Eating Disorders

“National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.”

Eating disorders are very serious, but treatable illnesses. They do not affect any specific group of people, although more women receive a clinical diagnosis than men. Eating disorders often start in adolescence; however research is showing that an increasing number of children and older adults are suffering with them. Symptoms of an eating disorder can also change over the lifespan; a person can start with one eating disorder and later show signs of another.

Eating disorders are often related to other significant issues, such as depression, anxiety, self-injury, substance use, post-traumatic stress disorder and body image. Over time, an eating disorder can damage your heart, brain and gastrointestinal system. It can also affect your hormones and if left untreated, be fatal.

Sometimes people think that guys can’t have eating disorders, but this in not true. Although the reported estimate of eating disorders for men is lower than women, there could be an issue with men underreporting their struggle with eating. Why? Many people feel that guys hesitate to get help for an eating disorder because they will be perceived as feminine or weak. In reality, eating disorders can affect everyone.

Research on the link between sexuality, gender identity and expression, body image and eating disorders is new. However, initial findings suggest that eating disorders may impact LGBTQ individuals disproportionately (more/less than other groups). LGBTQ identified people experience a variety of stressors that are unique, which can impact their self-esteem and create depression, anxiety or unhealthy coping skills, like self-injury or substance use. These factors can also contribute to the likelihood of having an eating disorder.

  • Body dissatisfaction
  • The internalization of the ‘thin ideal’
  • Extreme dieting habits
  • Lack of family or social supports
  • Low self-esteem 
  • Maladaptive coping skills
  • Social withdrawal or problems, isolation 
  • History of psychiatric illness
  • Experiences of violence which could contribute to post-traumatic stress disorder, which research shows greatly increases vulnerability to an eating disorder

Stressors specific to the LGBTQ community

  • Coming out and the stress associated with potential/actual rejection by loved ones
  • Internalized transphobia or homophobia- meaning an inner sense of hatred or shame a person may feel about their sexual orientation, gender identity or expression due to negative messages they receive externally about these identities
  • Discrimination and bullying
  • Homelessness or experiencing an unsafe home environment
  • Their own body image ideals within the context of being LGBTQ
  • LGBTQ individuals may also have more barriers to accessing treatment than other groups of people do, such as lack of support or lack of available competent treatment
Anorexia

Anorexia nervosa is a serious problem in which a person has significant weight loss, and does not maintain a healthy weight for their age and height. They normally do this by restricting their intake, however they can also exercise compulsively, purge by vomiting or using laxatives and diuretics or binge eat. They also often have a distorted view of their body image and have an intense fear of becoming overweight (even though they are underweight).

WARNING SIGNS

  • Losing a significant amount of weight
  • Dressing in layers to hide weight loss or to stay warm
  • Intense focus on weight, food, calories, fat grams, and dieting
  • Refusing to eat certain foods, or whole categories of foods (e.g., no carbohydrates, etc.)
  • Feeling “fat” or overweight despite having lost weight, or being afraid you will get fat
  • Constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
  • Saying you aren’t hungry when you are, makes excuses to avoid mealtimes or food situations
  • Using food rituals for what you do eat (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate or putting things on food to make it unappealing)
  • Cooking for others but not eating
  • Feeling the need to “burn off” calories taken in and maintaining a rigid exercise regime despite being sick, hurt or tired
  • Becoming more isolated, withdrawn, and secretive- even from loved ones and friends
  • Not eating in public
  • Not maintaining body weight
  • Denying body weight is low, even when friends, a medical professional or doctor tell you that you are underweight
  • Having a distorted self-image- seeing yourself as fat or ugly
  • Loss of your period (in females)
  • Feeling the need to be in control all the time
Orthorexia

Although it’s not formally a diagnosis, a disorder called orthorexia is on the rise. People with orthorexia become extremely fixated on so-called ‘healthy eating’ to the point where that they actually damage their own well-being. Similar to anorexia, these people severely restrict their intake, which can cause malnutrition and orthorexia can have similar physical consequences to anorexia.

