Understanding & Treating Eating Disorders
Updated: Jul 24
Eating Disorders are a range of mental health conditions marked by persistent eating behaviours that can negatively affect your health. Approximately 1 million Canadians are suffering from some form of eating disorder, according to the National Initiative for Eating Disorders (NIED). While North American society has considered it normal to be concerned about weight loss, body weight or appearance, and controlling food intake (like dieting), it could be a sign of an eating disorder when it becomes an obsession or fixation.
These eating behaviours can negatively impact your physical health, mental health, emotions, and ability to function in critical areas of your life. They can even be life-threatening if left untreated, having the highest mortality rate of any mental illness. It is essential to understand the different types of eating disorders, their signs, and symptoms and seek treatment as soon as possible. Eating disorders are treatable and can be fully recoverable with the proper care.
Who is at Risk of an Eating Disorder?
Eating disorders can affect everyone of all ages and genders but is most common in young women. They often appear during teen years and young adulthood but can also develop during childhood or later adulthood. The cause is not yet fully understood, but researchers know that genetics, biological, behavioural, psychological, and social factors can change a person's risk. These factors often correlate to significant life changes, abuse, stress, anxiety, and depression.
As mentioned earlier, eating disorders can be very dangerous and even deadly. Though a person with an eating disorder may appear healthy, these eating behaviours can have very damaging health consequences that affect almost all body systems. These medical implications include:
Lack of adequate nutrition
Harm to the heart; e.g. palpitations, angina
Issues with the digestive system; e.g., acid reflux, GIRDS, IBS, constipation
Loss of enamel from the teeth and possible sores
Lack of energy and feelings of weakness
Abdominal pain and bloating
Type II diabetes (binge and emotional eating)
Most Common Types of Eating Disorders
There are many types of eating disorders, and they are each associated with different but sometimes overlapping symptoms. If you are exhibiting any combination of the symptoms listed below, you should contact a health care provider.
Anorexia is one of the most well-known eating disorders, marked by body dysmorphia, which causes people to have an altered self-image; people can view themselves as overweight even if they are severely underweight. It creates a situation where the person feels they need to constantly monitor their weight, avoid certain foods, dangerously restrict their calorie intake, and exercise excessively.
Anorexia can also present obsessive-compulsive behaviors like obsessively collecting recipes, hoarding food, and being constantly preoccupied with food.
There are two sub-groups within the anorexia category: restrictive and binge-purge. Individuals in the restrictive category severely limit the amount and type of food they consume and lose weight solely through dieting, fasting, or excessive exercise.
Individuals within the binge-purge sub-group also restrict the amount and type of food they eat. Still, they may also have binge-eating and purging episodes. They can, but don't necessarily have to, consume large amounts of food, followed by purging activities like vomiting, taking laxatives or diuretics, or exercising excessively. It can make spotting others with this type of disordered eating more difficult, as they appear to eat with others yet purge in private.
Extremely restricted eating and/or intensive and excessive exercise
Extreme thinness (emaciation)
A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
Intense fear of gaining weight
Distorted body or self-image that is heavily influenced by perceptions of body weight and shape
Denial of the seriousness of low body weight
Preoccupation with bowel habits
Addiction to exercising
Thinning of the bones (osteopenia or osteoporosis)
Muscle wasting and weakness
Brittle hair and nails
Dry and yellowish skin
Growth of fine hair all over the body (lanugo)
Low blood pressure
Slowed breathing and pulse
Damage to the structure and function of the heart
Drop-in internal body temperature, causing a person to feel cold all the time
Lethargy, sluggishness, or feeling tired all the time
Multiple organ failure
Bulimia Nervosa is when a person has reoccurring episodes of binge-eating and purging. During these binges, people with bulimia often feel they do not have control over their eating and cannot stop eating until they are painfully full. Binge eating is then followed by purging activities, including forced vomiting, fasting, laxatives, diuretics, enemas, and extensive exercise to compensate for the calories consumed and relief from gut discomfort.
Bulimia is often confused with the binge-purge subgroup of anorexia because they have similar symptoms. However, individuals with bulimia stay at a relatively average weight instead of the emaciation associated with anorexia.
Often, dental professionals find evidence of Bulimia Nervosa during regular check-ups.
Recurrent episodes of binge eating with a feeling of lack of control
Recurrent episodes of inappropriate purging behaviours to prevent weight gain
Self-esteem is overly influenced by body shape and weight
Fear of gaining weight, despite having an average weight
Chronically inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Worn tooth enamel and increasingly sensitive and decaying teeth from exposure to stomach acid when vomiting
Acid reflux disorder and other gastrointestinal problems
Intestinal distress and irritation from laxative abuse
Severe dehydration from purging
Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) can lead to stroke or heart attack
Binge eating disorder is the most common eating disorder in Canada, affecting around 2% of the entire population. The symptoms are similar to the binge-eating aspects of bulimia nervosa and the binge-eating subgroup of anorexia. It is an uncontrollable over-eating creating a large intake of food in a short amount of time. However, these binges are not followed by purging activities or the restriction of calories. As a result, people with a binge-eating disorder tend to be overweight.
Eating large amounts of foods rapidly, in secret, and until uncomfortably full, despite not feeling hungry
Feeling a lack of control during episodes of binge eating
Feelings of distress, such as shame, disgust, or guilt, when thinking about the binge-eating behaviour
No use of purging behaviours, such as calorie restriction, vomiting, excessive exercise, or laxative or diuretic use, to compensate for the binging
Overweight or obese
Type II diabetes
Avoidant Restrictive Food Intake Disorder is a new term to replace "feeding disorder of infancy and early childhood," also known as "selective eating disorder." Someone with ARFID will limit the amount and type of food they eat. Still, unlike anorexia, there is no body dysmorphia or fear of weight gain. This disorder also generally develops earlier than the other disorders listed; symptoms can develop during infancy or childhood and persist through adulthood. Also, unlike other disorders, it affects both men and women at a similar rate.
ARFID goes beyond picky eating, but rather individuals can lack interest in eating or distaste for certain smells, tastes, colours, textures, or temperatures. The limited calorie intake can affect proper development in children and basic body function in adults.
Dramatic restriction of types or amount of food eaten
Lack of appetite or interest in food
Limited range of preferred foods that becomes even more limited (“picky eating” that gets progressively worse)
eating habits that interfere with normal social functions, such as eating with others
Weight loss or poor development for age and height
Upset stomach, abdominal pain, or other gastrointestinal issues with no other known cause
Nutrient deficiencies or dependence on supplements or tube feeding
Avoidance or restriction of food intake that prevents the person from eating sufficient calories or nutrients
Treatment for Eating Disorders
Eating disorders are treatable, and you can fully recover from them. Early detection is critical because of the medical implications and the higher risk of suicide. Eating disorders are most commonly treated with a combination of the following:
Psychotherapy or talk therapy such as ISTDP, CBT, EMDR, etc.
Medical care and monitoring
Medications (such as antidepressants and anti-anxiety medications)
A few of the treatment goals include: addressing self-image issues, addressing possible traumas, restoring adequate nutrition, bringing weight to a healthy level (this means either bringing it up or down), and reducing unhealthy behaviour such as excessive exercise binge-purge or binge eating behaviours.
The treatment plan is always modified to fit your situation and your needs. Because eating disorders are often paired with other mental health conditions like depression or substance abuse disorders, it is important to deal with them as part of the treatment plan. Including family members and other support systems in the treatment plan is vitally important to recovery, especially for adolescents.