What is an eating disorder?

In a general sense, eating disorders are experienced as disturbances in eating habits and are accompanied by physical and emotional distress. They lead to a deterioration of physical and psychological well-being. To understand what an eating disorder means for the individual experiencing these difficulties, it is more helpful to think of the eating disorder as something that an individual has developed in order to feel that they can cope with their lives. However, the more the individual relies on the eating disorder to cope, the more they need the eating disorder to cope, and very quickly they spiral into a situation where they feel they will only be able to cope and live if they hold onto the eating disorder. The individual's sense of who they are comes to depend on them holding onto the eating disorder and this is why it is so difficult and terrifying for a person to think about letting go of the eating disorder. Therefore, while it is clear to everyone else that the person is harming his / herself, the only way the individual with the eating disorder feels they can survive is by maintaining the eating disorder.

Eating disorders present in many different ways. To find out more about each eating disorder diagnosis, you can click the links below:


What causes an eating disorder?

Eating disorders (EDs) are complex medical and psychiatric illnesses that individuals don’t choose; they are bio-psycho-social diseases. Several decades of genetic research show that biological factors play a significant role in who develops an eating disorder. A societal factor (like the media-driven thin body ideal) is an example of an environmental trigger that has been linked to increased risk of developing an eating disorder. Environmental factors also include physical illnesses, childhood teasing and bullying, and other life stressors. EDs commonly co-occur with other mental health conditions like major depression, anxiety, social phobia, and obsessive-compulsive disorder. Additionally, they may run in families, as there are biological predispositions that make individuals vulnerable to developing an eating disorder.

While some people can point to a reason or event that they believe caused their eating disorder, plenty of people with eating disorders don’t have a specific reason. Nor is there any evidence that uncovering the cause of an eating disorder is correlated with recovery. Regardless of why someone may have developed an eating disorder, generally the first priorities of treatment are to restore normal eating and weight.


Who suffers from eating disorders?

National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

  • 0.9% of women and 0.3% of men had anorexia during their life
  • 1.5% of women and 0.5% of men had bulimia during their life 
  • 3.5% of women and 2.0% of men had binge eating disorder during their life

The most common age of onset is between 12-25. Although much more common in females, 10 percent of cases detected are in males.


Are eating disorders really that serious?

Eating disorders have the highest mortality rate of any psychiatric illness. Besides medical complications from binge eating, purging, starvation, and over-exercise, suicide is also common among individuals with eating disorders. People who struggle with eating disorders also have a severely impacted quality of life. 

Many eating disorders begin during adolescence, but psychologists and doctors have found an increasing number of young children and older adults diagnosed with these illnesses. The more quickly an eating disorder is diagnosed and effective treatment begun, the greater the chances of recovery.


What types of therapy are used in treating eating disorders?

Many professionals recommend the use of evidence-based treatment, which is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” In eating disorder therapies, evidence-based treatment usually means that the therapy has been used in a research study and found to be effective in reducing eating disorder symptoms, encouraging weight restoration in underweight patients, and decreasing eating disorder thoughts. Some of the main forms are evidence-based treatment are described below:

Family Based Therapy (FBT): Also known as the Maudsley Method or Maudsley Approach, this is a home-based treatment approach that has been shown to be effective for adolescents with anorexia and bulimia. FBT doesn’t focus on the cause of the eating disorder but instead places initial focus on refeeding and full weight restoration to promote recovery. All family members are considered an essential part of treatment, which consists of re-establishing healthy eating, restoring weight and interrupting compensatory behaviors; returning control of eating back to the adolescent; and focusing on remaining issues.

Cognitive behavioral therapy (CBT): A relatively short-term, symptom-oriented therapy focusing on the beliefs, values, and cognitive processes that maintain the eating disorder behavior. It aims to modify distorted beliefs and attitudes about the meaning of weight, shape and appearance, which are correlated to the development and maintenance of the eating disorder.

Dialectical Behavior Therapy (DBT): A behavioral treatment supported by empirical evidence for treatment of binge eating disorder, bulimia nervosa and anorexia nervosa. DBT assumes that the most effective place to begin treatment is with changing behaviors. Treatment focuses on developing skills to replace maladaptive eating disorder behaviors. Skills focus on building mindfulness skills, becoming more effective in interpersonal relationships, emotion regulation, and distress tolerance. Although DBT was initially developed to treat borderline personality disorder, it is currently being used to treat eating disorders as well as substance abuse.

Acceptance and Commitment Therapy (ACT): The goal of ACT is focusing on changing your actions rather than your thoughts and feelings. Patients are taught to identify core values and commit to creating goals that fulfill these values. ACT also encourages patients to detach themselves from emotions and learn that pain and anxiety are a normal part of life. The goal isn’t to feel good, but to live an authentic life. Through living a good life, people often find they do start to feel better.


