A person experiencing anorexia nervosa will restrict the amount of food and the types of food they eat. Some people with the disorder also purge via compulsive exercise, vomiting or misuse of medications, and may binge eat. This results in weight loss and a body weight that is too low for their age, sex, stage of development and physical health. The person is extremely worried about gaining weight and may engage in life-threatening behaviours to avoid this. They rarely appreciate the effect of these behaviours on their health and well-being.
Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. Although the disorder most often begins during adolescence or when a young person first leaves home, younger children and older adults are also being diagnosed with anorexia.
Bulimia (or bulimia nervosa) is also a serious mental illness with potentially life-threatening consequences. It can affect anyone of any age, gender, or background. People with bulimia are caught in a cycle of eating quantities of food much larger than a regular portion (called bingeing), and then trying to compensate for the bingeing by vomiting, misusing medications or exercising excessively.
During a binge, people with bulimia don’t feel in control of how much or how quickly they’re eating. The food eaten during a binge may include things the person would usually avoid that are high in sugar or fat. Binging creates distress because people with bulimia place strong emphasis on their weight and shape. People with bulimia often maintain a “normal” weight and often hide their illness from others because they feel ashamed of their loss of control.
Bulimia nervosa is different to anorexia nervosa as a person experiencing bulimia nervosa is not underweight for their age, sex, stage of development and physical health.
Eating disorders are serious mental Illnesses but they are treatable and recovery is possible.
BINGE EATING DISORDER (BED)
Binge Eating Disorder is now a category of eating disorder on its own.
It is a severe, life-threatening and treatable eating disorder characterized by recurrent episodes of bingeing – eating large quantities of food quickly, often until the point of feeling intense discomfort. The person often has a feeling of a loss of control during the binge, and will feel shame, distress or guilt afterwards. Unlike bulimia, a person who has a binge eating disorder does not use purging behaviours to counter the binge eating.
People with binge eating disorder may or may not have extreme body image concerns.
OTHER SPECIFIED FEEDING AND EATING DISORDERS (OSFED)
This diagnosis is used when people are experiencing severe eating disorder symptoms that do not quite fit any other eating disorder diagnosis. Other Specified Feeding or Eating Disorder” (OSFED) accounts for a significant percentage of eating disorders and is as serious as anorexia, bulimia, or binge eating disorder. People with OSFED need treatment.
Some specific examples of OSFED include:
- Atypical anorexia –someone has all the symptoms of anorexia, except that in spite of losing considerable weight, their weight remains within a “normal” range. For example, it can apply to someone who started out over-average weight before losing weight and who may be genetically pre-disposed to being larger than average.
- Bulimia nervosa – someone has all of the symptoms of bulimia but the binge/purge cycles don’t happen as often or over as long a period of time
- Binge eating disorder –someone has all of the symptoms of binge eating disorder, except the binges don’t happen as often or over as long a period of time as with binge eating disorder
- Purging disorder – where someone purges in an effort to control weight, but not as part of anorexia or bulimia
- Night eating syndrome – where someone repeatedly eats at night, either after waking up from sleep, or by eating a lot of food after their evening meal.
AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER (ARFID)
Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis. Like people with anorexia those with ARFID limit the amount and/or types of food they consume. However, they are not motivated by body image dissatisfaction nor by fear of getting fat.
ARFID is identified when a child does not eat sufficiently to support their growth and development. This can happen, for instance, when a child chokes while eating and becomes so worried they will choke again, that they refuse to eat the food they were eating the first time it happened. Gradually any food that makes they feel like they might choke gets cut out. An adult with ARFID similarly can’t maintain basic body function because of their severe limits with food.
Because ARFID is a new category, not much is known about how common it is but researchers say that people with ARFID tend to be younger and male and may include some of the following symptoms:
- food avoidance
- decreased appetite
- abdominal pain
- fear of vomiting
Recent research also suggests that some children with ARFID may have a co-existing mood disorder or anxiety disorder or may have an autism spectrum condition.
OTHER EATING DISORDERS
Pica is an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value. Examples might be hair, dirt, and paint chips.
Pica often occurs with other mental health disorders associated with impaired functioning (e.g., intellectual disability, autism spectrum disorder, schizophrenia).
Rumination disorder involves regularly regurgitating food after eating to rechew or swallow. When someone regurgitates their food, they appear to do it without effort, stress or disgust.
Unspecified feeding and eating disorder (UFED): The unspecified feeding and eating disorder category is used in situations in when there is insufficient information to make a more specific diagnosis. Symptoms may appear to have characteristics of a feeding and eating disorder but do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class.
Orthorexia: Although not formally recognized, there is growing awareness about this disorder. The word ‘orthorexia’ was coined in 1998 and means an obsession with proper or ‘healthful’ eating. People with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.
It’s difficult to get an estimate on precisely how many people have orthorexia, and if it’s a stand-alone eating disorder, a type of existing eating disorder like anorexia, or a form of obsessive-compulsive disorder.
Sometimes, another psychological disorder can begin around the same time as an eating disorder. It can present before, or after the eating disorder has already begun. Perfectionism, depression, anxiety – especially social anxiety, and obsessive-compulsive disorder are most common to occur alongside eating disorders, but post-traumatic stress disorders, self-harm and ADHD are also relatively common.
There is an overwhelming amount of online information about eating disorders. Without a definitive go-to source it’s easy to feel confused and unsure about where to go to find the help you need. Please visit our resources section for more information and useful links.