancer. Some symptoms that are more unique to anorexia nervosa include:

• Believing your body is overweight even when underweight
• Periods of fasting or severe calorie restiction
• Avoiding eating with others and picking at food when it does happen
• Getting chilled even in hot weather because of electrolyte imbalance and low body fat
• Anemia
• Using baggy clothes to conceal your body
• Little or no menstruation
• Hair loss

If an anorexic is vomiting, symptoms of purging may also be present. An estimated one third to half of anorexics develop bulimia. In eating disorder treatment, anorexia is the most complicated eating disorder to treat of all types of eating disorders.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines two forms of anorexia. The first is called “Restricting Type” and refers to food restriction which is done by a variety of methods including food restriction, fasting, starvation, and exercise. The second type of anorexia is called the “Binge-Eating/Purging Type” which includes behaviors that are bingeing and purging. Purging is often done using calorie restriction and fasting, but drug abuse and vomiting is also common.

Eating Disorder Counseling for Bulimia Nervosa

Bulimia, also known as bingeing and purging, is more common than anorexia, and usually affects teenage girls and women in their twenties. Unlike those with anorexia, some people affected by bulimia maintain normal or even excessive body weight.

Binge-eating disorder is similar to bulimia but no purging is done. It is more common than either bulimia or anorexia nervosa, and people with binge-eating disorder are usually overweight. Some of the signs that tend to be more common in bulimia are:

• Long absences, or unexplained disappearances after meals
• Swollen glands under the chin (from vomiting)
• Bloodshot eyes, and popped blood vessels around the eye area (from vomiting)
• Teeth problems from increased acidic levels from starving and/or vomiting
• Scars on knuckles from vomiting

People with bulimia nervosa often go to extremes to keep their disorders secret. Because there are often no overt signs of bulimia nervosa as there is with anorexia, many cases of bulimia go undetected by health care professionals.

Eating Disorder Therapy for Binge Eating Disorder

Binge eating involves more than just eating a lot. With binge eating, a person feels out of control and powerless to stop eating while he or she is doing it. That’s why binge eating is also called compulsive overeating.

Like bulimia, binge eating disorder is characterized by consuming large amounts of food. The act of binge eating is compulsive and the person feels out of control during the bingeing episode, followed by guilt and shame. The way is which bulimia nervosa is distinct from binge eating disorder is that a person with bulimia develops compensatory purging behaviors. Someone with a binge eating problem would tend to do the following:

• Consuming a large amount of food more quickly than would be considered normal
• Continuing to eat after being full
• Consuming food when there is no hunger
• Eating in secret
• Experiencing guilt or shame after consuming a large amount of food
• Weight gain doe to consuming excessive food during bingeing episodes

The key diagnostic features for binge eating disorder according to the DSM-IV are as follows:

• Recurrent episodes of binge eating involving a) eating, within a discrete time period (such less than 2 hours) an abnormally large amount of food, and b) a sense of lack of control over eating
• Marked distress about binge eating
• Binge eating on at least two days per week for six months
• Not associated with regular use of inappropriate compensatory behaviors

Eating Disorder Treatment Can Help

Because these patients tend to conceal the true nature of their illness, they often convince doctors to engage in expensive tests, and may be diagnosed with other co-occurring condition like malabsorption, pituitary disease, gastric problems, and food allergies while their eating disorder remains overlooked. Experts in the field of eating disorders treatment use a multidisciplinary approach that involves nutritional counseling and other health professionals as needed.