Comic on Eating Disorders
Eating Disorders
Overview of Eating Disorders
For some people, eating food can bring up difficult emotions, and this can lead to unhealthy behaviors.
Restricting
Some people think they weigh too much, even when they do not. This causes a lot of anxiety, so they may eat less than their body needs. When this happens, people can sometimes lose an unhealthy amount of weight. This is called "restricting."
Some people may be bothered by certain types of foods for other reasons. They may think certain foods taste bad, or may not like the texture. Everyone prefers some foods over others. But if a person is bothered by many foods, they may not get all the nutrients they need, and may lose an unhealthy amount of weight without meaning to. This is a different type of restricting.
Bingeing
Sometimes, people will use food to help them deal with difficult feelings, like sadness, loneliness, or anxiety. When people feel that they can't control how much they eat, it is called "compulsive eating." When people eat a very large amount at one time, and then feel ashamed or embarrassed afterward, it is called "bingeing."
Purging
After eating, people may worry that they will gain weight, and may do something to try to stop that from happening. Some people will try to get the food out of their bodies right after eating it, by making themselves throw up or by taking laxatives. Others may exercise for a very long time, to try to burn a large amount of calories. This is called "purging."
More Information on Eating Disorders
The most well-known eating disorders are anorexia nervosa and bulimia nervosa. These two disorders are related; they both involve an unhealthy relationship to one’s own body shape & weight, resulting in unhealthy eating patterns.
Anorexia Nervosa
In anorexia nervosa, the preoccupation with weight tends to be especially severe. People with anorexia have an intense fear of gaining weight. They often perceive themselves to be larger than they are, and when they are underweight, they may not be able to appreciate the medical risks associated with this. To be diagnosed with anorexia, a person must engage in “restricting” behavior, and become underweight as a result. Many people restrict by limiting calories, and some may avoid large categories of foods entirely (such as carbohydrates).
Bulimia Nervosa
People with bulimia nervosa engage in repeated episodes of “bingeing” and “purging” (at least once per week, on average). During a binge, a person eats far more than they normally would, and feels that they cannot control how much they are eating. A binge is different than simply eating a large meal. Generally, bingeing occurs in secret, and people frequently feel ashamed and/or physically uncomfortable afterward. After a binge, individuals with bulimia will use purging behaviors to try to prevent weight gain. These can include intentionally vomiting, fasting, using laxatives, or exercising excessively.
Some people who meet criteria for anorexia also engage in bingeing and purging; these individuals are diagnosed as having the “binge-eating/purging” subtype of anorexia nervosa (as opposed to the “restricting” subtype). Other people may engage in binge-eating without purging afterward; if these episodes occur frequently and cause distress, they may be diagnosed with “binge-eating disorder.”
Eating Disorders, Painful Emotions, and Trauma
The symptoms of anorexia, bulimia, and binge-eating disorder are often connected to painful emotions or past trauma, which people may or may not be aware of. They may suffer from co-occurring disorders, such as depression, PTSD, or anxiety. Treatment for eating disorders, sometimes including medication but almost always including psychotherapy, can be very helpful in addressing the underlying emotional causes, and restoring healthier eating behaviors.
Compulsive Eating
There are also many people who struggle to control their eating but do not meet criteria for a formal eating disorder. When people eat in response to emotional cues (rather than physical hunger) and struggle to control how much they eat, this is often referred to as “compulsive eating,” which may benefit from treatment as well.
Avoidant/Restrictive Food Intake Disorder (ARFID)
There is another type of eating disorder that can have significant medical consequences, but is not connected to concerns about shape and weight. This disorder, which is more common in children than adults, is known as “Avoidant/Restrictive Food Intake Disorder (ARFID).” Children with ARFID eat less than their bodies need because the experience of eating is bothersome to them, often for sensory reasons. Sometimes, they may seem to simply be uninterested in food. Frequently, they may be bothered by certain characteristics of food (such as texture), so much so that they are only willing to eat a few things. Many children are “picky eaters,” but this is not considered a disorder if it does not result in negative medical or psychosocial consequences. Children with ARFID, however, are so selective in what they eat that they often end up being underweight or nutritionally deficient. The disorder can also cause great stress for families around mealtime. Specific therapies are available to help these children become comfortable eating a variety of different foods.