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Eating Disorder or Disordered Eating?
While the terms "eating disorders" and "disordered eating" are often used interchangeably and the differences between the two are often subtle, they are different problems. Both are prevalent in adolescence and young adulthood, but they have been reported in children and older adults, too. Whoever they affect, one thing is for sure: both can have harmful consequences. Disordered eating can lead to eating disorders.
An eating disorder may begin when someone starts to eat either smaller or larger amounts of food than they usually do, but at some point the compulsion to eat less, or more, spirals out of control. The person often becomes overly preoccupied with eating, food, and weight control, sometimes to the point that they cannot concentrate or focus on other things in life. People with eating disorders often have other mental illnesses such as depression, substance abuse, or anxiety disorders.
Despite all the research that has been conducted to gain an understanding of eating disorders, the cause of eating disorders, whether it be biological, behavioral, or social, is unclear. Concerns about weight and body size and shape play a role in all eating disorders, but the actual cause may include cultural and family pressures, emotional disorders, genetics, and biological factors.
Statistics from the National Institute of Mental Health suggest that 2.7 percent of adolescents suffer from an eating disorder and that girls are more than two and a half times as likely as boys to have an eating disorder. According to the American Academy of Pediatrics, eating disorders are on the rise, particularly in children under the age of 12 years, males, and minority populations. Five to ten percent of all cases of eating disorders occur in boys.
There is a wide range of abnormal eating behaviors, but there are only three clinically identified eating disorders according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified (EDNOS). The third category was designed to describe behaviors that meet some but not all of the criteria for anorexia or bulimia.
Anorexia NervosaAnorexia nervosa is a condition that goes beyond out-of-control dieting. It is estimated that .6% of the United States adult population and .5% of adolescent girls have anorexia nervosa.
Anorexia nervosa is characterized by:
Many people with anorexia see themselves as overweight, even when they are clearly starved and malnourished. They may weight themselves frequently, portion their food carefully, and eat tiny quantities of only certain foods. Often they will wear baggy clothes to hide their body. Sometimes people with anorexia nervosa also engage in a cycle of binge-eating followed by extreme dieting or purging behaviors such as vomiting, excessive exercise, and/or the misuse of enemas, diuretics, or laxatives.
Over time, a person with anorexia nervosa may experience a loss of bone density, dry hair and skin, hair loss, the growth of a downy layer of hair all over the body, muscle loss and weakness, and an abnormally slow heart rate and low blood pressure. Eventually, the heart and brain are damaged from malnutrition.
Of all the types and subtypes of eating disorders, anorexia nervosa is the deadliest. In a recent meta-analysis, the mortality rate for those with anorexia nervosa had a weighted annual rate of five deaths per 1000 person-years. Of those who died, one in five died of suicide.