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Information on Eating Disorders
An eating disorder is defined as an “obsessive attitude to food: an emotional disorder that manifests itself in an irrational craving for, or avoidance of, food." Although the Diagnostic and Statistical Manual of Mental Disorders, currently only lists four types of classified eating disorders, there are many more that are both diagnosed and recognized by medical and mental health fields. Having the essential information on eating disorders can lead to early detection and treatment.
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Nature vs. Nurture
Dr. Walter Kaye is but one of the many who feel there is evidence to suggest a genetic predisposition to eating disorders. According to Kaye’s international study, 10 percent of patients with anorexia or bulimia had a family history of at least one relative also having an eating disorder.
On the other hand, other influences, both behavioral and environmental, may also play a role. A study by the National Institute of Mental Health indicated that in homes where mothers are overly concerned or comment excessively about their daughter’s weight or physical appearance, there was a higher presence of eating disorders. The study also showed that girls with eating disorders reported having a father or a brother who was also overly critical regarding their weight and physical appearance.
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A Compulsion is not a Binge
Many people use “compulsive" and “binge" eating interchangeably. However, this is a mistake, as these are different and separate eating disorders. If a person eats for emotional reasons (happiness, depression, sadness, or stress), instead of eating simply for nutritional value or in social settings for enjoyment, it may be an example of someone with compulsive eating disorder. According to the National Institute of Mental Health, compulsive eating disorder is the most common eating disorder in the U.S. “2.8 percent of the adult population will suffer from compulsive eating disorder." Compulsive eating involves an addictive component related to the food, and usually stems from a history of family and friends offering food for comfort, which turn food into a coping mechanism.
A person who suffers from binge eating disorder will eat a large quantity of food in one sitting, usually in secret. The eating event is followed by intense feelings of embarrassment, shame, depression, and guilt. As binge eaters are addicted to food, they are aware of their abnormal behaviors, but feel they have no control over them. Binge eating is hard to discover, as those affected usually eat alone out of guilt and embarrassment, as well as fear of judgment. Unlike bulimics, binge eaters do not purge after their eating session. In addition, as large quantities of calories are consumed at one time with no off-setting activities, binge eaters are usually overweight or obese, but some can be of normal weight. The number of women affected by binge eating is only slightly higher than that of men.
It is important to note that while the majority of those affected with both compulsive eating and binge eating disorders are overweight or obese, not all overweight or obese people binge or are compulsive eaters.
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Commonly known as an eating disorder in children, PICA affects adults as well. However, PICA often goes unrecognized and undiagnosed in adults, as many won’t seek help due to embarrassment, and their family and friends won’t confront them, as they may not truly understand the disorder.
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When Healthy Food is Bad for You
According to Steven Bratman, MD, orthorexia is born out of a desire to be healthy. “Orthorexia begins innocently enough, as a desire to overcome chronic illness or to improve general health." Orthorexia is a condition in which the person affected is obsessed with eating only healthy foods, or develops a fixation on food quality, or how the food impacts their health or affects their body. Those suffering from orthorexia spend most of their day figuring, planning, and searching for healthy, pure, and natural foods. As the disorder progresses, it will drive the person to abstain from eating anything that they feel will harm their body, or is not pure and natural, often resulting in unhealthy weight loss, dehydration, and malnutrition.
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“He’ll Eat Anything …"
Most people would never think of eating chalk, hair, paint, dirt, or rocks, but those who suffer from PICA actually crave these types of things – and there are other substances too. Commonly known as an eating disorder in children, PICA affects adults as well. However, PICA often goes unrecognized and undiagnosed in adults, as many won’t seek help due to embarrassment, and their family and friends won’t confront them, as they may not truly understand the disorder. PICA is common during a woman’s first pregnancy, but usually disappears after childbirth and may be unlikely to return in any future pregnancies. However, even if PICA behaviors disappear temporarily, they can reoccur later in life.
