At least 10 million Americans are estimated to suffer from potentially life-threatening eating disorders, a family of behaviors characterized by an unhealthy relationship with food, an unhealthy relationship with one's body, and unhealthy weight-regulation practices. Combined, these illnesses are one of the leading killers of young women in western nations.
Consider these statistics:
- Among western women between 15 and 24 years old, approximately 1 out of every 200 suffers from anorexia nervosa, while about 1 in 50 is bulimic.
- Between 10 and 50 percent of American college women report having binge eaten and then vomited to control their weight.
- Approximately 40 percent of American girls ages 9 and 10 report being or having been on a diet to lose weight.
- Some 50 to 60 percent of teenage American girls believe they are overweight, yet only 15 to 20 percent of them actually are overweight.
Individuals with eating disorders are at the highest risk of premature death (from both natural and unnatural causes) of all people who suffer from psychiatric disorders.
Eating disorders are commonly considered to affect primarily teenage girls and young women (who are in fact the most likely to seek treatment). However, experts report that other groups, such as men, minorities, and lower-income Caucasians, increasingly are developing eating disorders. Because they don't fit the stereotype, these people are not commonly identified by caregivers and do not typically seek treatment.
Because disordered eating originates from a combination of genetic, environmental, and individual factors, the path to developing such a disorder is complex—and as unique as each person affected.
The presentation of disordered eating is also extremely individualized. For example, some people may appear to eat in a healthy manner, but their extreme exercise habits negatively impact their health and their relationships. Others may eat very little during the day but eat throughout the evening. Some people may try to compensate for binge eating with strategies such as self-induced vomiting or laxatives, while others may not.
Categories of Eating Disorders
When people think of eating disorders, anorexia nervosa and bulimia nervosa usually come to mind. Many don't realize that the expression of disordered eating comes in a variety of forms. While each category has its own symptoms, as described below, the common denominators are nutritional problems and disturbances in people's experiences of their bodies that negatively affect their ability to function.
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Often referred to as self-starvation, anorexia nervosa is an eating disorder that results in drastic, life-threatening weight loss. Estimated to affect 1 percent of adolescent females in the United States, anorexia nervosa has one of the highest death rates of any mental health condition.
In the United States, approximately 86 deaths in 100,000 among 15-to-24-year-olds are attributed to anorexia nervosa—about five times more than what is expected among people in that age group. Perhaps more troubling, the suicide risk among individuals with anorexia nervosa is approximately 32 times that of the general population.
Anorexia nervosa is most likely to occur among teenage girls and young women—at least 90 percent of sufferers are females—although it can strike both males and females at any age. Because the disorder robs the body of the fuel it needs to perform properly, the body begins to slow down critical functions in an effort to conserve energy. This can lead to serious medical complications, including:
- Slowed heart rate
- Low blood pressure
- Loss of bone and muscle mass
- Cessation of a menstrual cycle in post-pubescent females
- Fainting or lightheadedness
Bulimia nervosa is an eating disorder characterized by binge eating and dangerous weight-loss behaviors. That is, people with bulimia regularly consume large amounts of food followed by efforts to rid the body of that food (purging).
Purging and compensatory behaviors include self-induced vomiting, the abuse of laxatives and diuretics, excessive exercising, and fasting. Many people with bulimia feel as though they are powerless against their compulsions to binge and purge.
Although bulimia nervosa affects approximately 2 percent of adolescent Americans—primarily teenage girls and young women—those afflicted may not always be obvious to others, as many are of normal body weight for their height and age.
Bulimia nervosa's assault on the body can take a life-threatening toll. Bulimics can develop serious related medical conditions that include:
- Electrolyte and chemical imbalances resulting from the dehydration and loss of critical vitamins and minerals that are consistent with frequent vomiting. Such imbalances can lead to irregular heartbeat, a cumulative decline in cardiac function, and death
- Chronic gastrointestinal irregularity and distress due to abnormal eating and elimination habits or the abuse of substances such as laxatives and diuretics
- Damage to the esophagus caused by regular self-induced vomiting
While many people equate eating disorders with extreme weight loss, that is not always the case. Arguably the most common eating disorder in the United States, binge eating disorder affects an estimated 2 million Americans.
Binge eating is characterized by the quick consumption of more food than would be expected given the situation in which the eating occurs. People who are binge eaters often describe feeling that a part of them wants to stop eating, but because they continue to eat despite this internal struggle, they frequently describe a feeling of loss of control. After the eating episode, binge eaters may feel guilty, shameful, or disgusted with themselves.
This category includes forms of nutrition and body image disturbance that do not fit neatly into the more well-known categories of eating disorder. An "ED-NOS" diagnosis means that a person's body image and nutritional disturbance hinder his or her ability to live an optimal life by interfering with aspects such as health, concentration, job performance, or relationships.
Behaviors may include extreme methods of weight regulation, such as over-exercising; chronic dieting; the abuse of diet pills, laxatives, enemas, or diuretics (with or without binge eating); chewing and spitting out food; and binge eating at lower frequencies than in binge eating disorder.
While these behaviors are frequently exhibited by individuals with anorexia nervosa and bulimia nervosa, they also make up a category of their own and have a strong psychological component.
Because there are currently no standardized diagnostic criteria for these disorders, national statistics for them do not exist. However, the Eating Disorders Program at Duke University Medical Center reports that approximately half of its clinical patients fall into this category—and that many of these individuals suffer from similar levels of social and cognitive impairment as do those with anorexia nervosa or bulimia nervosa.
While sufferers are overwhelmingly, but not exclusively, teenage girls and young women, all sufferers struggle with nutrition and body image disturbances at levels that interfere with their functioning and have a negative impact on their lives.
Last reviewed on 1/28/10
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