Understanding Eating Disorders

What is an Eating Disorder?

Eating disorders, disordered eating, body image and exercise concerns usually entail complex emotional/psychological and medical/physiological issues. Eating disorders affect people of all ages, races/ethnicities, genders, sexual orientations, and body weights, shapes, and sizes. Generally, students suffering from an eating disorder experience dissatisfaction with their body shape/weight and high concern about their eating behaviors. Symptoms of anxiety and depression are often present. Many may feel decreased confidence and self-esteem. Independent of their body size, students with eating disorders can experience medical complications because of their disordered eating behaviors.

How do Eating Disorders Develop?

There are many theories present today which provide explanations for why an eating disorder develops. What is known about the development of an eating disorder is that it is complex and may involve multiple causes. Risk factors for eating disorders involve a range of biological, psychological, and sociocultural issues. A constraining concept of beauty and social pressure to conform to this idealized and often unrealistic beauty standard increases the risk of developing an eating disorder, particularly if there are biological and/or psychological risk factors present.

What Signals That You or Someone You Know, May Have an Eating Disorder?

Anorexia Nervosa

Intense fear of gaining weight and/or of being “fat”
Preoccupation with weight, food, calories, and dieting
Focus on “burning off” calories consumed – maintains an excessive, rigid exercise regimen despite weather, fatigue, illness, or injury
Dry skin/nails and/or hair loss
Limited social spontaneity, social withdrawal, and/or concerns about eating in public
Intolerance of cold
Disruption in menstrual cycle
Distorted body image
Denial of hunger and/or skipping meals

Bulimia Nervosa

Frequent overeating, especially when under stress or when giving themselves a break from intense restricting behaviors.
Feelings of being out-of-control
Excessive concern/guilt over-eating
Recurrent use of self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise to prevent weight gain.
Using bathrooms after meals in connection to purging behaviors
Self-evaluation is unduly influenced by body shape and weight.

Binge Eating Disorder

Eating, in a short period of time, an amount of food that is more than what most people would eat in a similar period of time under similar circumstances – often to the point of discomfort or feeling sick
Feeling out of control while eating
Eating large amounts of food despite not being hungry
Embarrassment of eating habits, often resulting in eating alone or efforts to hide eating habits/food
Feeling disgusted, guilty, or depressed after a period of binging
Significant distress around the binge eating behaviors

Orthorexia

Rigidity around eating “clean” or “healthy” – cutting out food groups if they do not fall within these categories
Unusual focus on the health of what other people are eating
Significant levels of distress when “clean” or “healthy” food options may not be available
Increase in concern about the health of ingredients
Compulsive checking of food labels and lists of ingredients
Body image concerns MAY OR MAY NOT be present

ARFID (Avoidant-Restrictive Food Intake Disorder)

Significant nutritional deficit
Fear of choking or vomiting
Limited number of preferred (“safe”) foods that may become more limited over time
Lack of appetite or interest in food
Significant restriction in amount or types of food eaten.
NO body image disturbance or fear of weight gain
Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
Menstrual irregularities
Dry skin/nails, hair loss, sensitivity to cold, hair loss, muscle weakness
Poor wound healing and/or impaired immune functioning

How Can You Help Someone Who May Have an Eating Disorder?

Approach with compassion and a plan that involves a statement of concern and the basis for that concern.

Avoid making a statement about weight (e.g., "you look too thin") which may be taken as a compliment. Instead, confront the person with your observation about behaviors you have observed (e.g. it seems that you no longer come to eat with us, it seems that you are working out for long periods of time at a given time, I worry because you are not eating enough, it seems that you run to the bathroom after meals and I am concerned about it, it gives me the impression that you have been preoccupied and sad in the last few weeks, it appears that you are isolating more lately, etc.) and that you are concerned and know where they can get help.

Be prepared – your friend’s eating disorder is serving a need and they may not feel ready to admit they have a problem or to do the work that is needed to address the issue. The eating disorder may feel like a “security blanket” that they need to manage what is going on in their lives.

Use positive statements and affirmation that you truly care about their well-being.

Have on-hand specific information about the options for help: where to go, whom to see, how to get an appointment, etc. You might offer to go with the person and wait for them while they are being seen or even go into the session, if that is what they would prefer..

Consult a professional for help in making your caring confrontation.

How Can You Make an Appointment?

To make an appointment, request programs, arrange a consultation, or to find out further information about our services, or services in the community, feel free to call (757) 221-3620 or stop by the Counseling Center. Considering that complex emotional and physiological issues tend to be present when an eating disorder develops, an interdisciplinary treatment model (psychiatric, medical, psychological, and nutritional support) provides the most effective care for students managing these types of concerns.

Some useful literature on eating disorders are:

Life Without ED by Jenni Schaefer
Eating in the Light of the Moon by Anita A. Johnston, Ph.D.
Goodbye Ed, Hello Me: Recover from Your Eating Disorder and Fall in Love with Life by Jenni Schaefer
The Body Image Workbook by Thomas F. Cash
Loving Someone with an Eating Disorder: Understanding, Supporting, and Connecting with your Partner by Dana Harron, Psy.D.
The Eating Disorder Sourcebook by Carolyn Costin
Sick Enough by Jennifer Gaudiani, M.D.
Surviving an Eating Disorders: Perspectives and Strategies for Family and Friends, 3RD Edition, by Michelle Siegell, Ph.D., Judith Brisman, Ph.D., and Margot Weinshel, Ph.D.