How do I know if I have an eating disorder?

If you find yourself pre-occupied with your weight, body image and appearance, portions or counting calories, or exercising to the point that it’s intruding into your thoughts, interfering with your daily life and relationships, or causing loved one’s concern, you may be at risk for an eating disorder.

If you are concerned that you may have an eating disorder, please follow the link below (click on "Start the Online Self Assessment") to participate in a brief online assessment. This process will help you identify behaviors that may indicate an eating disorder and provide suggestions about what steps to take next.

https://www.nationaleatingdisorders.org/screening-tool

Please note: the results of this assessment do not constitute a formal medical diagnosis. If you have concerns, you should see your doctor or call Rooted Counseling at (724) 454-9024 to schedule an intake session.

NEDA toll-free, confidential helpline: 1-800-931-2237


I’m concerned my loved one may have an eating disorder. What should I do?

Recovery from an eating disorder requires professional help, and chances of recovery are improved the sooner a person begins treatment. It can be frustrating to watch a loved one suffer and refuse to seek help. Parents of children under 18 can often require that their child’s eating disorder be treated, even if the child doesn’t buy in to the idea that treatment is necessary.

For parents of older sufferers, and other loved ones of sufferers of any age, encouraging a reluctant eating disorder patient to seek help can be a delicate task. It’s crucial to their future well-being, however, to seek recovery, and encouraging proper treatment of their eating disorder can help them move towards that goal.

Although every discussion with an eating disorder sufferer will be slightly different, here are a few basic points to keep in mind:

  • Taking the first step towards recovery is scary and challenging. Although the act of seeking help might seem straightforward to you, it can be very stressful and confusing. Keeping that in mind will help you empathize with what the other person is going through.
  • Ask if they want help making the first call or appointment. Some individuals may find it less anxiety-provoking if someone else sets up the appointment or goes with them to discuss a potential eating disorder. 
  • Don’t buy the eating disorder’s excuses. It’s easy enough to promise to see a doctor or a therapist, but the sufferer needs to follow through with making the appointment and seeing a professional on a regular basis. Yes, everyone’s busy, treatment can be expensive, and the eating disorder might not seem like a big deal. Don’t making eating disorder treatment the only thing you talk about with your loved one, but follow up on their promise to see someone.
  • If the first professional isn’t a good match, encourage them to keep looking. Finding the right therapist isn’t easy, and someone may have to interview several potential candidates before finding one that works. Sometimes it takes several tries before a person identifies the right clinician.
  • Make sure they get a medical check-up. Eating disorders cause a wide range of medical issues, and sufferers need to see a physician regularly to make sure their health isn’t at immediate risk. Remember that lab work may remain stable even if someone is close to death, so don’t rely on blood tests alone.
  • Ally with the part of them that wants to get well. Often, eating disorder sufferers are hesitant to change their behaviors. Some people have found it easier to focus on some of the side effects of the eating disorder that the sufferer may be more willing to acknowledge and tackle, such as depression, social isolation, anxiety, insomnia, fatigue, or feeling cold. This can help get them in the door, where the eating disorder can begin to be addressed.
  • Remind the person of why they want to get well. What types of goals does your loved one have? Do they want to travel? Have children? Go to college? Start a new career? Helping them reconnect with their values and who they want to be can help them stay focused on long-term recovery and not the short-term benefits of the eating disorder.
  • Find a middle ground between forcing the issue and ignoring it. If you become overly insistent and combative about your loved one seeking help, they may start to avoid you. On the other hand, you don’t want to ignore a potentially deadly illness. It’s not easy to find a middle ground between these two extremes, but regularly checking in with your loved one about how they’re doing and if they are willing to seek treatment can help nudge them in the right direction.

Can you tell someone has an eating disorder just by their appearance?

Many people with eating disorders are of normal weight, or even overweight. Weight is not a tell-all sign of an eating disorder. Furthermore, individuals suffering from an eating disorder can become quite skilled at hiding their disordered eating behaviors.


Is full recovery possible?

The short answer to this question is YES. Individuals with eating disorders can and do make full recoveries. Recovery is sometimes described as learning to re-connect with oneself, building up a trust in one's ability to cope without needing to control, and not translating life issues into food issues as a way of dealing with them. Recovery has a very individual meaning for each person so it is difficult to generalize and give a time scale to the recovery process. Factors such as how long the person has had the eating disorder and the quality of support they receive will influence the length of time the recovery process


Where can I find more information on eating disorders?

Glad you asked! You can find a list of resources in our Recommended Resources page.


 
Food matters because it’s one of the things that forces us to live in this world — this tactile, physical, messy, and beautiful world — no matter how hard we try to escape into our minds and our ideals. Food is a reminder of our humanity, our fragility, our createdness.
— Shauna Niequist