Eating Disorders - types and warning signs

[emilykate]

Basically, I can't put it better than the Eating Disorders Foundation of Victoria and so I'm going to give you the link to their website and post the text below. Unless stated otherwise, the information below was last updated on the Eating Disorders Victoria web pages in March 2009.

Remember, 'Eating Disorders' is something of an umbrella term and they can be different for different people. Just as 'Depression' could mean dysthymia, major depression or bipolar disorder and 'Anxiety Disorder' may be panic disorder, post raumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) or even a fear of flying, 'Eating Disorder' covers a variety of conditions.


Source for Warning Signs: www.eatingdisorders.org.au/eating-disorders/warning-signs.html ...

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Warning Signs
It is important to know the warning signs of an eating disorder. These may indicate that an eating disorder is developing or is being experienced in full. Below are lists of behavioural, physical and psychological signs or changes which often accompany an eating disorder. If you or somebody you know is experiencing several of the following symptoms, it is important to seek help immediately to determine if you/they have a problem. Early intervention is vital in promoting recovery.

It is also important to realise that these warning signs may not be as easy to detect as they sound. The person with the eating disorder often experiences shame or guilt about their behaviour, and will try to hide it. Also, many people with eating disorders do not realise they have a problem, or even if they do they will not want to give up their behaviour at first, because it is their mechanism for coping with an issue. Thus they will go to extraordinary lengths to hide the signs of their behaviour.

Please note that any combination of these symptoms can be present in an eating disorder, because no one eating disorder is exactly the same as another. It is also possible for a person to demonstrate several of these signs and yet not have an eating disorder. It is always best to seek a professional opinion.

Behavioural warning signs

• Constant or repetitive dieting (eg. counting calories/kilojoules, skipping meals, fasting, avoidance of certain food groups or types such as meat or dairy, replacing meals with fluids)
  
• Evidence of binge eating (eg. disappearance of large amounts of food from the cupboard or fridge, lolly wrappers appearing in bin, hoarding of food in preparation for bingeing)
  
• Evidence of vomiting or laxative abuse (eg. frequent trips to the bathroom during or shortly after meals)
  
• Excessive or compulsive exercise patterns (eg. exercising even when injured, or in bad weather, refusal to interrupt exercise for any reason; insistence on performing a certain number of repetitions of exercises, exhibiting distress if unable to exercise)
  
• Making lists of ‘good’ and ‘bad’ foods
  
• Changes in food preferences (eg. refusing to eat certain foods, claiming to dislike foods previously enjoyed, sudden interest in ‘healthy eating’)
  
• Development of patterns or obsessive rituals around food preparation and eating (eg. insisting meals must always be at a certain time; only using a certain knife; only drinking out of a certain cup)
  
• Avoidance of all social situations involving food
  
• Frequent avoidance of eating meals by giving excuses (eg. claiming they have already eaten or have an intolerance/allergy to particular foods)
  
• Behaviours focused around food preparation and planning (eg. shopping for food, planning, preparing and cooking meals for others but not consuming meals themselves; taking control of the family meals; reading cookbooks, recipes, nutritional guides)
  
• Strong focus on body shape and weight (eg. interest in weight-loss websites, dieting tips in books and magazines, images of thin people)
  
• Development of repetitive or obsessive body checking behaviours (eg. pinching waist or wrists, repeated weighing of self, excessive time spent looking in mirrors)
  
• Social withdrawal or isolation from friends, including avoidance of previously enjoyed activities
  
• Change in clothing style, such as wearing baggy clothes
  
• Deceptive behaviour around food, such as secretly throwing food out, eating in secret (often only noticed due to many wrappers or food containers found in the bin) or lying about amount or type of food consumed
  
• Eating very slowly (eg. eating with teaspoons, cutting food into small pieces and eating one at a time, rearranging food on plate)
  
