Understanding Eating Disorders

Anorexia Nervosa

Obsession. Rigidity. Perfectionism.
These are some of the most common mental traits present in someone suffering from anorexia nervosa. Contrary to what many people may think, those with anorexia do not stop eating completely, and there are actually two different types of anorexia. The first subtype is called the restricting subtype, which is what is most likely brought to mind when someone mentions an eating disorder. In restricting anorexia, sufferers severely limit their intake of food and may also engage in excessive exercising. The second subtype is known as the binge eating/purging subtype. Like the restricting subtype, people with binge/purge anorexia also may limit their food intake, however; they also engage in bingeing, purging, and may use laxatives, diuretics, or enemas to control weight gain. It is actually somewhat common for anorectics to move back and forth between the two subtypes, as when food intake is so limited, the body begins to NEED the nutrition so badly, it may cause the person to binge almost uncontrollably.

The DSM-IV Diagnostic Criteria for Anorexia Nervosa includes:

A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected, or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

B. Intense fear of gaining weight or becoming fat, even though underweight.

C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body shape on self-evaluation, or denial of the seriousness of the current low body weight.

D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.

Recently, there has been a large movement to change the diagnostic criteria for anorexia nervosa concerning the amount of weight lost. The proposition is to substitute "less than 85%" to "markedly low weight". This is because many eating disorder sufferers are denied treatment because their weight is not low enough! This is incentive for sufferers to be MORE involved with their eating disorder so that they may be "sick" enough to be accepted at treatment centers.

Bulimia Nervosa

Chaos. Impulsivity. Anger.
These are just a few of the things that go hand-in-hand with bulimia nervosa. This is a disorder that can rip a person apart from the inside, literally and figuratively. As with anorexia, there are two main subtypes with bulimia. The first is the purging subtype. It is characterized by the vomiting behavior occurring after a binge. The second subtype is non-purging bulimia. Characteristics of the form include using means OTHER THAN vomiting to compensate for binge-eating. These include using laxatives, diuretics, enemas, excessive exercise, or starvation. (Note: Purging-subtype bulimics may also use the methods of the non-purging subtype IN ADDITION to vomiting.)
People suffering with bulimia are typically at a normal or above-average weight. When someone with bulimia drops below the weight percentage used in the DSM-IV criterion for anorexia nervosa, they are then diagnosed with anorexia. Sufferers of bulimia have a very high likelihood of having extreme electrolyte imbalances and dehydration. Like anorexia, this is a dangerous illness which may lead to coma or death.

The DSM-IV Diagnostic Criteria for Bulimia Nervosa include:

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by the following:
    1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely
        larger than most people would eat during a similar period of time and under similar circumstances.
    2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating
        or control what or how much one is eating).

B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting, or excessive exercise.

C. The binge eating and inappropriate compensatory behaviors occur, on average, at least twice a week for three months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

EDNOS (Eating Disorder Not Otherwise Specified)

Binge Eating Disorder. Body Dysmorphic Disorder. Pica.
These are just a few types of EDNOS. Sometimes a person may not fit the criterion for anorexia or bulimia, so they are put into the category of EDNOS. In cases, people may be diagnosed with one of the three disorders listed above, however; many incidents of EDNOS occur when someone is trying to meet the criterion of anorexia or bulimia so that they may be taken more seriously when trying to get treatment!

BED (Binge Eating Disorder)

BED is the most common type of eating disorder. Like those with bulimia nervosa, people suffering from BED also binge. However, unlike those with bulimia, people with BED do not use compensatory behaviors to aid in weight management or weight loss.

BDD (Body Dysmorphic Disorder)

People with BDD may or may not consider themselves "fat". Those with this disorder become overly obsessed with a certain body part or a certain area of the body. They believe that if they could just change or remove this part then their life would be infinitely better. A low self-esteem is present and fuels this disorder. It is possible for BDD to lead to anorexia or bulimia when someone is preoccupied with the thought that a certain body part is "fat". This is why BDD is considered a type of EDNOS.


Pica is a disorder in which a person craves and consumes non-food items. This is actually somewhat common in children, pregnant women, and those suffering from mineral deficiencies. Some common non-food items consumed by people with pica include, but are not limited to: dirt, paint chips, chalk, cigarette ashes, coffee grounds, baking soda, and rust.

Muscle Dysmorphia (Bigorexia)

This is a condition in which someone believes that they are "too small". It is more common in males than in females and often affects bodybuilders or people who take working out to the extreme. Sufferers may take extreme amounts of steroids or other muscle-enhancers to try to increase their body size or body capacity. This is a disease which can largely affect the hormone testosterone.

Anorexia Athletica

This is a condition characterized by compulsive exercise and exercising beyond what is considered the normal amount. Exercise is used to increase self-worth and provide a sense of control. Many risks are involved with anorexia athletica, including dehydration, stress fractures, osteoporosis, as well as reproductive and heart problems. Sufferers may feel guilty when they miss an exercise and may deny responsibilities in order to get their workout in.

NSRED (Nocturnal Sleep-Related Eating Disorder)

NSRED is relatively new in the eating disorder spectrum and is not considered a "true" eating disorder at this time. This condition occurs when a person unconsciously consumes food during sleep. They may wake up with food remnants on or near them, or may notice wrappers or other remains of food packaging that they don't remember opening.

Orthorexia Nervosa

Orthorexia occurs when a person is overly preoccupied with "healthy" or raw foods. They only consume the purest foods in their strict diet regime. Though orthorexia, like anorexia, may lead to extreme weight loss, with orthorexia there is no goal to become thin. The only obsession concerns the purity of the food they are eating. Unlike other eating disorder, physical complications are rare unless one becomes underweight. The most common consequences of orthorexia are social isolation, and spending a lot of time planning and purchasing food.