WARNING SIGNS

  • Compulsive checking of ingredient lists and nutritional labels
  • Increased concern about the health of ingredients of the foods you eat
  • Cutting out more and more food groups (carbs, then meat, then dairy…)
  • Having a very restricted list of foods you are willing to eat
  • Intense interest in what other people are eating
  • Intense thoughts or distress about going to events/places where “acceptable” foods aren’t available
  • Obsessively following food or healthy lifestyle blogs, or apps
  • Sometimes body image issues

HEALTH CONSEQUENCES

The following physical problems may result from having anorexia or orthorexia:

  • Stomach cramps, constipation, or acid reflux
  • Irregular periods
  • Trouble concentrating
  • Dizziness or fainting, muscle weakness
  • Constantly being cold or tired, or having trouble sleeping
  • Cuts and calluses across the top of finger joints (from inducing vomiting)
  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity, dry skin, brittle nails, thinning hair on the head or fine hair that grows on the body
  • Poor immune system, always getting sick
Bulimia

Bulimia nervosa is a serious problem, where person cycles through periods of binge eating, followed by periods where they take drastic measures, like forcing themselves to vomit, in order to compensate. Binge eating is described as eating a portion of food (much larger than most would eat) over a short period of time. Often people who binge eat say that they do not feel in control of their eating.

WARNING SIGNS

  • Weight loss, dieting, and control of food are primary concerns
  • Taking or hiding large amounts of food, hiding empty wrappers/containers
  • Purging, by vomiting after meals (and needing to leave the table to do so), smelling of vomit or constantly using gum, mints, mouthwash, or perfume to cover scent, using/hiding packages of laxatives or diuretics 
  • Discomfort eating around others 
  • Food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate or putting things on food to make it unappealing)
  • Skipping meals or eating very small portions 
  • Putting large amounts of food in odd places (like a closet)
  • Drinking excessive amounts of water or non-caloric beverages  
  • Expressing a need to “burn off” calories taken in and maintaining a rigid exercise regime despite being sick, hurt or tired
  • Swelling of your cheeks, jaw or calluses/discoloration to teeth, hands and knuckles from vomiting
  • Becoming more isolated, withdrawn, and secretive- even from loved ones and friends
  • Being bloated from fluid retention
  • Distorted self-image, intense concern with your body
  • Secretly binging and purging (through vomiting, over-exercise, use of laxative/diuretics)

 

HEALTH CONSEQUENCES

  • Weight fluctuates noticeably (up and down)
  • Stomach cramps, constipation, or acid reflux
  • Irregular periods
  • Trouble concentrating
  • Dizziness or fainting, muscle weakness
  • Constantly being cold or tired, or having trouble sleeping
  • Cuts and calluses across the top of finger joints (from inducing vomiting)
  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity, dry skin, brittle nails, thinning hair on the head or fine hair that grows on the body
  • Poor immune system, always getting sick
Binge Eating

Binge eating disorder is a severe and life-threatening eating disorder in which a person eats large quantities of food (often very quickly and to the point of discomfort), during which they feel a loss of control (and experience shame, distress or guilt afterwards). Afterward, they may compensate the way people with bulimia do (purging through vomiting, over-exercise or laxative/diuretics) but they don’t do so regularly. 

WARNING SIGNS

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when you are not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much you are eating
  • Feeling disgusted with yourself, depressed, or very guilty afterward or low self-esteem
  • Using fad diets or eliminating food groups
  • Distorted self-image, intense concern with body

HEALTH CONSEQUENCES

  • Fluctuation in weight
  • Stomach cramps, constipation, or acid reflux
  • Trouble focusing
  • Increasing feelings of shame, guilt and depression
Getting help for an eating disorder
  • Admitting that you need help is a good first step. As you move forward, you will also need to be willing to work through treatment, meaning that you may have to do some things that could make you uncomfortable at first.
  • Talk to someone- you can’t handle something this big alone, and you don’t have to! Trusted adults like your parents or caregivers, a guidance counselor, coach or religious leader, just to name a few. You can also build up a group of friends. A support group will encourage you in your healthy lifestyle and hold you accountable to continue!
  • Professional guidance will also be helpful, you can work with trusted adults in your support group to get help from people like your medical doctor, a therapist and/or a psychiatrist.
  • Groups are another great way to keep you moving in a positive direction is to find a recovery group of individuals who are also healing from an eating disorder and can share your successes and challenges.
  • Be careful with online resources- only access trusted resources, some sites will give you negative information that is not healthy.