• Continual denial of hunger
  

Physical warning signs

[/li][li] Sudden or rapid weight loss
[/li][li] Frequent changes in weight
[/li][li] Sensitivity to the cold (feeling cold most of the time, even in warm environments)
[/li][li] Loss or disturbance of menstrual periods (females)
[/li][li] Signs of frequent vomiting - swollen cheeks /jawline, calluses on knuckles, or damage to teeth
[/li][li] Fainting, dizziness
[/li][li] Fatigue - always feeling tired, unable to perform normal activities


Psychological warning signs

• Increased preoccupation with body shape, weight and appearance
  
• Intense fear of gaining weight
  
• Constant preoccupation with food or with activities relating to food
  
• Extreme body dissatisfaction/ negative body image
  
• Distorted body image (eg. complaining of being/feeling/looking fat when actually a healthy weight or underweight)
  
• Heightened sensitivity to comments or criticism about body shape or weight, eating or exercise habits
  
• Heightened anxiety around meal times
  
• Depression or anxiety
  
• Moodiness or irritability
  
• Low self-esteem (eg. feeling worthless, feelings of shame, guilt or self-loathing)
  
• Rigid ‘black and white’ thinking (viewing everything as either ‘good’ or ‘bad’)
  
• Feelings of life being ‘out of control’
  
• Feelings of being unable to control behaviours around food
  
• Fear of growing up/taking on adult responsibility
  "
  
  
  Types of Eating Disorder
  
  Anorexia Nervosa
  Sources: www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/anorexia-nervosa/what-is-anorexia-nervosa.html
  www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/anorexia-nervosa/physical-effects-of-anorexia-nervosa.html
  www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/anorexia-nervosa/psychological-effects.html
  
  
  "
  What is Anorexia Nervosa?
  Anorexia Nervosa is a psychological illness with devastating physical consequences. Anorexia Nervosa is characterised by low body weight and body image distortion with an obsessive fear of gaining weight which manifests itself through depriving the body of food. It often coincides with increased levels of exercise.
  
  Anorexia Nervosa is usually developed during adolescence and generally has an earlier age of onset than Bulimia Nervosa and Binge Eating Disorder (the latter are often developed during late adolescence or early adulthood). However like all eating disorders, Anorexia Nervosa can be developed at any age or stage of life for both males and females.
  
  Anorexia Nervosa is the most fatal of all psychiatric illnesses. Extreme food restriction can lead to starvation, malnutrition and a dangerously low body weight – all of which are synonymous with a host of health problems, and in some cases death.
  
  Types of Anorexia Nervosa
  Two main sub-types of anorexia are recognised:
  
  1. Restricting type: this is the most commonly known type of Anorexia Nervosa whereby a person severely restricts their food intake. Restriction may take many forms (e.g. maintaining very low calorie count; restricting types of food eaten; eating only one meal a day) and may follow obsessive and rigid rules (e.g. only eating food of one colour).
  2. Binge-eating or purging type: less recognised; a person restricts their intake as above, but also during some bouts of restriction the person has regularly engaged in binge-eating OR purging behaviour (e.g. self induced vomiting, over-exercise, misuse of laxatives, diuretics or enemas).
  
  Physical Effects of Anorexia Nervosa
  Most physical symptoms associated with Anorexia Nervosa are related to malnutrition. A person may experience some or all of the following symptoms, which tend to become more severe the longer the disorder remains untreated.
  
  • Dry skin
    
  • Dry or chapped lips
    
  • Poor circulation resulting in pins and needles and/or purple extremities
    
  • Headaches
    
  • Brittle fingernails
    
  • Bruising easily
    
  • Frail appearance
    
  • Endocrine disorder leading to cessation of periods in girls (amenorrhoea)
    
  • Decreased libido; impotence in males
    
  • Reduced metabolism
    
  • Abnormally slow heart rate
    
  • Low blood pressure
    
  • Hypotension
    
  • Hypothermia
    
  • Anaemia (iron deficiency)
    
  • Abdominal pain
    
  • Oedema (retention of fluid giving a “puffy” appearance)
    
