What are Eating Disorders?

Eating disorders are dangerous and complex mental health conditions that affect the lives of millions of Americans of all ages and demographics. Despite ongoing research and education about eating disorders, many still believe they are  “by choice” or “in the head” of the person who is suffering. Data released by the National Association of Anorexia Nervosa and Associated Disorders (ANAD) indicates the widespread prevalence of eating disorders in America.

• At least one American dies every 62 minutes from complications directly related to eating disorders.
• Across the nation, more than 30 million people of all ages, races, and genders have at least one eating disorder.
• Eating disorders are among the most deadly mental health conditions, exceeded only by opioid addiction and overdose.

Eating disorders are complex mental health challenges that lead to significant physical and psychological consequences. It is not uncommon for someone with eating disorder symptoms to experience a co-occurring disorder or dual diagnosis, meaning they simultaneously experience the symptoms of an eating disorder and a substance use disorder. Specialized dual diagnosis treatment is crucial to achieving sobriety and recovery in these cases.

What are Eating Disorders?

Eating disorders are complex mental illnesses diagnoses characterized by harmful and abnormal eating patterns. The physical effects of untreated eating disorders do not stop at weight loss or gain. Eating disorders can (and do) have a significant and detrimental impact on your physical and psychological health. More than ten thousand Americans of all ages lose their lives to complications directly related to eating disorders each year. Furthermore, up to five percent of those who struggle with an eating disorder will attempt suicide.

What are the Most Common Eating Disorders?

The common eating disorders include anorexia nervosa, bulimia nervosa binge eating disorder, and ARFID, or Avoidant/restrictive food intake disorder as outlined in the Diagnostic Manual for Mental Disorders, Fifth Edition (DSM-5). Each of these disorders has specific behaviors and psychological issues associated with it. Recognizing these disorders is crucial for identifying their effects and pursuing the right treatment.

Anorexia Nervosa

Anorexia nervosa involves using food (or the lack of it) to maintain a thin appearance. Common symptoms include altered eating habits, low body weight, distorted body image, low blood pressure, dehydration, and anxiety. 

Anorexia nervosa (AN) is characterized by strict food intake restrictions, leading to abnormally low body weight and an intense fear of gaining weight. While primarily studied in young women in Western countries, AN can affect men and women of all ages worldwide. The disorder significantly increases the risk of death, potentially by fivefold or more. It is linked to a psychological profile that includes a drive for thinness and physical dissatisfaction. 

According to Feng B,’s 2023 study, “Current Discoveries and Future Implications of Eating Disorders”,  AN shows significant heritability, with first-degree relatives of affected individuals being about 11 times more likely to develop the disorder.

Approximately 40% of patients with AN experience reduced bone mineral density, resulting in a threefold increase in lifetime fracture risk. Chronic energy deprivation in AN can suppress the hypothalamic-pituitary-gonadal (HPG) axis, affecting hormonal balance and leading to conditions such as functional hypothalamic amenorrhea. 

Neurobiologically, AN is associated with abnormalities in the neuroendocrine and immune systems, including altered levels of leptin and changes in neurotransmitter regulation. Potential therapeutic targets for AN treatment include glial cells and specific neurotransmitter pathways.

Without assistance from a treatment program like The Los Angeles Outpatient Center, the untreated effects of anorexia can lead to lasting and dangerous consequences for both medical and emotional health.

Bulimia Nervosa

Bulimia nervosa, or bulimia involves binging and purging behaviors. Individuals with bulimia binge by consuming excessive amounts of food in one sitting and then forcibly purging it from their bodies, often through self-induced vomiting or laxative use. Other common symptoms include food aversions, persistent hunger, anxiety, bad breath, dental hygiene issues, and weight fluctuations. 

Feng B.’s 2023 study indicates that bulimia nervosa predominantly affects females and young adults, with a female-to-male ratio between 3:1 and 8:1. 

Binge Eating Disorder

Binge eating disorder (BED) is the most common eating disorder, often confused with bulimia nervosa due to similar symptoms, but they are distinct illnesses. Individuals with binge eating disorder consume excessive amounts of food in a short period, typically within a few hours or less. Unlike bulimia, binge eating disorder does not involve purging. The diagnostic criteria for binge eating disorder specify that excessive food intake must occur at least once per week for three months.

Mars, J. A.,’s 2023 study, the severity of BED can range from mild, with 1 to 3 episodes per week, to extreme, with over 14 episodes per week. 

This disorder is more prevalent in women and often begins in late adolescence or early adulthood, with a lifetime prevalence of approximately 1.9% in international surveys and 2.6% in studies conducted in the United States. 79% of individuals with a history of BED have at least one-lifetime psychiatric comorbidity, highlighting the significant distress and impairment it can cause in daily life.

