There are three main categories of eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
Anorexia Nervosa (AN)
Anorexia is characterized by an intense fear of weight gain, a distortion of body image, a relentless pursuit of thinness as well as an unwillingness or inability to maintain a normal or healthy body weight. In females it presents with amenorrhea (absence of menstruation). A person who develops anorexia will often become obsessive about eating, food, and weight control. Frequently checking body weight, careful control of food portions, and food restrictions are common with this disorder.
Often an individual with anorexia believes they are overweight, even though they may clearly appear poorly nourished or emaciated. There are different types within the subcategory of Anorexia, Restrictive Type and Binge-Eating/Purging type. These types refer to the way in which the individual consumes food when they do eat.
Warning Signs of Anorexia:
Deliberate Food Restriction
Fear of Gaining Weight
Refusal to eat of incredibly restrictive eating
Abnormal Weight Loss
Sensitivity to Cold
Amenorrhea or irregular menstruation in females
Increased facial hair/body hair due to lack of protein in diet
Hair Loss (on scalp)
Bulimia Nervosa (BN)
Individuals struggling with bulimia have similar concerns to those struggling with anorexia. But unlike anorexia, people with bulimia often fall within the normal range for their age and weight. Bulimia is characterized by frequent and recurring cycles of binging (eating atypically large amounts of food) followed by a period of purging (vomiting, overuse of laxatives or diuretics). The purge phase of bulimia is often in hopes to compensate for the binge behavior, and to help the individual feel they have regained control. This cycle typically repeats several times within one week.
As with any eating disorder, there is often another underlying psychological illness (e.g. depression, anxiety, and substance abuse) that accompanies bulimia nervosa. This behavior can have serious physical implication, including dental decay, gastrointestinal problems, and nutritional imbalances.
Warning Signs of Bulimia
Preoccupation with Food
Binge Eating ( secretive)
Vomiting after bingeing
Abuse of Laxatives, diuretics, and/or diet pills
Denial of Hunger
Swollen salivary glands
Broken blood vessels in the eyes (from purging)
It is important to note, again, that individuals with bulimia may not appear to be under weight. In fact, they can range anywhere from overweight, normal weight, or underweight. For this reason, it can be more difficult to immediately identify bulimia in a friend or family member.
Binge Eating Disorder (BED)
While BED is not yet recognized in the DSM-IV, it is proposed as a new addition to the DSM V. Binge Eating Disorder is characterized by insatiable cravings that can occur at any point during the day or night. Thebehavior is usually secretive and filled with shame for the individual. It is estimated that BED occurs in1 out of every 35 adults in the U.S, approximately 3-5% of women and 2% of men.
It is also important to note that Binge Eating Disorder does not co-occur with Anorexia or Bulimia. In BED, the individual does not purge after bingeing, so individuals with this disorder are more likely to be overweight.
Proposed Criteria for BED Diagnosis:
- Loss of control of amount eating.
- Distress over binge episode
- Occurs at least 1 time per week for a 3 month period
- Eating more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food without feeling hungry
- Eating alone due to embarrassment
- Guilt after overeating.
It is important to note that obesity and BED are not the same situation. Obesity exists as a medical illness, while BED is a psychiatric disorder and simply being overweight does not mean you have BED.