When you picture someone with an eating disorder, who comes to mind? Is it a troubled adolescent teenager, the start of acne covering her face? A celebrity with big sunglasses covering half his face as he checks himself into a hospital? A professional ballerina pushing her body to the limit to perform the role she’s always dreamed of dancing?

What about your friends, family, neighbors, or even yourself?

The truth is, eating disorders can affect anyone, male or female, at any age. They are considered more common among females and in people in their teens and 20s, but there are still many patients with eating disorders that do not follow these patterns.

In honor of National Eating Disorder Awareness Week, let’s take a look at the different kinds of eating disorders.

1. Anorexia nervosa

   You have probably heard something about this disorder among celebrities. In fact, Kim Kardashian was heavily criticized in 2018 after responding “Thank you!” to her sisters telling her she looked anorexic after she lost some weight. Kardashian did eventually apologize for the comment and acknowledged the seriousness of eating disorders.

   Anorexia is a disorder where the sufferer becomes unusually concerned about becoming fat even though they are, in fact, too skinny. In response to this fear, they deny themselves food, count calories, and exercise to the point of exhaustion in attempts to lose weight. Patients with anorexia may also engage in binge and purging behaviors, such as abuse of laxatives or diet aids to compensate for what they perceive as intake of too many calories.

   When asked about the behavior, many patients deny there is a problem. The weight loss may cause normal menstrual cycles to become irregular or stop completely, abdominal pain, constipation, low blood pressure, sleep problems, irritability, or irregular heart rhythms. Patients often conceal the problem from friends and family until it is far progressed.

2. Bulimia nervosa

   Sufferers of bulimia, often called bulimics, binge on large amounts of food over a short period of time, then attempt to purge the excessive calories from their bodies by inducing vomiting, abusing over the counter laxatives, or exercising excessively. Bulimia is different from anorexia in that patients with anorexia try to purge themselves of calories even though they haven’t eaten much food, while bulimics first eat large amounts of food then purge themselves of calories in unhealthy ways.

   Psychologically, bulimia has been associated with low self-esteem and poor body image, just like anorexia. Sufferers of both conditions share an intense fear of gaining weight. Bulimics often feel out of control when eating, but more in control when purging. Patients can also feel guilt or shame associated with eating which can then cause them to withdraw from friends and family.

   Bulimia causes dental problems in patients who regularly induce vomiting, as the stomach acid eats away dental enamel. Any of the purging behaviors can disrupt electrolytes in the body which in turn can cause irregular heart rhythms and even death. Like anorexia, patients often conceal the problem until it is far progressed.

3. Binge eating disorder

   Binge eating disorder isn’t in the Hollywood celebrity spotlight as much as anorexia and bulimia. Binge eating is similar to bulimia in that patients binge on foods (as the name of the disease suggests), feel their eating is out of control, and feel guilt and shame related to eating and food in general. These patients may continue to eat in spite of feeling full or overfull. Unlike bulimics, sufferers of binge eating disorder do not engage in purging. Thus, many people who suffer with this disorder are overweight or obese, though it is possible to also be normal weight.

   Sufferers of binge eating disorder often talk of dieting but don’t lose weight, and may hoard food in unusual places. Friends and family may notice evidence of a binge based on empty food wrappers or containers, or the disappearance of large quantities of food.

   Binge eating and the weight gain often associated with it puts patients at risk for other diseases often associated with obesity, such as diabetes and heart disease.

Since gastroenterology by definition has to do with disorders of the digestive tract, patients whose true diagnosis is an eating disorder may find themselves in our office. These patients have already taken a big step toward recovery just by seeking treatment. Many have friends, family, and other support on the sidelines encouraging them to continue in their efforts to become well again. With the help of medications, therapy, and/or nutritional counseling, many patients are able to reverse damage caused by the eating disorder and get back to their normal lives. 

Here at GIH, we encourage all patients with eating disorders, as well as friends and family who suspect a loved one has an eating disorder, to take the first step toward getting healthy again: see your doctor.