Eating disorders affect every part of society.
Do you know anyone who exercises obsessively, even when he or she is injured or exhausted? Or someone who’s preoccupied with his or her weight and always dieting? This kind of behavior could be a sign of an eating disorder, says Dr. Carolyn Coker Ross, who specializes in integrative medicine for eating disorders at her private practices in Denver and La Jolla, California. “Eating disorders affect all segments of society, all education levels and all races. Eating disorders can cause an enormous amount of suffering to the person who has an eating disorder and to family members,” Ross says. “It can cause financial difficulties from recurrent need for treatment and in some cases for those who spend a lot of money on bingeing foods. It’s important to understand that the weight may be the primary focus of the person with an eating disorder, but the eating disorder is not about weight. Eating disorders often are a way of coping with traumatic experiences or an attempt to control factors in someone’s life when they feel out of control.”
Tens of millions of people struggle with an eating disorder.
The National Eating Disorders Association estimates that approximately 20 million females and 10 million males in the U.S. have a clinically significant eating disorder at some point in their lives. Common eating disorders include anorexia nervosa, in which people limit their food consumption dramatically, even when they’re hungry; bulimia nervosa, characterized by episodes of eating large amounts of food in a short period of time followed by vomiting, fasting, excessive exercise and/or excessive use of laxatives and diuretics; and binge eating disorder, in which people frequently gorge on huge quantities of food. Anorexia nervosa has the highest death rate of any psychiatric illness, according to NEDA. According to research by the National Association of Anorexia Nervosa and Associated Disorders, 5 to 10 percent of people with anorexia die within 10 years, and 18 to 20 percent of anorexics will be dead after 20 years. “Females with anorexia between the ages of 15 to 24 have a mortality rate that is 12 times higher than the death rate of all other causes of death,” says Gregory Ammon, administrator of the outpatient eating disorders program at AMITA Health Alexian Brothers Behavioral Health Hospital in the Chicago area. “We need to pay attention to warning signs of eating disorders because an individual’s life, not just his or her lifestyle, is at stake.” Here are 12 possible signs of eating disorders:
Weight fluctuations
Significant weight fluctuations could be a sign of an eating disorder. “People with anorexia tend to lose weight below what is normal for them and may look very thin or emaciated while feeling or seeing themselves as being overweight,” Ross says. “They are unable to maintain a normal weight. Individuals with bulimia may be normal weight or overweight but may be obsessed with losing weight. About half of those with binge eating disorder are overweight or obese [living in larger bodies] and may have been frequent dieters with periods of weight loss and weight gain.
Overemphasis on weight and body image
People with eating disorders tend to obsess over their weight and body image, says Lori A. Schur, the clinical training director for the Medical Stabilization Program for Eating Disorders at Torrance Memorial Medical Center in Torrance, California. “Even when underweight, individuals with anorexia [and bulimia] continue to be fearful of weight gain,” she says. “Their thoughts and feelings about their size and shape have profound impact on their sense of self and their self-esteem as well as their relationships,” she says. People with anorexia “often do not recognize or admit the seriousness of their weight loss and deny it may have permanent adverse health consequences.” People of all sizes may struggle with any of the eating disorders, says Lauren Smolar, director of programs at the NEDA. “People of higher-weight bodies may struggle with symptoms of anorexia, and people of lower-weight bodies can struggle with bulimia and binge eating disorder. Size really cannot tell you what someone’s diagnosis may be.”
Overindulgent eating
Someone who eats a gallon of ice cream in one sitting or consumes several pounds of chocolate or other candy at a time without realizing he or she is overeating could have binge eating disorder, says Mayra Mendez, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica, California. “Binge eating may be triggered by stress and high levels of responsibility,” she says. “The emotional experience while eating the food may be calming and gratifying, but the emotional aftermath following the ingestion of excessive amounts of food is usually one of self-deprecation, feeling intense guilt about the eating behavior and a significant decline in self-esteem and self-confidence.”
Excessive exercise
Working out compulsively can be linked to anorexia or bulimia, says Mira Franco, a licensed clinical social worker and site director at The Renfrew Center of Chicago, which specializes in treating anorexia, bulimia, binge eating disorder and related mental illnesses. Some people with anorexia exercise for hours every day, running outside even in extreme weather or working out at the gym, with the goal of “canceling out” their daily caloric input, Franco says. “This is very dangerous, as exercise without refueling appropriately poses many medical risks, including heart strain and the body using muscle instead of fat reserves for energy,” she says.