  • Stunting of height and growth
    
  • Fainting
    
  • Abnormality of mineral and electrolyte levels
    
  • Thinning of the hair
    
  • Lanugo (growth of fine hair layer all over the body to promote warmth)
    
  • Constantly feeling cold
    
  • Zinc deficiency
    
  • Reduction in white blood cell count
    
  • Reduced immune system function
    
  • Pallid complexion and sunken eyes
    
  • Reduction of bone density which results in dry and brittle bones (osteoporosis)
    
  • Constipation or diarrhoea
    
  • Tooth decay
    
    Psychological Effects
    
    
  • Distorted body image
    
  • Self-evaluation based largely or entirely in terms of weight and appearance
    
  • Pre-occupation or obsessive thoughts about food and weight
    
  • Refusal to accept that one’s weight is dangerously low despite warnings from family, friends and/or health professionals
    
  • Low self esteem
    
  • Mood swings
    
  • Clinical depression
    
  • Withdrawal from interpersonal relationships in favour of social isolation
    
    Behavioural Effects
    
  • Excessive exercise and/or food restriction
    
  • Secretive behaviour surrounding eating or exercise
    
  • Overly sensitive to references about weight or appearance
    
  • Obsessive interest in cooking or preparing food for others
    
  • Refusal to eat in the presence of others
    
  • Aggressive when forced to eat “forbidden foods”
    
  • Self harm
    
  • Substance abuse
    
  • Suicide attempts
    
    About 40 per cent of people with Anorexia Nervosa will later develop Bulimia Nervosa.
    "
    
    Remember, if you feel that yourself or someone you know has Anorexia Nervosa, the Eating Disorders Foundation of Victoria CAN help you. You can call their Helpline on 1300 550 236
    

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Bulimia Nervosa
Source: msawomensdepartment.proboards.com/index.cgi?board=mentalhealth&action=post


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What is Bulimia Nervosa?
Bulimia Nervosa is a serious psychiatric illness characterised by recurrent binge-eating episodes (the consumption of abnormally large amounts of food in a relatively short period of time), followed by compensatory behaviour (purging or overexercising). Binge episodes are associated with a sense of loss of control and immediately followed by feelings of guilt and shame, which leads the person to compensatory behaviour (purging) such as self-induced vomiting, fasting, overexercising and/or the misuse of laxatives, enemas or diuretics.

A person with Bulimia Nervosa usually maintains an average weight, or may be slightly above or below average weight for height, which often makes it less recognisable than serious cases of Anorexia Nervosa. Many people, including some health professionals, incorrectly assume that a person must be underweight and thin if they have an eating disorder. Because of this, Bulimia Nervosa is often missed and can go undetected for a long period of time.

Bulimia Nervosa often starts with weight-loss dieting in the ‘pursuit for thinness’. The resulting food deprivation and inadequate nutrition can trigger what is, in effect, a starvation reaction - an overriding urge to eat. Once the person gives in to this urge, the desire to eat is uncontrollable, leading to a substantial binge on whatever food is available – often foods with high fat and sugar content, which is followed by compensatory behaviours. A repeat of weight-loss dieting often follows, perhaps even more strictly – which leads to a frantic binge/purge/exercise cycle which becomes more compulsive and uncontrollable overtime.
"

See also www.eatingdisorders.org.au/uploads/Bulimia%20Nervosa%20EDA.pdf

Remember, if you feel that yourself or someone you know has Bulimia Nervosa, the Eating Disorders Foundation of Victoria CAN help you. You can call their Helpline on 1300 550 236



Binge Eating Disorder

Source: www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/binge-eating-disorder-2/what-is-binge-eating-disorder.html
www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/binge-eating-disorder-2/physical-effects-2.html
www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/binge-eating-disorder-2/psychological-effects-3.html
www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/binge-eating-disorder-2/behavioural-effects-3.html At the time of posting, this page was last update in June 2009.

