Types of Eating disorders
Eating disorders are complex mental illnesses that can affect anyone of any age, gender, or background. They are not a lifestyle choice or a “stage” but they can cause major harm and in extreme cases can be fatal – Anorexia Nervosa has the highest death rate of all psychiatric illnesses (Smink, van Hoeken, & Hoek, 2012). But even though eating disorders can cause serious harm, they can be treatable and full recovery is possible.
There often tends to be some overlap between different types of eating disorders. The food and body image symptoms may affect everyone in different ways and degrees. Many individuals can move between eating disorder diagnoses if they experience changes in their symptoms. A diagnosis can help ensure that someone is getting the most appropriate support and treatment for the difficulties they are experiencing from their illness. Noticing some of these symptoms early may help prevent them from getting worse.
The following are the different types of Eating Disorders and their symptoms:
Anorexia Nervosa (Anorexia)
Anorexia Nervosa is a serious mental health illness diagnosed when an individual’s weight is dangerously low due to their restricted intake of food. Commonly, individuals with Anorexia have a distorted view of their body/shape and have an intense fear of gaining weight (American Psychiatric Association, 2013; World Health Organization, 1992).
Someone with Anorexia typically has an extreme preoccupation with food, body image and has low self-esteem. Many individuals can be left feeling distressed, guilty, ashamed and/or anxious whilst preparing/eating food which can result in developing strict food ‘rituals. As well as extreme restriction, individuals with Anorexia may engage in behaviours which offsets some of the guilt of eating food such as exercising excessively, vomiting, or abusing laxatives.
Severe health consequences are associated with Anorexia due to extreme malnutrition, such as low blood pressure, muscle weakness, loss of bone density, hair loss, severe dehydration, irregular hormone functions, fatigue and difficulty regulating temperature.
Bulimia Nervosa (Bulimia)
Often, individuals with Bulimia Nervosa will experience cycles of excessive eating, in a short period of time and sometimes beyond the point of comfortable fullness (bingeing) followed by attempts to get rid of the food consumed (purging), typically in the form of self-induced vomiting, laxative abuse, diet pills, over-exercising or fasting.
Frequent cycles of bingeing and purging put massive amounts of strain on the body and can result in serious physical health problems, such as gastrointestinal (digestive) complications, dental problems, dehydration, heart rhythm abnormalities and electrolyte (chemical) imbalances.
Many individuals diagnosed with Bulimia may experience the cycle of bingeing and purging episodes becomes a way to release uncomfortable emotions. It is common to experience feeling out of control or secrecy during a binge and the overwhelming urge to purge can serve to satisfy the desire to stop weight gain. It often leaves an individual with extreme feelings of shame, guilt, disgust, and low self-esteem.
Binge Eating Disorder (BED)
Binge Eating Disorder is characterised by frequent episodes of excessive eating, typically all at once until feeling uncomfortably full, (bingeing). It is common to find it difficult to stop eating, feel disconnected from what you are consuming, eat alone because of embarrassment and often struggle to remember what has been eaten during/after a binge. Often, individuals with BED will experience feelings of shame, self-hatred, embarrassment, and guilt during and/or after a binge.
Unlike a diagnosis of Bulimia, individuals with binge eating disorder tend not to engage in compensatory behaviours to “undo” the binge. This means not using purging methods such as self-induced vomiting, laxative abuse, diet pills, over-exercising or fasting after a binge.
BED can often lead to the development of unwanted weight gain and/or obesity related complications, such as diabetes, cardiovascular disease, high blood pressure and insomnia.
Other Specified Feeding and Eating Disorder (OSFED) or Avoidant/Restrictive Food Intake Disorder (ARFID)
Individuals diagnosed with Other Specified Feeding and Eating Disorder, often experience disordered eating behaviours, distorted body image and an intense fear of weight gain but do not meet the full diagnostic criteria for Anorexia or Bulimia or BED. For example, an individual dealing with OSFED may experience many of the same symptoms that of Anorexia, except their weight may remain within a “normal” range, likewise many individuals may not meet the frequency and/or duration criteria for Bulimia and BED but may experience cycles of bingeing or purging episodes. OSFED has many of the same associated physical health risks of Anorexia, Bulimia and BED and is just as harmful.
Individuals diagnosed with Avoidant Restrictive Food Intake Disorder typically do not restrict their intake of food due distress surrounding body image, rather, it is classified by highly selective eating habits, difficulty digesting food and refusal of particular foods due to a sensitivity in taste, temperature, texture, smell or appearance. Sometimes individuals may have had a past distressing experience whilst eating food such as choking or previous illness which has affected their relationship with food. Most recently, there has been links made with ARFID and Autism Spectrum Condition (ASC) due to sensory sensitivity (Dovey, Kumari, Blissett, 2019). ARFID often results in significant nutritional deficiencies, due to inadequate intake of food.
1) American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). American Psychiatric Press. https://doi.org/10.1176/appi.books.9780890425596
2) Dovey, T. M., Kumari, V., & Blissett, J. (2019). Eating behaviour, behavioural problems and sensory profiles of children with avoidant/restrictive food intake disorder (ARFID), autistic spectrum disorders or picky eating: Same or different? European Psychiatry, 61, 56-62. https://doi.org/10.1016/j.eurpsy.2019.06.008
3) Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414. https://doi.org/10.1007/s11920-012-0282-y
4) World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization. https://apps.who.int/iris/handle/10665/37958.
You might find these interesting too!
Information on what is autism and answers to other questions you might have about the neurodevelopmental condition.
This blog post aims to provide dietetics with a greater understanding of the development of the PEACE care pathway and how dieticians can support.