My View of Eating Disorders
You do not necessarily have an eating disorder simply because you are overweight and/or like to eat. I define an eating disorder as the abuse of food, exercise, and/or the physical body itself.
When obsessions or focus on food, eating, diet, weight, exercise and body image interfere with your life and relationships, you could have an eating disorder. These obsessions, behaviors, and distortions of thinking may lead to consequences such as obesity, anorexia, and other physical and emotional problems. Just as often, emotional problems lead to an eating disorder.
People with Eating Disorders use and abuse food to manage their problems, similar to the way addicts or alcoholics use drugs and alcohol. Food, in particular becomes at once a friend and an enemy. A whole interactive relationship is formed surrounding food and what food represents. There is a "high" that occurs at some point in the behavior, followed by guilt, depression and other negative feelings. Eating disorders can be very complex and cyclical and often manifest themselves in a variety of different forms.
There are several personality traits present in sufferers of eating disorders. The first is an inadequate amount of unconditional self-acceptance. The second is a feeling of displaced control. Feelings of inadequacy or discomfort with the self lie beneath eating and body image disorders. If other areas of life feel out of control, an obsessive drive to control food consumption and the physical body may develop. I call this the "Paradox of Control."
A tell tale sign of one who is suffering from an eating disorder may be a superficial display of rigid control or lack thereof. Either of these cases may be a marked sign of being out of control in other areas of life. The diagnoses to follow are some of the different ways that failure to accept oneself and feelings of being out of control may manifest.
Compulsive overeating
Compulsive overeating is defined as eating when you are not physically hungry. This eating is done primarily to minimize emotional distress. This may temporarily relieve anxiety, sadness, boredom, anger, or other forms of discomfort, but can engender some very unpleasant side effects such as feelings of guilt, depression, self-contempt, and loss of control.
Bingeing is the most common form of overeating and is often done behind closed doors. People who binge customarily consume normal or smaller than normal amounts of food in front of others. However, once in private, larger quantities of food are usually consumed. Another form of overeating is perpetual "grazing" which can take place throughout the day. Grazing consists of snacks becoming meals and meals becoming snacks. Food consumption becomes an activity, as opposed to a necessity.
Compulsive overeaters are caught in a cycle of attempts to manage their weight. Sometimes, they are restricting/dieting, but more often they are either gorging themselves or obsessing about food, eating and their weight. Obvious consequences are obesity and a higher risk of health problems, such as heart disease, diabetes, cancers, etc. Mood changes and depression are typical. Further, the development of more severe eating disorders, like bulimia or anorexia becomes more of a threat.
Anorexia Nervosa
Anorexia nervosa is an eating disorder that is characterized by an individual's over-restriction and rigidity about food consumption in order to maintain an abnormally low body weight (technically 85% of normal expected body weight). An anorexic has a deeply ingrained distorted body image, with complicated underlying issues. Persons with anorexia are obsessive about regulation of food and body weight. They commonly regulate intake by measuring and weighing foods, eating a certain way and only eating certain foods at certain times. These habitual eating patterns are created and strictly adhered to by the sufferer of anorexia in order to provide a false sense of being in total control. In actuality control is lost, not gained as the anorexic's efforts become completely self-destructive. Outpatient psychotherapy can assist with modification of these negative behaviors so that true control may be realized.
Due to the phobic nature of anorexia, it can difficult to treat. The sufferer's attempts to avoid a <more healthy> "normal" weight are common because "normal" weight may be considered to be "fat". In more severe cases of anorexia, a dangerously advanced level of malnutrition requires hospitalization.
Bulimia Nervosa
Bulimia Nervosa is a vicious cycle of bingeing and purging. The consumption of hugely excessive quantities of food (sometimes 50,000 calories or more) is followed by quickly "purging" all of the food consumed. Purging is the practice of eliminating consumed food by any means possible. Purging is commonly done by self-induced vomiting, laxative abuse, or compensatory exercise.
Bulimia is a maladaptive way to manage feelings by "stuffing" them and literally throwing them up. These episodes are usually triggered by unpleasant states of depression, anger, boredom, loneliness and self-contempt. The bulimic feels a sense of control, as they think they can have "the best of both worlds". By thinking they can eat anything they like, and still maintain relative control over their weight, the binge purge cycle is perpetuated. However, over time, the binge-purge cycle can be very damaging to the body to the point of spiraling completely out of control. Depression leads to binging, which leads to purging, which intensifies depression eventually leads back to more severe, painful, and frequent bingeing and purging episodes.
Similar to sufferers of anorexia, those who are bulimic tend to have an irrational, inconsistent sense of self, based primarily distorted body image. Bulimia is a condition that has potential to seriously damage the gastro-intestinal track and can be fatal if not treated.
Bulimia (Non-purging Type)
These bulimics will binge without self-induced vomiting. Rather, they will use other extreme means to regulate body weight such as fasting, over-exercising, abusing laxatives and diuretics.
Binge Eating Disorder (BED)
With the incidence obesity and eating disorders steadily on the rise in America, much research is being conducted in this arena. BED is a relatively newly recognized form of compulsive overeating. BED occurs in both overweight and normal weight individuals, approximately 2% of the general population. BED consists of eating (bingeing) very large quantities of food in short periods of time. People with BED are aware that their eating is out of control. They feel ashamed and embarrassed. They will eat in private, until they are painfully full, way beyond the point of being satiated. BED has similarities to Bulimia Nervosa, but without fasting, over-exercising, self-induced vomiting or laxative abuse.
Body Dysmorphic Disorder (BDD) (Body Image Disorder)
The American Psychiatric Association (APA) defines this newer diagnosis as: a preoccupation with an imagined defect in appearance, where even a slight anomaly causes a markedly excessive amount of concern.
BDD has also been described as "Body Image Disorder," "Biggorexia" and "The Adonis Complex." Persons with this disorder have an irrational view of their physical body or a part of their body. Men with BDD-<Biggorexia> often have intentions to gain larger quantities of muscle mass, while managing radically low body fat percentages. They may compulsively exercise, sometimes spending more time in physical fitness pursuits than what would be considered "routine." Cosmetic surgery is routinely sought as a means to the perfect physique. Sadly, BDD sufferers are seldom ever happy with the results.
Although BDD is technically diagnosed separately from the other eating disorders, there are similar insecurities and body image distortions that lie beneath the surface-level behaviors and compulsions. There has been an explosion of recent literature detailing the finer points of this disorder, particularly as it pertains to men. In a sense, both Anorexia and Bulimia have a body image disorder component.
All types of compulsive overeaters can suffer a depleted sense of their physical body (being), amidst their erratic eating and typical weight fluctuations.
