What are the signs?

An increase in awareness of the true signs and symptoms of eating disorders will decrease the associated stigmas and will ultimately help those in need.

What is anorexia nervosa?

One of the most well-known eating disorders, anorexia is also the one with the most fatalities[1].

To be diagnosed with anorexia nervosa, a health professional will look for the following signs:

  • Self-induced weight loss to below the expected range for age and height
  • Fear and avoidance of particular ‘fattening’ foods
  • Distorted self-perception of being too fat
  • Amenorrhea in women (loss of periods) and lack of sexual interest

Other signs that you need to be aware of include[2][3]:

  • An obsession over food
  • Disbelief that there is a problem, even after diagnosis
  • Low confidence
  • Perfectionism
  • Reduced pleasure in eating despite taste buds not changing[4]
  • Other mental health issues like anxiety, OCD or depression
  • Lying about eating or weight
  • Avoidance of specific foods or macronutrients, especially ones that they may believe to be fattening (carbohydrates and fats are common)
  • Abnormal activity during mealtimes, like avoiding eating with others, cutting food into very small pieces, and eating slowly
  • Counting calories and other nutrients religiously
  • Wearing baggy clothing
  • Taking diet pills
  • Excessive exercising
  • Rigid behaviours, not particularly limited to food-related situations
  • Irritability
  • Stunted growth (in children)
  • Growth of fine hair all over the body
  • Tiredness and weakness
  • Stomach issues like bloating, pain or constipation

What is bulimia nervosa?

Bulimia is the most common eating disorder [1].

To be diagnosed with bulimia nervosa, the health professional will look for these signs:

  • Recurrent episodes of binge eating, where the person will eat a significant amount of food in a short period of time.
  • A persistent craving or preoccupation with eating.
  • Counteraction of eating by one + of the following: self-induced vomiting, self-induced purging (read on), alternating periods of starvation, and/or use of drugs.
  • A self-perception of being fat and a fear of gaining weight.

Here are other signs of bulimia [2] [3] that you should be aware of:

  • An obsession over food
  • Low confidence
  • Feeling a loss of control when eating [5]
  • Feeling guilty after eating
  • Other mental health issues like anxiety, OCD or depression
  • Taking diet pills, laxatives, diuretics
  • Excessive exercising
  • Hoarding food
  • Secrecy around eating behaviours
  • Irritability and mood swings
  • Social withdrawal
  • Damage to teeth
  • Poor skin condition
  • Enlarged salivary glands and face puffiness [4]
  • Calluses on the back of hands if fingers are used to induce vomiting4
  • Weight fluctuations
  • Tiredness and weakness
  • Stomach issues like bloating, pain or constipation

What is binge eating disorder?

Signs of binge eating disorder that you should be aware of [2]:

  • Recurrent episodes of binge eating, characterised by eating a large amount of food within a short period of time, and the feeling of a lack of control during this time.
  • The episodes being associated with 3+ of the following: eating quicker than usual, eating until uncomfortably full, eating large portions of food when not hungry, eating alone, feeling very guilty after overeating.

What is OSFED?

Other Specified Feeding or Eating Disorder – this basically encompasses all other eating disorders like[5]:

Atypical anorexia

A disorder encompassing most of anorexia’s characteristics however not all diagnostic criteria is met, for example amenorrhea may not be present.

Atypical bulimia

A disorder encompassing most of bulimia’s characteristics however not all diagnostic criteria is met, for example the binges may not occur as frequently.

Overeating associated with psychological disturbances

There are multiple links arising in new research for the link between obesity and eating disorders as a reaction to traumatic events.

Pica

The eating of substances that are not normally consumed, for example paper or coal.

Psychogenic loss of appetite

Undereating due to psychological reasons.

Night eating syndrome

Where the majority of food eaten is during the night/ unsociable hours. A study has shown that someone with night eating syndrome will consume 56% of their daily food intake during the night compared with 15% for people without the disorder[6].

[1] BEAT (n.d.) Statistics for Journalists. Available at: https://www.beateatingdisorders.org.uk/media-centre/eating-disorder-statistics (Accessed: 6 August 2018).

[2] American Psychiatric Association. (1994) Diagnostic and statistical manual of mental disorders. Washington: American Psychiatric Association.

[3] World Health Organisation. (1993) ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organisation.

[4] Gross, R. and MclIveen, R. (1996) Abnormal Psychology. London: Hodder and Stoughton.

[5] World Health Organisation. (1992) ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organisation.

[6] Birketvedt, G.S., Florholmen, J., Sundsfjord, J., Osterud, B., Dinges, D., Bilker, W. and Stunkard, A. (1999) ‘Behavioural and neuroendocrine characteristics of the night-eating syndrome’, JAMA, 282(7), pp. 657-663.

written by a student dietitian

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