Eating Disorders

An eating disorder (ED) is a disturbance of normal eating, tied to a desire for thinness, emotional numbness, or control. It is associated with rigid, black-and-white thinking that labels foods "good" or "bad" and ties worth to eating and weight. 

There are three main eating disorder diagnoses:

• Anorexia Nervosa (AN), characterized primarily by restrictive eating, leading to weight loss or refusal to reach/maintain a healthy body weight. People with anorexia may also engage in any of the eating disorder behaviors described below.
• Bulimia Nervosa (BN), characterized by episodes of binge eating (eating an unusually large amount of food in a short period of time), followed by "compensatory behavior" - a range of behaviors designed to compensate for the amount eaten, often by preventing food from being absorbed (e.g., self-induced vomiting, laxative or diuretic abuse).
• Binge Eating Disorder (BED), characterized by binge eating without compensatory behavior.

However, many people with diagnosable eating disorders can't be easily categorized because they engage in the full range of possible ED behaviors, may engage in different behaviors at different times, or may "just" restrict" but not be underweight. These people are given a diagnoses of Other Specified Eating Disorder or Unspecified Eating Disorder. 

The frequency of EDNOS diagnosis demonstrates that the specific behaviors a person is engaging in are often much more informative than the diagnostic label when it comes to understanding any one person's ED. ED behaviors can include:

• Restriction: significantly limiting the amount or type of food eaten, often by limiting calories, or cutting out food groups such as carbohydrates or dietary fats. Eating nothing for 8 or more waking hours is considered fasting (from a medical rather than spiritual perspective).
• Bingeing: eating a large amount of food in a short amount of time, often feeling loss of control over eating.
• Purging: preventing absorption of calories from food by inducing vomiting, taking laxatives or diuretics. Purging often follows bingeing, but can be done after eating smaller amounts of food.
• Excessive exercise: exercising more than is healthy, beyond what can be sustained by food intake, and/or more than normative for a particular sport or activity (e.g., going to the gym after soccer practice, when everyone else is going home).
• Use of diet pills or stimulants, including excessive caffeine, to boost metabolism or suppress appetite.
• Other unusual eating behaviors include tearing or cutting food into small pieces, mixing unusual combinations of foods, using only specific plates or silverware, excessive condiments, etc.

It's important to note that AN is the only ED that references weight as a defining criterion. Eating disorders come in all shapes and sizes. They are often accompanied by significant emotional distress, distorted thinking and perception (e.g., seeing one's body differently than it actually appears).

Eating disorders cause a host of medical complications, including osteoporosis, tooth decay, gastrointestinal tearing or bleeding, slowed metabolism, nerve damage, muscle atrophy, electrolyte imbalance, kidney failure, liver damage, or even heart attack. Many of these effects are reversible with a return to normal eating and weight, but not all of them. Some can be fatal. If you think you or someone you care about may have an eating disorder, reach out for support (see the Resources page for some options).