"
What is Binge Eating Disorder?
Binge Eating Disorder is a psychological illness characterised by frequently eating excessive amounts of food, often when not hungry. Binges represent a distraction that allows a person to avoid thinking about the real root of their problems. Feelings of guilt, disgust and depression often follow a bingeing episode.

Binge Eating Disorder is similar to, but not the same as Bulimia Nervosa. Where people experiencing Bulimia Nervosa will partake in purging activities after bingeing, Binge Eating Disorder is characterised by an absence of purging, despite suffering similar feelings of intense guilt, shame and self-hatred after binges. While a lack of purging is evident, a person experiencing Binge Eating Disorder will often participate in sporadic fasts and repetitive diets in response to the negative sensations which follow a binge episode.

Binge Eating Disorder can affect anybody, regardless of age, gender or ethnicity. In fact, research suggests equal percentages of males and females experience Binge Eating Disorder.

“People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating. Body weight may vary from normal to mild, moderate, or severe obesity”.

- National Eating Disorders Association (NADA)

Physical Effects
Most of the physical signs and symptoms associated with Binge Eating Disorder are long-term, and these can include:

• Weight gain, often leading to obesity
  
• High blood pressure
  
• High cholesterol
  
• Chronic kidney problems or kidney failure
  
• Osteoarthritis
  
• Diabetes
  
• Stroke
  
• Complications during pregnancy
  
• Gallbladder disease
  
• Irregular menstrual cycle
  
• Skin disorders
  
• Heart disease
  
• Certain types of cancer
  
  Psychological Effects
  
• Difficulties with activities which involve food which may lead to self-imposed isolation
  
• Low self esteem and embarrassment over physical appearance
  
• Feeling extremely distressed, upset and anxious during and after a binge episode
  
• Fear of the disapproval of others
  
• Self harm or suicide attempts
  
• Overly sensitive to references about weight or appearance
  
• Guilt, self disgust, self loathing
  
• Anxiety
  
• Depression
  
  Behavioural Effects
  
• An overwhelming sense of lack of control regarding eating behaviour
  
• Eating more rapidly than normal
  
• Periods of uncontrolled, impulsive or continuous eating whereby a person may consume many thousands of calories, often to the point of feeling uncomfortably full
  
• Eating when not physically hungry
  
• Repeated episodes of binge eating which often results in feelings of shame or guilt
  
• Eating in secret
  
• Avoiding social situations, particularly those involving food.
  
• Eating ‘normal’ quantities in social settings, and gorging when alone
  "
  
  Remember, if you feel that yourself or someone you know has Binge Eating Disorder, the Eating Disorders Foundation of Victoria CAN help you. You can call their Helpline on 1300 550 236
  
  
  Eating Disorders Not Otherwise Specified (EDNOS)
  
  Source: www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/eating-disorders-not-otherwise-specified-ednos/what-is-ednos.html At the time of posting, this page was last updated on the Eating Disorders Victoria site in July 2009.
  www.eatingdisorders.org.au/eating-disorders/types-of-eating-disorders/eating-disorders-not-otherwise-specified-ednos/types-of-ednos.html
  
  "
  What is an EDNOS?
  EDNOS is a term used when a person shows signs of disordered eating but does not meet all of the diagnostic criteria for one of the three Diagnostic Statistical Manual (DSM) recognised eating disorders, Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder. For example, a person could show all of the psychological signs of anorexia and be losing weight, but still be menstruating and is not yet underweight for their height.
  
  The DSM has assigned criteria for EDNOS, however there are several forms of disordered eating emerging in recent decades which are not covered by the DSM.
  
  When making an assessment of a patient, a doctor has only certain diagnostic criteria to go by according to the Diagnostic and Statistical Manual of Mental Disorders. If the patient meets some but not all of the criteria of Anorexia Nervosa or Bulimia Nervosa, a doctor may diagnose an EDNOS.
  
