What are eating disorders?
Eating disorders are moderate to severe mental illnesses characterized by disturbances in behaviour and thinking around food, eating, weight and/or shape. They comprise a wide spectrum of illness and are serious, potentially-life threatening, mental health problems; they are not a lifestyle choice. Eating disorders affect people of all ages, from all cultural backgrounds and may arise in response to a range of risk factors.
Eating disorders can begin at any age, but usually begin in adolescence. While people tend to think that they are rare, they are not – eating disorders affect 2-3% of the population. While the majority of sufferers are female, males can also suffer from eating disorders and body image related issues.
Even though everyone’s experience of an eating disorder is different, it can be helpful to know something about the broad diagnostic ‘categories’ that are used within the health system. Eating disorders are classified into four different types, depending on the kind of symptoms and frequency of behaviours.
Anorexia nervosa (AN): Restriction of energy intake relative to an individual’s requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory and health status. Disturbance of body image, an intense fear of gaining weight, lack of recognition of the seriousness of the illness and/or behaviours that interfere with weight gain are also present.
Bulimia Nervosa (BN): Binge eating (eating a large amount of food in a relatively short period of time with a concomitant sense of loss of control) with purging/compensatory behaviour (e.g. self-induced vomiting, laxative or diuretic abuse, insulin misuse, excessive exercise, diet pills) once a week or more for at least 3 months. Disturbance of body image, an intense fear of gaining weight and lack of recognition of the seriousness of the illness may also be present.
Binge Eating Disorder (BED): Binge eating, in the absence of compensatory behaviour, once a week for at least 3 months. Binge eating episodes are associated with: eating rapidly, when not hungry, until extreme fullness, and/or associated with depression, shame or guilt.
Other Specified Feeding and Eating Disorder (OSFED): An ED that does not meet full criteria for one of the above categories, but has specific disordered eating behaviours such as restricting intake, purging and/or binge eating as key features.
Unspecified Feeding or Eating Disorder (UFED): ED behaviours are present, but they are not specified by the care provider.
Avoidant/Restrictive Food Intake Disorder (ARFID): Significant weight loss, nutritional deficiency, dependence on nutritional supplement or marked interference with psychosocial functioning due to caloric and/or nutrient restriction, but without weight or shape concerns
For more comprehensive descriptions of eating disorders, visit National Eating Disorders Collaboration www.nedc.com.au
Nine Truths about Eating Disorders
Truth #1: Many people with eating disorders look healthy, yet may be extremely ill.
Truth #2: Families are not to blame, and can be the patients’ and providers’ best allies in treatment.
Truth #3: An eating disorder diagnosis is a health crisis that disrupts personal and family functioning.
Truth #4: Eating disorders are not choices, but serious biologically influenced illnesses.
Truth #5: Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses.
Truth #6: Eating disorders carry an increased risk for both suicide and medical complications.
Truth #7: Genes and environment play important roles in the development of eating disorders.
Truth #8: Genes alone do not predict who will develop eating disorders.
Truth #9: Full recovery from an eating disorder is possible. Early detection and intervention are important
Produced by the Academy of Eating Disorders (www.aed.org) in collaboration with Dr. Cynthia Bulik, PhD, FAED, who serves as distinguished Professor of Eating Disorders in the School of Medicine at the University of North Carolina at Chapel Hill and Professor of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden. “Nine Truths” is based on Dr. Bulik’s 2014 “9 Eating Disorders Myths Busted” talk at the National Institute of Mental Health Alliance for Research Progress meeting.
Leading associations in the field of eating disorders also contributed their valuable input.