Eating Disorders

There are many diseases, disorders, and problem conditions involving food, eating, and weight, but in everyday conversation, the term "eating disorders" has come to mean anorexia nervosa, bulimia, and binge eating, which are defined on this page.

Anorexia nervosa: the relentless pursuit of thinness

Person refuses to maintain normal body weight for age and height.

Weighs 85% or less than what is expected for age and height.

In women, menstrual periods stop. In men levels of sex hormones fall.

Young girls do not begin to menstruate at the appropriate age

Person denies the dangers of low weight.

Is terrified of gaining weight even though s/he is markedly underweight.

Reports feeling fat even when very thin.

In addition, anorexia nervosa often includes depression, irritability, withdrawal, and peculiar behaviors such as compulsive rituals, strange eating habits, and division of foods into "good/safe" and "bad/dangerous" categories. Person may have low tolerance for change and new situations; may fear growing up and assuming adult responsibilities and an adult lifestyle. May be overly engaged with or dependent on parents or family. Dieting may represent avoidance of, or ineffective attempts to cope with, the demands of a new life stage such as adolescence.

Bulimia nervosa: the diet-binge-purge disorder

Person binge eats.

Feels out of control while eating.

Vomits, misuses laxatives, exercises, or fasts to get rid of the calories.

Diets when not bingeing. Becomes hungry and binges again.

Believes self-worth requires being thin. (It does not.)

May shoplift, be promiscuous, and abuse alcohol, drugs, and credit cards.

Weight may be normal or near normal unless anorexia is also present.

Like anorexia, bulimia can kill. Even though bulimics put up a brave front, they are often depressed, lonely, ashamed, and empty inside. Friends may describe them as competent and fun to be with, but underneath, where they hide their guilty secrets, they are hurting. Feeling unworthy, they have great difficulty talking about their feelings, which almost always include anxiety, depression, self-doubt, and deeply buried anger. Impulse control may be a problem; e.g., shoplifting, sexual adventurousness, alcohol and drug abuse, and other kinds of risk-taking behavior. Person acts with little consideration of consequences.

Binge eating disorder

The person binge eats frequently and repeatedly.

Feels out of control and unable to stop eating during binges.

May eat rapidly and secretly, or may snack and nibble all day long.

Feels guilty and ashamed of binge eating.

Tends to be depressed and obese.

People who have binge eating disorder do not regularly vomit, overexercise, or abuse laxatives like bulimics do. They may be genetically predisposed to weigh more than the cultural ideal (which at present is exceedingly unrealistic), so they diet, make themselves hungry, and then binge in response to that hunger. Or they may eat for emotional reasons: to comfort themselves, avoid threatening situations, and numb emotional pain. Regardless of the reason, diet programs are not the answer. In fact, diets almost always make matters worse.

Eating disorders not otherwise specified (ED-NOS)

An official diagnosis

The phrase describes atypical eating disorders

Including situations in which a person meets all but a few of the criteria for a particular diagnosis.

What the person is doing with regard to food and weight is neither normal nor healthy.

Less-well-known eating disorders and related problems

There are many diseases, disorders, and problem conditions involving food, eating, and weight. Here are brief descriptions of problems other than anorexia nervosa, bulimia, and binge eating disorder.

Anorexia athletica (compulsive exercising)

Not a formal diagnosis. The behaviors are usually a part of anorexia nervosa, bulimia, or obsessive-compulsive disorder.

The person repeatedly exercises beyond the requirements for good health.

May be a fanatic about weight and diet.

Steals time to exercise from work, school, and relationships.

Focuses on challenge. Forgets that physical activity can be fun.

Defines self-worth in terms of performance

Is rarely or never satisfied with athletic achievements.

Does not savor victory. Pushes on to the next challenge immediately.

Justifies excessive behavior by defining self as a "special" elite athlete.

Compulsive exercising is not an official diagnosis as are anorexia, bulimia, and binge eating disorder. We include it here because many people who are preoccupied with food and weight exercise compulsively in attempts to control weight. The real issues are not weight and performance excellence but rather control and self-respect.

Eating disorders warning signs

Because everyone today seems concerned about weight, and because most people diet at least once in a while, it is hard to tell what is normal behavior and what is a problem that may escalate to threaten life and happiness. No one person will show all of the characteristics listed below, but people with eating disorders will manifest several.

In addition, the early stages of an eating disorder can be difficult to define. When does normative dieting become a health and emotional problem? When does weight loss cross the line and become pathological? Answering these questions is hard, especially when the person has not yet lost enough weight to qualify for a clinical diagnosis. Nevertheless, the questions are important. The sooner an eating disorder is treated, the easier it is for the person to recover. If warning signs and symptoms are allowed to persist until they become entrenched behaviors, the person may struggle for years before s/he can turn matters around.

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