Eating disorders are devastating mental illnesses that affect an estimated 20 million women and 10 million men sometime during their life. Approximately 85 percent to 95 percent of the people who suffer from the eating disorders anorexia nervosa and bulimia nervosa are women.
Although eating disorders revolve around eating and body weight, they are often more about control, feelings and self-expression than they are about food. Women with eating disorders often use food and dieting as ways of coping with life's stresses. For some, food becomes a source of comfort and nurturing, or a way to control or release stress. For others, losing weight may start as a way to gain the approval of friends and family. Eating disorders are not diets, signs of personal weakness or problems that simply will go away without proper treatment.
Eating disorders occur in all socioeconomic and ethnic groups. They usually develop in girls between ages 12 and 25. Because of the shame associated with this complex illness, many women don't seek treatment or get help until years later. Eating disorders also occur in young children, older women and men, but much less frequently.
There are four official eating disorders diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified (EDNOS).
Anorexia is a disorder in which preoccupation with dieting and thinness leads to excessive weight loss. If you suffer from this disease, you may not acknowledge that weight loss or restricted eating is a problem, and you may "feel fat" even when you're emaciated. Women with anorexia intentionally starve themselves or exercise excessively in a relentless pursuit to be thin, losing more than 15 percent of their normal body weight. Roughly half of all women suffering from anorexia never return to their pre-anorexic health, and about 20 percent remain chronically ill. The death rate for anorexia is among the highest of any psychiatric illness. The deaths are about evenly divided between suicide and medical complications related to starvation.
Women with bulimia regularly and sometimes secretly binge on large quantities of food—often between 2,000 and 5,000 calories at a time and, on rare occasions, even up to 20,000 calories at a time—then experience intense feelings of guilt or shame and try to compensate by getting rid of the excess calories. Some people purge by inducing vomiting, abusing laxatives and diuretics, or taking enemas. Others fast or exercise to extremes. If you suffer from this disease, you feel out of control and recognize that your behavior is not normal but often deny to others that you have a problem. Women struggling with bulimia can be normal weight or overweight and may experience weight fluctuations.
Women with binge eating disorder (BED) also binge on large quantities of food in short periods, but unlike women with bulimia, they do not use weight control behaviors such as fasting or purging in an attempt to lose weight or compensate for a binging session. When the binge is over, an individual with BED will often feel disgusted, guilty and depressed about overeating.
A fourth type of eating disorder, eating disorder not otherwise specified, refers to symptoms that don't fit into the other three eating disorders diagnoses. Individuals struggling with EDNOS, may have elements of BED, or be close to a diagnosis of anorexia or bulimia, but don't quite meet full diagnostic criteria. EDNOS is simply a catchall term for anyone with significant eating problems who doesn't meet the criteria for the other diagnoses. The majority of those who seek treatment for eating disorders fall into this category.
Although it has become synonymous with eating disorders, anorexia is relatively rare, affecting between 0.5 percent and 1 percent of women in their lifetimes, according to the National Alliance on Mental Illness. Another 2 percent to 3 percent develop bulimia and 3.5 percent develop binge eating disorder.
Yet, statistics don't tell the whole story. Many more women who don't necessarily meet all the criteria for an eating disorder are preoccupied with their bodies and are caught in destructive patterns of dieting and overeating that can seriously affect their health and well being.
There is no single cause of eating disorders. Biological, social and psychological factors all play a role. Evidence suggesting a genetic predisposition reveals that anorexia may be more common between sisters and in identical twins. Therefore, a woman with a mother or sister who has anorexia is 12 times more likely than the general public to develop that disorder and four times more likely to develop bulimia. Furthermore, among identical twins, whose genetic makeup is 100 percent the same, there is a 59 percent chance that if one twin has anorexia, then the other twin will also develop an eating disorder. For fraternal twins sharing only 50 percent of their siblings’ genes, there is an 11 percent chance that the other twin will have an eating disorder.
Other research points to hormonal disturbances and to an imbalance of neurotransmitters, chemicals in the brain that, among other things, regulate mood and appetite.
In some women, an event or series of events triggers the eating disorder and allows it to take root and thrive. Triggers can be as subtle as a degrading comment or as traumatic as rape or incest. Times of transition, such as puberty, divorce, marriage or starting college, can also provoke disordered eating behaviors. Parents who are preoccupied with eating and overly concerned about or critical of a daughter's weight, and coaches who relentlessly insist on weigh-ins or a certain body image from their athletes, especially in weight-conscious sports such as ballet, cheerleading, diving, wrestling and gymnastics, may also unintentionally encourage an eating disorder. Additionally, the pressure of living in a culture where self-worth is equated with unattainable standards of slimness and beauty can also perpetuate body image and/or eating issues.
Furthermore, the discrepancy between our society's concept of the "ideal" body size for women and the size of the average American woman has never been greater—leading many women to unrealistic goals where weight is concerned.
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