Eating Disorders
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What are Eating Disorders?

Bridget Engel, Psy.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

There are three primary eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Each disorder is characterized by a distinctive pattern of disordered and harmful eating behavior. Anorexia generally involves the severe and extreme restriction of eating in an effort to lose weight. Because of this restriction, anorexics are typically underweight (defined as weighing only 85% or less of the expected weight for their height and gender). Bulimia is characterized by the presence of binges, which are episodes of consuming abnormally large amounts of food in a short period of time. Bulimic binges are often followed by compensatory purge behaviors that are an attempt to get rid of the consumed calories. Inducing vomiting, taking laxatives and excessive exercising are examples of purging behavior characteristic of bulimia, all performed in an effort to prevent weight gain.

Binge and purge behavior may occur during anorexia as well as in bulimia. However, extreme eating restriction is always present in anorexics and rarely in bulimics. Binge Eating Disorder is similar to Bulimia because both conditions share binge-eating behavior. However, individuals with Binge Eating Disorder do not purge or get rid of what they have consumed, unlike those with Bulimia.

Harmful eating behavior may start as isolated experiments with food restriction or binge/purge behaviors that gradually progress to become both chronic and cyclic in nature. In other words, disordered eating becomes an ongoing problem, one that often waxes and wanes in intensity over time. Eating disordered individuals who successfully manage to restrict and control what they eat may feel a short-term sense of empowerment and accomplishment. Such positive feelings do not tend to last very long, however. A bad day at school or work, a conflict with another person, or simply reading a fashion magazine or watching television may trigger renewed feelings of self-hatred and disgust, and lead to consumption of "banned" foods. This breakdown in willpower leads to self-perceptions of weakness and unacceptability, which in turn motivate further food restriction. Endless cycling of dysfunctional eating behaviors create ripe conditions for a disorder.

Things all eating disorders have in common:

As mentioned previously, all three eating disorders are serious mental and physical conditions with potentially life-threatening repercussions. These disorders can impair daily functioning and destroy general health. Individuals typically experience painful emotions before, during and after the maladaptive eating behaviors. In addition, people with eating disorders are generally fixated on their weight. They often fear gaining any weight, and their self-esteem is highly influenced by their body weight. This fixation can develop into a distorted body image. Body image has to do with how people interpret images of their bodies, including literal images (such as occur when looking in a mirror), and remembered images (such as occur when thinking about what you look like). Most of those suffering from eating disorders feel badly about their body image, and furthermore, are not able to accurately see themselves as others perceive them. Even when friends, family and coworkers worry about an individual's weight loss and painfully thin appearance, these individuals still consider themselves fat, and discount the value and worth of other's opinions. Rejecting other people's perceptions enables eating disordered individuals to maintain their negative opinion of themselves, as well as their distorted sense of body image.

People diagnosed with eating disorders tend to be anxious about and sensitive to social acceptance. They tend to measure their success against unrealistically high standards or social ideals that are virtually unattainable. They are often acutely aware of their failure to reach these self-imposed standards, and believe that they have let down their community and themselves as a consequence. Frequently, this sense of failure drives them to work harder toward reducing the discrepancy between their current weight and their idealized weight. This drive can be so strong that some people abuse their bodies to the point of serious illness and even death.