While most substances and objects eaten by those who suffer from PICA are relatively harmless, the disorder can cause cravings to ingest things that can be extremely harmful – such as needles, metal, light bulbs, detergent, or even feces.
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According to the American Psychiatric Association, the classification given to a person who suffers from an eating disorder that does not fall within the diagnosis parameters of any other disorder is said to be EDNOS - Eating Disorder Not Otherwise Specified. More commonly referred to as an “atypical eating disorder," those who fall in this category may exhibit symptoms of numerous eating disorders, or may not meet all the criteria to receive a full diagnosis of one. EDNOS is where eating disorders go when they don’t fit anywhere else. However, the mental health field keeps up-to-date with all the latest information on eating disorders in order to keep the public informed and educated.
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Men & Women are Created Equal
Centering around a distorted body image, and altering the thoughts, feelings, and behaviors of those affected, muscle dysmorphia is an eating disorder that affects primarily men. Also referred to as “bigorexia," muscle dysmorphia is the polar opposite of anorexia. The most common behaviors associated with this disorder include compulsive and excessive exercising – most frequently free weights, misuse of performance enhancing substances (such as anabolic steroids), obsession with diet and dietary intake, and training or exercising even in the presence of an injury. Those who suffer from muscle dysmorphia are usually male athletes, such as body-builders, wrestlers, football players, and boxers. As a significant amount of each day is dedicated to the disorder, muscle dysmorphia can disrupt the social life, career, relationships, and especially the finances of those affected.
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Sleep eaters are those who eat while they are fast asleep. Similar to sleep walking, sleep eaters will be completely asleep when they get out of bed, walk to the kitchen, prepare food, and eat it. In extreme cases some sleep eaters have been known to cook complete meals and consume them.
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Many people eat a snack before bed, or may make their way to the kitchen when they can’t sleep. For those who suffer from night eating (or drinking), sleep comes only when accompanied by food. Night eaters consume over 50 percent of their daily dietary intake during the night. For some, an eating event may happen only once; for others, it happens many times a night. Those who are affected by night eating are physically unable to fall asleep until they have eaten. Those with recurring events will wake up every few hours, having to eat again in order to return to sleep. This urge to eat is not hunger – it is an abnormal need for food. Night eaters don’t eat much during the day, and when they do, it's usually in small portions. The majority of those with this disorder are overweight, and may have excess stress or anxiety.
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Sleep Eating Disorder
Sleep eaters are those who eat while they are fast asleep. Similar to sleep walking, sleep eaters will be completely asleep when they get out of bed, walk to the kitchen, prepare food, and eat it. In extreme cases some sleep eaters have been known to cook complete meals and consume them. However, in the morning when they wake, they have no recollection of the events. Odd foods, combinations of foods, and non-food items prepared as if they were food have all been reported to be consumed during a sleep eating event. Sleep eaters are at risk of weight gain, injury while preparing or cooking food, choking, and poisoning (from eating non-food items such as soaps, detergents, and cleaners often found in the kitchen). There is also the risk of the sleep eater accidentally starting a fire when using the stove.
Both men and women suffer from sleep eating, but of the reported cases, the majority are women. The actual number of those suffering from sleep eating is unclear, as many cases go unreported due to embarrassment or shame. However, current information on eating disorders estimates that anywhere from one to three percent of the population suffers from sleep eating.
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Bratman, Steven, M.D. Orthorexia Home Page. Retrieved December 5, 2010 from http://www.orthorexia.com/.
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994) Retrieved December 4, 2010 from http://www2.massgeneral.org/harriscenter/understanding_clinical.asp.
Kaye, Walter, Dr. BBC Online Network. Retrieved December 6, 2010 from http://news.bbc.co.uk/2/hi/health/259226.stm.
Kaye, Walter, Dr. National Eating Disorders Association. Retrieved December 6, 2010 from http://www.nationaleatingdisorders.org/research-efforts/.
National Institute of Mental Health. Retrieved December 8, 2010 from http://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml.