Education About Eating Disorders

Definitions and Diagnostic Criteria for Eating Disorders

This information is only very general, and IS NOT A SUBSTITUTE FOR PROFESSIONAL DIAGNOSIS OR TREATMENT. Meeting any of these symptoms and behaviors indicates that a professional evaluation is necessary. Because eating disorders are tied to self-destructive, habitual behaviors that are attempts to cope with other stressing aspects of life, only a professional can help to untangle the thoughts and feelings that drive these behaviors. Most importantly, the longer these unhealthy thoughts and behaviors continue, the harder they are to treat and resolve. Face the fear, uncertainty and suspicion that surround eating disorders and get a professional evaluation so recovery can begin.

Early intervention provides the highest cure rate for eating disorders

  1. Eating disorders are not a phase that people go through.
  2. Eating disorders are the most deadly of all mental illnesses.
  3. Eating disorders have more physical health consequences than any other mental illness.

Anorexia

Anorexia nervosa is a fear of weight and food, no purging involved

  • Extreme weight loss and restrictive eating
  • 85% for weight
  • Loss of menstrual period, Amenorrhea
  • Terrified of weight gain
  • Noticeably underweight yet can't see self, reports "feeling" fat
  • Onset often early to mid adolescence
  • Often depression, irritability and/or withdrawal are also experienced
  • Strange eating habits
  • Self-worth is tied to self-discipline, denial of hunger is empowering

Bulimia

Bulimia nervosa is often the sufferer is of normal weight or slightly more

  • Binge purge cycles 2 times per week for 3 months
  • Purge methods can be varied; vomiting, laxative abuse, excessive exercise, fasting
  • Rigid dietary "rules" cause hunger
  • Self-doubt, guilt, depression, and anxiety may also be present
  • Often impulsive behavior is also experienced

Overeating

Binge eating disorder is believed to be the most common eating disorder, an estimated 4% of the population, often related to obesity rather than thinness

  • Eating large amounts in a given time, 2 X per week over 6 months
  • Eating fast
  • Eating while full and uncomfortable
  • Eating large quantities though not hungry
  • Eating alone because of shame of the behavior
  • Feelings of disgust, depression, and/or guilt after over eating
  • No regular purge behavior

EDNOS

Eating Disorders Not Otherwise Specified are hybrid collections of inappropriate thoughts and behaviors that can be as varied as human beings themselves. These symptoms do not neatly fit into any of the above diagnoses and may be more difficult to sort out. An eating disorders specialist is best suited to investigate and evaluate these symptoms.

Complete diagnostic criteria for eating disorders are addressed in the Diagnostic and Statistical Manual of Mental Disorders. The DSM is revised every five years, as research and treatment evolve.

Some books to help you understand eating disorders

  • The Eating Disorders Sourcebook, by Carolyn Costin is a comprehensive guide to the causes, treatment and prevention of eating disorders.
  • Helping Your Child Overcome an Eating Disorder: What You Can Do at Home, by Teachman, Schwartz, Gordic and Coyle, based on research from the experts at the Yale Center for Eating and Weight Disorders and intended to supplement professional care.
  • An extensive library eating disorders books are available from Gurze Books at http://www.bulimia.com/index.cfm

Self Test

As the paragraph at the end of the Self-test suggests, your completed copy of this survey is a great tool to take to your first meeting with a mental health professional (MHP) or physician. PLEASE NOTE that it is necessary to seek out a MHP for a thorough evaluation of the symptoms indicated in the self-test. Physicians/MDs seldom have the resources to do psychological evaluations within their practice.

Physicians screen for physical health problems, NOT MENTAL HEALTH problems. Although eating disorders have numerous physical health consequences, they are classified as mental health issues. This fact is a major problem with finding and coordinating eating disorder treatment which ideally will include a specially trained psychologist, a physician, a nutritionist or dietitian, and if medication that treats brain chemistry is needed, a psychiatrist. This collection of clinicians is typical in forming an eating disorders treatment team, also referred to as multi-modal care.

It is not unusual for a medical doctor to be dismissive of the information indicated by the self-test. Physicians tend to be so burdened by the health consequences related to overweight and obesity that they, like Ivan Trump tend to believe that "You can never be to rich or to thin." This is a treacherous myth!

Generally, physicians have very little training in nutrition and even less formal training about eating disorders. Whether you take your self-test to a physician or a mental health professional, don't be shy about asking if they have any formal training that has equipped them to treat eating disorders. Be pleasantly shocked if they say yes. If they say no, ask them for referral information to other providers in your community. If they have no referrals, and you have health insurance, call the company for treatment provider info. If you are uninsured, call you local hospital and ask for mental health information. If you have no success with these, go online to EDReferrals.org

Self-test for Anorexia, Bulimia and related eating disorders