  Types of EDNOS
  Please note many of the following terms are relatively new and may not be recognised or diagnosed by a doctor. Research and treatment for these disorders are predominantly in the developmental stage.
  
  
• Purging disorder is characterised by recurrent purging (self-induced vomiting, misuse of laxatives, diuretics, or enemas) to control weight or shape, in the absence of binge eating episodes that occurs in people with normal or near-normal weight. Purging disorder differs from Anorexia Nervosa because individuals with purging disorder are not underweight, and purging disorder differs from Bulimia Nervosa because individuals do not consume a large amount of food before they purge.
  
• Body Dysmorphic Disorder (BDD) is an obsession with a perceived defect in a person’s body or appearance, such as facial features or certain body parts. When the sufferer's obsession is with their weight or being "fat", the risk of developing Anorexia Nervosa or Bulimia Nervosa is increased. The preoccupation causes significant distress or impairment in social, occupational, and/or other important areas of functioning.
  
• Pica is a condition where a person craves and eats non-food items. Pica is more likely to affect some people than others. It is most commonly found in children, pregnant women, people whose diets are deficient in minerals contained in the consumed substances and people with developmental disabilities or impairments. The types of non-food items consumed can vary, but common items include:
  1. Dirt and clay
  2. Paint chips, plaster and chalk
  3. Cornstarch, laundry starch and baking soda
  4. Coffee grounds
  5. Cigarette ashes, burnt match heads
  6. Rust
  
• Muscle Dysmorphia is a condition whereby a person believes they are underweight or unacceptably small, when the opposite is true. It is also referred to as ‘bigorexia’ or ‘reverse anorexia’. It tends to affect bodybuilders and avid gym-goers and is more common in males than in females. Muscle dysmorphia becomes dangerous when sufferers take excessive amounts of steroids or other muscle-enhancing drugs to increase their body size and muscle capacity.
  
• Anorexia Athletica (also known as compulsive exercise, obligatory exercise, exercise addiction) is characterised by the compulsion to exercise for an amount of time or at an intensity that is beyond normal and frequently beyond healthy. A person with Anorexia Athletica utilises exercise to gain a sense of temporary power, control and/or self-respect, often in response to a poor body image that is distorted by their own perception. Physical dangers associated with overexercising may include dehydration, stress fracture and osteoporosis, degenerative arthritis, amenorrhea (loss of menstrual cycle), reproductive problems, and heart problems. Anorexia Athletica often goes hand in hand with other eating disorders, whereby compulsive exercise is used as a ‘replacement’ for food restriction or purging. Symptoms unique to Anorexia Athletica include:
  1. Repeatedly exercising beyond what is considered safe
  2. Finding time to exercise at any cost whereby a person may skip work or social commitments
  3. Extreme guilt or anxiety as a result of missing exercise
  4. Rarely being satisfied with athletic achievements
  5. Defining self worth in terms of athletic performance
  
• Nocturnal Sleep-Related Eating Disorder (NSSED) occurs when a person eats in their sleep, often waking up with food remnants or packaging around with no recollection of the episode. Strictly speaking, NSSED is not an eating disorder because the person is not consciously aware of their behaviour. NSSED is a fairly new term that is still being investigated.
  
• Orthorexia Nervosa occurs when an individual has a fixation on only eating food they consider to be healthy, beneficial or ‘pure’ through strict diet regimes. While extreme food restriction is a characteristic of both Anorexia Nervosa and Ortherexia Nervosa, the fundamental difference lies in the nature of the obsession – somebody with Ortherexia Nervosa is not consumed by thoughts of being ‘thin’, losing weight or the quantity of food, rather they concentrate on the quality and purity of the food. The physical dangers are generally not as extreme as other eating disorders. Instead, the problems tend to be social ones, such as self imposed isolation, eating alone and spending a considerable amount of time planning and buying food.
  
  
  Remember, if you feel that yourself or someone you know has an EDNOS, the Eating Disorders Foundation of Victoria CAN help you. You can call their Helpline on 1300 550 236
  

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