ARFID (Avoidant/Restrictive food intake disorder)

ARFID, or Avoidant/restrictive food intake disorder, involves severe restrictions in eating patterns without body image concerns. Individuals with ARFID exhibit extreme picky eating, leading to nutritional deficiencies and significant weight loss. They may avoid certain foods due to sensory sensitivities (texture, smell, appearance), past traumatic experiences with food, or fear of choking/vomiting. Other common symptoms include slow eating, difficulty trying new foods, social isolation during meals, growth delays in children, dependence on nutritional supplements, and anxiety around mealtimes. Unlike other eating disorders, ARFID is not driven by concerns about body shape or size.

How Common Are Eating Disorders?

Eating disorders are highly prevalent, impacting a substantial segment of the population. According to Feng B,’s 2023, study, “Current Discoveries and Future Implications of Eating Disorders”, indicate that the prevalence of these disorders can vary:

• Anorexia Nervosa (AN): The broad occurrence among women is estimated to be between 1-4%.
• Bulimia Nervosa (BN): The estimated lifetime prevalence ranges from 0.3% to 1.6%.
• Binge Eating Disorder (BED): It affects approximately 5% of American adults.
• Avoidant/Restrictive Food Intake Disorder (ARFID): The prevalence is approximately 1.98% (95% CI 1.63-2.41) in adolescents, with females showing slightly higher rates than males (ratio 1.7:1). This prevalence is comparable to other eating disorders like anorexia nervosa in adolescent populations according to Van Buuren’s 2023 study, ‘The prevalence and burden of avoidant/restrictive food intake disorder (ARFID) in a general adolescent population’.

These disorders can develop during adolescence or early adulthood and are more commonly diagnosed in young adult females, although they can affect individuals of any gender and age.

What Are The Signs of Eating Disorders?

Signs of eating disorders include extreme weight loss or gain, preoccupation with food, calories, and dieting, avoidance of social situations involving food, excessive exercise, distorted body image, and withdrawal from friends and activities.

According to the 2020 study, Eating Disorders: recognition and Treatment the signs of eating disorders are:

• Sudden weight loss.
• Engaging in dieting or restrictive eating habits (such as dieting while underweight) that raise concerns for themselves, their family, caregivers, or health professionals.
• An atypically low or high body mass index (BMI) or body weight relative to their age.
• Reports from family members or caregivers indicating a change in eating habits.
• Increased social isolation, especially in situations involving food.
• An excessive preoccupation with their weight or body shape (for instance, worries about weight gain from contraceptive medications).
• Co-occurring mental health issues.
• Difficulties in managing a chronic condition that impacts dietary choices, such as diabetes or celiac disease.
• Irregularities in menstrual cycles other hormonal issues, or unexplained digestive problems.
• Physical manifestations of malnutrition, which may include:
  • Poor blood circulation
  • Lightheadedness
  • Heart palpitations
  • Episodes of fainting
  • Pale skin

What Are The Causes of Eating Disorders?

The common causes of eating disorders can include pressures of societal beauty standards, low self-esteem distorted thinking, and even a means of coping with deeper emotional issues. Understanding these factors can help in identifying and addressing the underlying problems related to eating disorders.

According to Polivy J, Herman CP’s 2002 study, “Causes of eating disorders”, the possible causes of eating disorders are below:

1. Sociocultural Factors: Influences from media, peer pressure, and societal standards of beauty can contribute to body dissatisfaction and unhealthy eating behaviors.
2. Family Dynamics: Factors such as enmeshment, criticism, and lack of support within the family can play a significant role in the development of eating disorders.
3. Psychological Factors: Issues like negative affect, low self-esteem, and body dissatisfaction are common among individuals with eating disorders.
4. Cognitive Aspects: Distorted thinking patterns and beliefs about food, weight, and body image can lead to disordered eating behaviors.
5. Biological Factors: Genetic predisposition and neurobiological factors may also contribute to the risk of developing eating disorders.
6. Coping Mechanisms: For some individuals, eating disorders may serve as a way to cope with problems related to identity and personal control.

What Are the Characteristics and Prevalence of Eating Disorders in Specific Demographics?

The characteristics and prevalence of eating disorders in specific demographics include significant risks among athletes, where over one-third of female college-level athletes show symptoms that may lead to anorexia due to performance pressures. Specific demographics also include Teens, college students, and more.

Eating disorders affect individuals across all demographics, not just young, white, affluent females. These disorders transcend race, gender, religion, and sexual orientation, impacting people from diverse cultural and societal backgrounds.

Athletes: In a recent study, more than one-third of female college-level athletes were found to have symptoms and attitudes that may place them at risk for anorexia. There is significant pressure for athletes to perform and maintain a specific body size and shape. Without the benefit of good information related to eating disorders, these pressures can put even the most physically fit at risk.

