Eating Disorders

Anorexia is a condition where people avoid eating, severely restrict their food intake, or consume very small amounts of specific foods. They may also weigh themselves repeatedly. Even when dangerously underweight, they may perceive themselves as overweight.

There are two types of anorexia: the restrictive type and the purging type.
In the restrictive type, individuals severely limit the quantity and type of food they consume. Additionally, they may experience episodes of binge-eating and purging—eating large amounts of food in a short period and then inducing vomiting or using laxatives or diuretics to rid themselves of what they consumed.

Anorexia can be life-threatening. It has an extremely high mortality rate compared to other mental disorders. Individuals with anorexia are at risk of dying from medical complications related to starvation, with suicide being the second leading cause of death for those diagnosed with neurogenic anorexia.


Symptoms include:

- Extremely restricted food intake.
- Severely low body weight with significant weight loss in a short time.
- An unrelenting pursuit of weight loss and reluctance to maintain normal or healthy body weight.
- Intense fear of weight gain.
- Distorted body image, with self-esteem highly influenced by perceptions of body weight and shape, or denial of the seriousness of low body weight.

Other symptoms may develop over time, such as:
- Osteopenia or osteoporosis.
- Mild anemia, muscle loss, and weakness.
- Brittle hair and nails.
- Dry and yellowish skin.
- Increased fine hair all over the body (lanugo).
- Severe constipation.
- Low blood pressure.
- Slowed heart rate and breathing.
- Damage to the structure and function of the heart.
- Brain damage.
- Multi-organ failure.
- Lowered body temperature, leading the individual to feel cold all the time.
- Lethargy, sluggishness, or constant fatigue.

Infertility may also occur due to hormonal imbalances resulting from extreme weight loss.

Bulimia is a condition where individuals have recurrent and often uncontrollable episodes of consuming unusually large quantities of food and feel a lack of control during these episodes. This overeating is followed by compensatory behaviors to offset the excessive food intake, such as induced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors.
People with bulimia may be slightly overweight, of normal weight, or overweight.

Symptoms include:
- Chronic inflammation and sore throat.
- Swollen salivary glands in the neck and jaw area.
- Tooth enamel erosion and increasingly sensitive and damaged teeth due to exposure to stomach acid.
- Gastrointestinal disturbances and discomfort.
- Bowel irregularities and irritation from laxative abuse.
- Severe dehydration from purging fluids.
- Electrolyte imbalances (very low or very high levels of sodium, calcium, potassium, and other minerals) that can lead to stroke or cardiac arrest.

Binge-eating disorder is a condition in which people lose control of their eating and have recurrent episodes of consuming unusually large amounts of food. Unlike neurogenic (neurotic) bulimia, binge-eating episodes are not followed by purging, excessive exercise, or fasting. As a result, individuals with binge-eating disorder are often overweight or obese. Binge-eating disorder is the most common eating disorder.

Symptoms include:
- Eating unusually large amounts of food in a specific time period, such as a 2-hour window.
- Eating even when you are not hungry or when you are uncomfortably full.
- Rapid consumption during binge-eating episodes.
- Eating until you are uncomfortably full.
- Eating alone or in secret to avoid embarrassment.
- Feeling distress, shame, or guilt about your eating.
- Frequent dieting, possibly without weight loss.

Avoidant/Restrictive Food Intake Disorder (ARFID), formerly known as Selective Eating Disorder, is a condition where people restrict the quantity or type of food they consume. Unlike anorexia nervosa, individuals with ARFID do not have a distorted body image or an excessive fear of gaining weight. ARFID is more common in middle childhood and usually has an earlier onset than other eating disorders. Many children go through phases of selective eating, but a child with ARFID does not consume enough calories to grow and develop properly, and an adult with ARFID does not consume enough calories to maintain basic bodily functions.

Symptoms include:
- Dramatic restriction of the variety or quantity of food consumed.
- Lack of appetite or interest in food.
- Significant weight loss.
- Gastrointestinal disturbances, abdominal pain, or other gastrointestinal problems with no other known cause.
- A limited range of preferred foods that becomes even more restricted (progressive selective eating).

Pica is an eating disorder in which an individual repeatedly consumes non-food items without nutritional value. The behavior persists for at least one month and is severe enough to require clinical attention.

Common substances ingested vary depending on age and availability and may include paper, crayons, soap, fabric, hair, strings, chalk, metals, pebbles, coal, or clay. Individuals with pica typically do not have an aversion to food in general.

The behavior is inappropriate for the individual's developmental level and is not part of a culturally supported practice. Pica often co-occurs with autism spectrum disorder and intellectual disabilities but can occur in typically developing children as well.

A person diagnosed with pica is at risk of potential intestinal blockages or toxic effects of ingested substances (e.g., lead in paint chips).

Treatment for pica includes assessing for nutritional deficiencies and addressing them if necessary. Behavioral interventions used to treat pica may include redirecting the individual away from non-food items and providing reinforcement for the removal or avoidance of non-food items.

Rumination disorder involves the repeated regurgitation and re-chewing of food after eating, during which the ingested food is voluntarily brought back into the mouth, re-chewed, and either re-swallowed or spit out. Rumination disorder can occur in infancy, childhood, adolescence, or adulthood. To make the diagnosis, the behavior must:

- Occur repeatedly for a duration of at least one month.
- Not present due to a gastrointestinal or medical condition.
-Does not occur as part of any of the other specified feeding or eating disorders

Other Specified Feeding or Eating Disorders are eating disorders that do not meet the criteria for any specific eating disorder. Some examples include:

1. For females, meeting all the criteria for anorexia nervosa except for having regular menstrual periods.
2. Meeting all the criteria for anorexia nervosa except that, despite significant weight loss, the individual's current weight is within the normal range.
3. Meeting all the criteria for bulimia nervosa except that the binge-eating episodes and inappropriate compensatory behaviors occur with a frequency less than twice a week or for a duration of less than three months.
4. Regular use of inappropriate compensatory behaviors by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).
5. Repeated chewing and spitting out, but not swallowing, large amounts of food.
6. Binge eating disorder: recurrent episodes of binge eating without the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.