Eating Disorders are Marked by Extremes

Eating disorders are present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.

A person may have started out just eating smaller or larger amounts of food than usual, but at some point, the urge to eat less or more spirals out of control.

Two main types of disorders are anorexia nervosa and bulimia nervosa. A third category includes several variations similar to anorexia or bulimia but with slightly different characteristics such as binge-eating.

Frequently appearing during adolescence or young adulthood these disorders are real, treatable medical illnesses with complex underlying psychological and biological causes.


Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, and an extremely disturbed eating behavior.

Many people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or issuing laxatives, diuretics or enemas.

They see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions.

People with anorexia also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development.


Eating disorders such as bulimia nervosa are characterized be recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over the eating.

This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise.

Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape.

Usually bulimic behavior is done secretly because it is often accompanied by feelings of disgust or shame.

Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems.


Eating disorders not otherwise specified (EDNOS), such as binge-eating is characterized by recurrent binge-eating episodes during which the person feels loss of control over his or her eating.

Unlike bulimia, excessive exercise or fasting does not follow binge-eating episodes. As a result, people with binge-eating disorders often are overweight or obese.

Obese people with binge-eating disorder often have coexisting psychological illnesses including anxiety, depression, and personality disorders. In addition, links between obesity and cardiovascular disease and hypertension are well documented.

Treatment for disorders involves three components:

  1. Restoring the person to a healthy weight
  2. treating the psychological issues related to the eating disorder
  3. Reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing relapse

Some warning signs of anorexia nervosa include:

  • Significant weight loss (15% below the normal weight for height)
  • Continual dieting (although thin)
  • Feelings of fatness, even after weight loss
  • Fear of weight gain
  • Lack of menstrual periods
  • Preoccupation with food, calories, nutrition, and/or cooking
  • Preference to eat in isolation
  • Compulsive exercise
  • Binge eating and purging
  • Insomnia

Some warning signs of bulimia nervosa include:

  • Uncontrollable eating (binge eating)
  • Purging by strict dieting, fasting, vigorous exercise, and/or vomiting
  • Abuse of laxatives or diuretics to lose weight
  • Frequent use of the bathroom after meals
  • Reddening fingers (from induced vomiting)
  • Swollen cheeks or glands (from induced vomiting)
  • preoccupation with body weight
  • depression or mood swings
  • Irregular menstrual periods

Eating disorders are very serious emotional and physical issues requiring the expertise of professionals. Always consult your health practitioner if you see any signs of eating disorders in yourself or your family

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