Feeding and Eating Disorders

Eating disorders are characterized by obsessive concerns with weight and disruptive eating patterns that negatively impact physical and mental health. Types of eating disorders include:

Anorexia Nervosa

Anorexia nervosa is characterized by restricted food consumption that can lead to weight loss. Some people with anorexia are underweight, while others may be of average or above-average weight. Those who experience this disorder also have a preoccupation and fear of gaining weight as well as a distorted view of their own appearance and behavior.

Bulimia Nervosa

Bulimia nervosa involves binge eating and then taking extreme steps to compensate for these binges. These compensatory behaviors might include self-induced vomiting, the abuse of laxatives or diuretics, or excessive exercise. 

Rumination Disorder

Rumination disorder is marked by regurgitating previously chewed or swallowed food in order to either spit it out or re-swallow it. Rumination disorder can occur in infants, children, teens, and adults. It’s also more common in people who have anxiety, depression, or another psychiatric disorder.13

Additional problems that can result from this behavior include dental decay, esophageal ulcers, and malnutrition.

Pica

Pica involves craving and consuming non-food substances such as dirt, paint, or soap. Pica is more common among young children than adults, but it is also known to occur during pregnancy. A lack of nutrients may also trigger non-food cravings in some instances

Binge Eating Disorder

Binge eating disorder involves episodes of binge eating where the individual consumes an unusually large amount of food during a short time period, such as a couple of hours.

People with binge-eating disorder often feel they have no control over their eating. Binge eating episodes are sometimes triggered by certain emotions such as feeling happy, anxious, or bored, or following stressful events.

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When to see a health Care worker

  • Skipping meals or snacks or making excuses for not eating.

  • Having a very limited diet that hasn’t been prescribed by a trained medical professional.

  • Too much focus on food or healthy eating, especially if it means not participating in usual events, such as sports banquets, eating birthday cake or dining out.

  • Making own meals rather than eating what the family eats.

  • Withdrawing from usual social activities.

  • Frequent and ongoing worry or complaints about being unhealthy or overweight and talk of losing weight.

  • Frequent checking in the mirror for what are thought to be flaws.

  • Repeatedly eating large amounts of foods.

  • Using dietary supplements, laxatives or herbal products for weight loss.

  • Exercising much more than the average person. This includes not taking rest days or days off for injury or illness or refusing to attend social events or other life events because of wanting to exercise.

  • Calluses on the knuckles from reaching fingers into the mouth to cause vomiting.

  • Problems with loss of tooth enamel that may be a sign of repeated vomiting.

  • Leaving during meals or right after a meal to use the toilet.

  • Talk of depression, disgust, shame or guilt about eating habits.

  • Eating in secret.

Causes

  • Genetics. Some people may have genes that increase their risk of developing eating disorders.
  • Biology. Biological factors, such as changes in brain chemicals, may play a role in eating disorders.
  • Family history. Eating disorders are more likely to occur in people who have parents or siblings who’ve had an eating disorder.
  • Other mental health issues. Trauma, anxiety, depression, obsessive-compulsive disorder and other mental health issues can increase the likelihood of an eating disorder.
  • Dieting and starvation. Frequent dieting is a risk factor for an eating disorder, especially with weight that is constantly going up and down when getting on and off new diets. There is strong evidence that many of the symptoms of an eating disorder are symptoms of starvation. Starvation affects the brain and can lead to mood changes, rigid thinking, anxiety and reduced appetite. This may cause severely limited eating or problem eating behaviors to continue and make it difficult to return to healthy eating habits.
  • A history of weight bullying. People who have been teased or bullied for their weight are more likely to develop problems with eating and eating disorders. This includes people who have been made to feel ashamed of their weight by peers, health care professionals, coaches, teachers or family members.
  • Stress. Whether it’s heading off to college, moving, landing a new job, or a family or relationship issue, change can bring stress. And stress may increase the risk of an eating disorder.

Complications

Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely it is that serious complications may occur. These may include:

  • Serious health problems.

  • Depression and anxiety.

  • Suicidal thoughts or behavior.

  • Problems with growth and development.

  • Social and relationship problems.

  • Substance use disorders.

  • Work and school issues.

  • Death.

Prevention

There’s no sure way to prevent eating disorders, but you can take steps to develop healthy eating habits. If you have a child, you can help your child lower the risk of developing eating disorders

Adults

To develop healthy eating habits and lifestyle behaviors

  • Choose a healthy diet rich in whole grains, fruits and vegetables. Limit salt, sugar, alcohol, saturated fat and trans fats. Avoid extreme dieting. If you need to lose weight, talk to your health care provider or a dietitian to create a plan that meets your needs.

  • Don’t use dietary supplements, laxatives or herbal products for weight loss.

  • Get enough physical activity. Each week, get at least 150 minutes of aerobic activity, such as brisk walking. Choose activities that you enjoy, so you’re more likely to do them.

  • Seek help for mental health issues, such as depression, anxiety, or issues with self-esteem and body image.

Children

Here are some ways to help your child develop healthy-eating behaviors:

  • Avoid dieting around your child. Family dining habits may influence the relationships children develop with food. Eating meals together gives you an opportunity to teach your child about the pitfalls of dieting. It also allows you to see whether your child is eating enough food and enough variety.
  • Talk to your child. There are many websites and other social media sites that promote dangerous ideas, such as viewing anorexia as a lifestyle choice rather than an eating disorder. Some sites encourage teens to start dieting. It’s important to correct any wrong ideas like this. Talk to your child about the risks of making unhealthy eating choices.
  • Encourage and reinforce a healthy body image in your child, whatever their shape or size. Talk to your child about self-image and offer reassurance that body shapes can vary. Don’t criticize your own body in front of your child. Messages of acceptance and respect can help build healthy self-esteem. They also can build resilience ⸺ the ability to recover quickly from difficult events. These skills can help children get through the challenging times of the teen and young adult years.
  • Ask your child’s health care provider for help. At well-child visits, health care providers may be able to identify early signs of an eating disorder. They can ask children questions about their eating habits. These visits can include checks of height and weight percentiles and body mass index, which can alert you and your child’s provider to any big changes.

Treatment plan

 

Typical treatment goals include

  • Restoring adequate nutrition
  • Bringing weight to a healthy level
  • Reducing excessive exercise
  • Stopping binge-purge and binge-eating behaviors
  • psychotherapy,
  • medical care and monitoring
  • nutritional counseling