Social isolation
People with anorexia nervosa often sit in the corner, show very little energy or enthusiasm for life and prefer not to spend time with other people, says Dr. Alexander Sackeyfio, a psychiatrist and eating disorder specialist at Beaumont Hospital-Royal Oak in Royal Oak, Michigan. This type of isolation isn’t associated with social anxiety, Sackeyfio says. Instead, they often look down on people who eat heartily. “They see people who eat and enjoy food as frivolous and unwilling to take life seriously,” he says.
Hair loss
Someone suffering from anorexia or bulimia may experience malnutrition and lack the necessary vitamins and healthy fats to provide for hair growth, regeneration and luster. “An individual suffering from anorexia or bulimia may experience bald spots, thinning hair or more brittle hair because the body needs to use the protein found in hair to keep us alive,” Franco says. “As fat stores are depleted, the body seeks a way to insulate itself, often resulting in the development of lanugo — soft, downy hairs on the arms or face.”
Post-meal disappearances
People who engage in binge eating and purging often try to hide their behavior to keep it secret. Disappearances after meals could be a warning sign, says Dr. Gene Beresin, executive director of The Clay Center for Young Healthy Minds at Massachusetts General Hospital in Boston. “While some might go directly to the bathroom to vomit, others may worry that they will be obvious, and instead go into another room to purge into a bag or container,” Beresin says. “If asked why they are rushing, they won’t say they are purging but offer a variety of other excuses.”
Laxative misuse
Abrupt changes in bowel or bathroom habits can be a sign that someone with bulimia is misusing laxatives or diuretics, says Dr. Adrienne Youdim, medical director of the Center for Weight Loss and Nutrition at the Lasky Clinic in Beverly Hills, California. Prolonged misuse of laxatives can cause stomach cramps and electrolyte imbalances, which in turn can cause dizziness, fainting or even seizures, she says. Severe cases of electrolyte imbalances can lead to bone loss and sudden cardiac arrest.
Obsession with food
Many people who struggle with a food disorder become obsessive with food. “Food controls them in a way that impacts their daily life,” Franco says. “We’ve worked with clients who avoid dinners out with friends because they can’t possibly know every exact ingredient going into the preparation of their meal; clients who shop exclusively at a particular grocery store because it’s in their comfort zone and are unwilling to buy a similar product at another store; clients who prepare one meal for their family and a separate meal to meet their self-determined needs.” This obsession about one’s food intake can manifest itself in many ways, but the underlying factor is a need for control and a lack of flexibility.
Declining physical health
Eating disorders exact a terrible toll on the body. “In someone with anorexia, significant warning signs can be weight loss below a healthy body mass index, though the diagnosis is not made by weight alone,” Ammon says. “In women, low BMI often leads to amenorrhea or cessation of periods because of the effect of weight loss on hormones.” This can cause weakness, fatigue, low blood pressure, heart rhythm disturbances and bowel problems. People with bulimia who purge, use laxatives inappropriately or exercise excessively face physical health challenges, too. “They can include tooth erosion due to stomach acid present in the mouth while vomiting, esophagus damage or swallowing problems, stomach issues and bowel changes as the digestive system is exposed to too many laxatives,” he says. “Laxative abuse can affect electrolyte balance, robbing the body of essential nutrients.” People with binge eating disorder may also struggle with digestive issues as the body tries to process the amount of food being ingested.
Swollen glands
Bulimia can cause the parotid glands in the neck and face to swell, leaving the person looking similar to someone with the mumps, says Tiffany Phillips, a licensed therapist at The Renfrew Center of Nashville in Tennessee. “This is caused by the body attempting to produce additional enzymes to begin digesting the large amounts of food being consumed during the binge cycle as well as the glands becoming irritated and swollen by overexposure to stomach acid during self-induced vomiting. This swelling is not only painful to the person with bulimia, but can also lead to body image disturbances, which can fuel further disordered behavior.”
Disconnection from self and others
Someone who’s suffering from an eating disorder may be physically present, but his or her mind may seem to be elsewhere, says Michael E. Berrett, co-founder and executive director of Center for Change, an eating disorders treatment center in Orem, Utah. That’s because he or she may be malnourished and ruminate obsessively about food and body image. This can lead to “disconnection from one’s sense of identity, self-worth, hopes and significant others,” Berrett says.
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12 Potential Signs of an Eating Disorder originally appeared on usnews.com