Teens and College-age students: According to the National Institute of Mental Health, among teens between the ages of 13 and 18, almost four percent of females and 2 percent of males are reported to have a diagnosed eating disorder. Also, other recent studies in the Journal of School Nursing found that almost twenty-five percent of those teens misjudge their weight, meaning they believe they are overweight when they are not. Teens who misjudge their weight are more likely to develop unhealthy dietary habits.

LGBTQ+: Those in the lesbian, gay, bisexual, transgender, and queer community commonly struggle with eating disorders. Unfortunately, treatment resources have not always been available to them for various reasons. Fortunately, as awareness increases, the availability of resources for treatment is widening.

Statistics regarding eating disorders for youth and adults who identify as LGBTQ+ are very inconsistent; however, the National Eating Disorder Association has stated that members of this population (especially teens) are thought to be at higher risk of binge eating and purging. Studies have shown the onset of these illnesses can occur as early as age 12 among LGBTQ+ youth. In comparison, the “normal” age of onset in the general population is one’s late teens and early twenties for binge eating disorders.

People of color: Eating disorder rates are similar among all races and ethnic backgrounds; however, people of color are less likely to receive treatment for an eating disorder.

How Are Eating Disorders Diagnosed?

Eating disorders are diagnosed based on the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 includes Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder, Pica, and Rumination Disorder as eating disorders. 

Diagnosis typically involves a comprehensive evaluation by a healthcare professional, including a physical examination, psychological evaluation, and review of eating habits and behaviors. Moreover, the individual’s history, symptoms, and impact on their overall health and well-being are also considered.

How Are Eating Disorders Treated?

Eating disorders are treated through a multidisciplinary approach that may include psychotherapy, medication, nutrition counseling, and family therapy. 

Eating disorders are primarily treated through a combination of psychotherapy and, in some cases, medication.

According to Costandache GI,’s 2023 study, “ An overview of the treatment of eating disorders in adults and adolescents: pharmacology and psychotherapy”, treatment options for eating disorders include:

1. Psychotherapy:
   • Cognitive Behavioral Therapy (CBT)
   • Family-based therapy (FBT) for adolescents
   • Enhanced Cognitive Behavioral Therapy for Eating Disorders (CBT-E)
   • Dialectical Behavior Therapy (DBT)
2. Medication:
   • Fluoxetine for bulimia nervosa
   • Lisdexamfetamine for binge eating disorder (in adults)

The treatment approach varies based on the type of eating disorder, the individual’s age, and the severity of the disorder. A multidisciplinary team of healthcare professionals—psychiatrists, psychologists, dietitians, and primary care physicians—collaborates in treating eating disorders.

Getting Help for Eating Disorders at Los Angeles Outpatient Center

Therapy for eating disorders can occur in several different settings, with treatment programs ranging from minimally to significantly intensive, depending on the needs of the individual. Most treatment plans involve a combination of psychological therapy (psychotherapy), nutrition education, medical monitoring, and sometimes medications. How long treatment lasts will depend on several factors, including the diagnosis, the severity of your illness, and the type of treatment program.

Eating disorder therapy involves several types of therapy. The most common examples include cognitive-behavioral therapy, dialectical behavior therapy (DBT), and family-based therapies. Cognitive-behavioral therapy, or CBT, focuses on behaviors, thoughts, and feelings related to the eating disorder. After helping the individual gain healthy eating behaviors, cognitive-behavioral therapy sessions help them learn to recognize and change distorted thoughts that lead to eating disorder behaviors.

DBT is a behavioral treatment supported by empirical evidence for the treatment of anorexia, bulimia nervosa, and binge eating disorder. Dialectical behavior therapy follows the premise that the most effective way to start eating disorder therapy is by encouraging behavioral change. DBT sessions focus on learning and practicing skills needed to replace harmful eating disorder behaviors. Family-based treatments involve family members learning to help their loved ones restore healthy eating patterns and achieve a healthy weight until the individual can do it on their own. This type of treatment can be beneficial for parents learning how to help a teen with an eating disorder.

Many people with an eating disorder fear seeking help to learn how to manage and overcome their symptoms. People who live with eating disorder symptoms often hide their symptoms from friends and loved ones for fear of how others will react. It is crucial to remember that eating disorders of all kinds can lead to dangerous medical and mental health consequences when left untreated. The safest way to recover from an eating disorder is to seek help at a professional treatment program like The Los Angeles Outpatient Center.

Eating disorder treatment at our Los Angeles treatment center ensures you or your loved one receives the care and support they need through therapy and nutritional counseling to develop better eating habits and a safe relationship with food. In addition to comprehensive therapy and nutrition education, your treatment team will ensure you have access to ongoing therapy and peer support after completing a primary treatment program. Although it is possible to recover from an eating disorder, there is no cure. Therefore, you must have a strong network of peer and family support available to help you during challenging times.

If you would like to learn more about treatment for eating disorders in Los Angeles, contact a member of our admissions team today for more information about our programs or to schedule a tour.