The first, most basic thing I want to discuss is what eating disorders are and then highlight the different types that exist. The majority of this information is coming from the National Eating Disorders website, with information from other resources thrown in.
“Eating disorders — such as anorexia, bulimia, and binge eating disorder – include extreme emotions, attitudes, and behaviors surrounding weight and food issues.” They are known for their “serious emotional and physical problems that can have life-threatening consequences for females and males.”
Anorexia is defined as “a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss” and is characterized by a fear of gaining weight, a resistance to or refusal to maintain an appropriate weight for one’s age and height, and debilitating thoughts of feeling “fat” or overweight (when in fact they are most often the direct opposite). In women, losing your period (amenorrhea) can be a sign and/or symptom of anorexia. At the very least, it’s a sign you’re not eating enough, regardless of whether or not an eating disorder is a factor.
While the specific causes of anorexia aren’t known, it is thought that one can be predisposed to it if you suffer from anxiety, poor self-image, etc.
Bulimia is defined as “a serious, potentially life-threatening eating disorder characterized by a cycle of binging and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating”. Those who suffer from it tend to ingest larger than normal quantities of food before feeling a sense of loss-of-control, which results in their use of laxatives, water pills, self-induced vomiting, etc. to purge what they ate.
“Larger than normal” quantities of food doesn’t mean eating an extra 1000 calories at dinner – for some people, it could mean eating an extra 10,000 calories in one sitting. Most often, people will hoard their food and then secretly indulge in it later when no one else is around to witness their behavior. That secretive behavior can be one of the main giveaways for someone suffering from bulimia. Their weight tends to be fairly normal since they’re not usually losing any weight, which is why it’s easier to hide bulimia. The only person who might be able to easily spot someone suffering from it is your dentist, since cavities, gingivitis, and worn enamel on the teeth (thanks to the stomach acid) are all trademark signs of bulimia.
One compensatory behavior of bulimia that we often forget about is obsessive and/or compulsive exercise. As athletes, our workout regimens are pretty regimented to begin with so hiding this behavior can be pretty easy. Sometimes this is classified as it’s own disorder known as “exercise bulimia“.
Binge eating, while not as commonly recognized as anorexia or bulimia (despite being more common than both), is an eating disorder that is “characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.” Similarly to bulimia, it involves consuming large quantities of food in short periods of time. They differ in that binge eating isn’t accompanied by the purging behaviors that bulimia is associated with.
Like other eating disorders the causes aren’t known but it’s thought to be linked with dieting, since after a period of dieting some people “reward” themselves by eating large quantities of food but then end up taking it too far by experiencing a loss of control in how much they consume, which leads to them eating to the point where they are uncomfortably full. This leads to strong feelings of guilt and depression which can come full circle and start the process of binging all over again. Stress, boredom, etc. are all emotions that can lead to binging.
Unlike anorexia and bulimia, at this time binge eating doesn’t fall under the DSM-IV‘s definition of mental illnesses but it has been studied and treated for well over 50 years.
Eating Disorders Not Otherwise Specified (ED-NOS)
Anorexia and bulimia are both known and classified as the two “main” eating disorders but there is another classification known as ED-NOS for those who are “struggling with eating disordered thoughts, feelings or behaviors, but does not have all the symptoms of anorexia or bulimia”. If you fall under the criteria for suffering from anorexia but you still get your period or your weight is still relatively normal, you would be classified under ED-NOS.
Men and women may also fall under the ED-NOS classification if they indulge in behaviors of multiple eating disorders (“crossing over” is how it’s defined). Of all the EDs though ED-NOS has a higher death rate than all of them so it’s just as serious, if not more, than anorexia and bulimia.
While not technically considered an eating disorder per se, orthorexia displays compulsions similar to those seen in anorexia and bulimia. The focus is not on losing weight or being thin but instead on eating healthy. It was considered an eating disorder in the 90s but due to society’s sudden fascination with organic food it’s become too “mainstream” to be considered one anymore.
This is a really interesting one and not something I had heard of until I started doing research for this post. It affects those who suffer from Type 1 diabetes and “is the reduction of insulin intake to lose weight.” Although those with diabetes can suffer from other eating disorders as well, diabulimia is specifically related to diabetes because instead of cutting calories through starvation (as in anorexia) or purging (as in bulimia), they’ll “eliminate” calories by restricting their insulin intake. If you know even the basics of diabetes you know how imperative it is for diabetics to follow a strict insulin regime so in addition to the negative health effects the would suffer from the eating disorder, they are also seriously comprising their health by ignoring the dangers of not taking their insulin.
Because there are two diseases that make up diabulimia, it is considered a “dual-diagnosis” disorder. The mortality rate of diabetes jumps to 35% when combined with an eating disorder but despite this it’s probably the least discussed disorder of all the ones listed so far. All of the usual diabetic symptoms would be experienced, in addition to a severe drop in energy, higher than normal levels of glucose, organ damage, etc.
As I mentioned yesterday, I’m going to finish this series with a post that highlights the experiences of rowers and coxswains who read the blog. Everything will be kept anonymous so if you’re interested in participating, send me an email.