• Posted March 13, 2023

What Are Eating Disorders, and What Are the Signs?

Eating disorders are on the rise, affecting about 30 million people worldwide, and they can be deadly.

The causes are "like pieces of a puzzle,"according to Amy Ethridge, an occupational therapist and clinical psychiatric specialist in the Adolescent Medicine and Eating Disorders Program at Penn State Milton S. Hershey Medical Center in Hershey.

"It is usually a response to stress, too,"Ethridge said in a center news release. "The point is, eating disorders are complex medical and psychiatric conditions that patients don't choose and parents don't cause."

A constant barrage of ads and TV programs idealizing unattainable body types doesn't help. Anxiety and depression can be factors, as can heredity.

Ethridge, along with clinical psychologist Jamal Essayli, director of the Young Adult Eating Disorders Program at the medical center, offered some information about eating disorders, their dangers and how someone can get help.

Patients don't wake up one day and suddenly decide to become anorexic, for example. It's not a choice, they said. All age groups, genders, cultures and backgrounds can be affected, not just teen girls.

Anorexia nervosa is one of the most common eating disorders.

With anorexia, a strong fear of weight gain prompts drastic limits on calorie consumption. Patients often have a distorted body image. Among the warning signs are intense focus on body image and weight, weight loss, anxiety and avoidance of calorie-rich or non-diet foods.

In atypical anorexia nervosa, symptoms are similar except the person isn't underweight. People who experience eating disorders can come in all shapes and sizes.

"Individuals in higher weight bodies are at increased risk for eating disorders, likely because they experience intense pressure to lose weight,"Essayli said in the release. "It is critical that providers screen for warning signs of eating disorders like anxiety about eating in individuals who are not underweight, as these individuals often go undetected due to their weight status."

In another eating disorder, bulimia nervosa, people also restrict their food intake to try to lose weight or prevent weight gain. But they also often have episodes of binge eating, in which they consume large amounts of food quickly.

To compensate for the calories eating during binges, they may vomit, take laxatives or exercise excessively. People with bulimia nervosa often suffer from a poor body image. Early symptoms can include a chronic sore throat, swollen salivary glands, digestive issues and worn tooth enamel because of stomach acid in the mouth.

Binge-eating disorder also includes out-of-control food consumption, often in response to dieting. People with this disorder sometimes eat when they aren't hungry, often in secret. They don't engage in behaviors like vomiting to compensate.

Avoidant/restrictive food intake disorder is another type of eating disorder. In this, people restrict and avoid food for reasons that are unrelated to body image. It might be because of severely picky eating, fear of choking or vomiting, or low appetite. The disorder can lead to a lack of development in children.

While it takes a medical professional to diagnose an eating disorder, there are warning signs.

You may notice that someone exercises excessively, has an extreme preoccupation with food and dieting, or gets anxious about what they will eat at a restaurant.

Refusing to eat certain types of foods, outside of an allergy, could be a sign. This might include restricting an entire category of food to lose weight, such as all carbohydrates.

Strict rituals with food, chewing excessively or being careful not to let two foods touch can be signs of avoidant/restrictive food intake disorder. So, too, can an insistence on eating alone, skipping meals or taking small portions.

While many people express concern with body size and shape, if their perception is distorted and it has become an obsession, that can be a sign.

Taking frequent trips to the bathroom and having dental erosion can also be indicators.

Ethridge offers advice for sharing your concerns with your loved one.

"The best way is to express concern about the behavior,"she said. "Discuss what you have noticed has changed or has become difficult. Avoid simplifying the situation by recommending to 'just eat.' Be prepared for negative reactions and even denial of the issue. The intent is not to diagnose it, but rather help them get to treatment by starting with a medical evaluation."

More information

The National Eating Disorders Association has a hotline to get help.

SOURCE: Penn State Health, news release, March 9, 2023