What are Eating Disorders?

According to The National Institute of Mental Health estimates, 5-10% of girls and women, 1 million boys and men, and over 15% of transgender and other gender individuals suffer from eating disorders. These include anorexia, bulimia, binge eating disorder, and other associated conditions.

Eating disorders are often associated with preoccupations with food, weight, or shape or with anxiety about eating or the consequences of eating certain foods. Behaviors associated with eating disorders include restrictive eating or avoidance of certain foods, binge eating, purging by vomiting or laxative misuse, or compulsive exercise. These behaviors can become driven in ways that appear similar to an addiction. 

What causes eating disorders?

A common misconception is that eating disorders are about weight, shape, size, and food. They are not at all about any of these. Instead, these things are only what is visible and the underlying development of eating disorders is related to much deeper rooted factors. 

Genes and heritability play a part in why some people are at higher risk for an eating disorder, but these disorders can also afflict those with no family history of the condition. Additionally, eating disorders often co-occur with other psychiatric disorders such as mood and anxiety disorders, obsessive-compulsive disorder, and alcohol and drug use. 

How Are Eating Disorders Treated?

Treatment for an eating disorder addresses psychological, behavioral, nutritional, and other medical complications. The latter can include consequences of malnutrition or purging behaviors such as heart and gastrointestinal problems as well as other potentially fatal conditions. 

With treatment,  those with eating disorders can resume healthy eating habits, and recover their emotional and psychological health. Although they can be a lifelong struggle it is so important to understand that full recovery is possible. The personality traits that may have led a person into an eating disorder are also traits that can be used for recovery and leading a productive and fulfilling life.

How can Skycloud Mental Health Help?

Skycloud Mental Health offers psychiatric medication management. Our providers can collaborate with your therapist, registered dietitian, primary care provider, and other providers. Based on medical stability, telehealth may not be appropriate and we can help you find resources for an appropriate level of care. 

How Do I Know If I Need a Higher Level of Care?

The mortality rate for anorexia nervosa and bulimia nervosa can be 5% or higher. Higher levels of care provide a structured and protective environment that may be essential for recovery. Eating disorders often involve behaviors that result in medical instability with symptoms of cardiovascular compromise, electrolyte disturbances, or hypoglycemia. Common reasons for needing higher levels of care include substantial weight loss that might be life-threatening; difficulty eating enough food to gain weight; severe binge/purge behaviors; incapacitating ED symptoms; comorbid substance abuse; and anxiety, depression, obsessive-compulsive disorder, or suicidal intent.

Depending on your medical status, need for structure to decrease eating disorder behaviors, motivation for recovery, degree of weight change necessary, and social support. Telemedicine may not be appropriate for you and we will help recommend an appropriate level of care for your needs. If you are uncertain if we can meet your needs please email admin@skycloudhealth.com.

What is Disordered Eating?

Disordered eating is a broad umbrella term that includes disordered relationships with food, exercise, and one’s body. Disordered eating is clinically defined as “a wide range of irregular eating behaviors that do not warrant a diagnosis of a specific eating disorder”. This means that disordered eating is not a diagnosis in itself, but rather a term used to describe the behavior patterns seen in someone who does not fit within the specific criteria for any of the diagnosable eating disorders.

Disorder Eating Behaviors/Symptoms May Include:

A distorted body image

Body shape or weight that is used as a primary measure of self-worth

Strict rules surrounding eating and exercise

Restricting many foods or eliminating food groups

Unhealthy weight control behaviors, such as skipping meals, fasting, using diet pills, vomiting after eating, and abusing laxatives

Using steroids or creatine to alter appearance or exercise performance

Trying several diets to lose weight

Frequent fluctuations in weight

Over-exercising with the purpose to burn calories or lose weight

Feelings of guilt and shame resulting from an inability to maintain food and exercise habits

A restricted social life due to conflicts with food or your child’s exercise routine

Feeling out of control when eating

Eating large quantities of food late at night

Eating for comfort, not hunger

An impaired quality of life due to a preoccupation with food, exercise, and body image

Eating Disorders exist on a spectrum from disordered eating habits to distinct subtypes. Eating disorders can exist in any weight or gender. At Skycloud Mental Health we can provide assessments to help you understand your eating behaviors. 

Types of Eating Disorders

Anorexia Nervosa

Characterized by self-starvation and weight loss resulting in low weight for height and age. Anorexia has the highest mortality of any psychiatric diagnosis and can be a very serious condition. Body mass index, a measure of weight for height, is typically under 18.5 in an individual with anorexia nervosa. Dieting behavior in anorexia nervosa is driven by an intense fear of gaining weight or becoming fat. Some persons with anorexia nervosa also intermittently binge eat and or purge by vomiting or misusing laxatives.

Symptoms may include: 

• Menstrual periods cease
• Dizziness or fainting from dehydration
• Brittle hair/nails
• Cold intolerance
• muscle weakness and wasting
• Heartburn and reflux (in those who vomit)
• Severe constipation, bloating, and fullness after meals
• Stress fractures from compulsive exercise as well as bone loss resulting in osteopenia or osteoporosis (thinning of the bones)
• Depression, irritability, anxiety, poor concentration, and fatigue

Serious medical complications can be life-threatening and include heart rhythm abnormalities, especially in those patients who vomit or use laxatives, kidney problems, or seizures.

Bulimia Nervosa

People with bulimia nervosa typically alternate between dieting (or eating only low-calorie “safe foods”) and binge eating (on “forbidden” high-calorie foods). Binge eating is defined as eating a large amount of food in a short period of time associated with a sense of loss of control over what, or how much one is eating. Binge behavior is usually secretive and associated with feelings of shame or embarrassment. Binges may be very large and food is often consumed rapidly, beyond fullness to the point of nausea and discomfort. Binges occur at least weekly and are typically followed by what are called “compensatory behaviors” to prevent weight gain. These can include fasting, vomiting, laxative misuse, or compulsive exercise. As in anorexia nervosa, persons with bulimia nervosa are excessively preoccupied with thoughts of food, weight, or shape which negatively affect, and disproportionately impact, their self-worth.

Symptoms may include:

• Frequent trips to the bathroom right after meals
• Large amounts of food disappearing or unexplained empty wrappers and food containers
• Chronic sore throat
• Swelling of the salivary glands in the cheeks
• Dental decay resulting from erosion of tooth enamel by stomach acid
• Heartburn and gastroesophageal reflux
• Laxative or diet pill misuse
• Recurrent unexplained diarrhea
• Misuse of diuretics (water pills)
• Feeling dizzy or fainting from excessive purging behaviors resulting in dehydration

Binge Eating Disorder

As with bulimia nervosa, people with binge eating disorder have episodes of binge eating in which they consume large quantities of food in a brief period, experience a sense of loss of control over their eating, and are distressed by the binge behavior. Unlike people with bulimia nervosa, they do not regularly use compensatory behaviors to get rid of the food by inducing vomiting, fasting, exercising, or laxative misuse. Binge eating can lead to serious health complications, including obesity, diabetes, hypertension, and cardiovascular diseases.

Symptoms may include:

• Eating more rapidly than normal
• Eating until uncomfortably full
• Eating large amounts of food when not feeling hungry
• Eating alone because of feeling embarrassed by how much one is eating
• Feeling disgusted with oneself, depressed, or very guilty afterward

Other Specified Feeding and Eating Disorders

This diagnostic category includes eating disorders that cause distress and impair family, social or work function but do not fit the other categories listed here. 

Avoidant Restrictive Food Intake Disorder

Avoidant/restrictive food intake disorder involves a disturbance in eating resulting in failure to meet nutritional needs and extreme picky eating.

Symptoms may include:

• Low appetite and lack of interest in eating or food.
• Extreme food avoidance based on sensory characteristics of foods ( texture, appearance, color, smell)
• Anxiety or concern about consequences of eating (fear of choking, nausea, vomiting, constipation, an allergic reaction)

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