The three main types of eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder. Anorexia is characterized by very restrictive – and inadequate – eating; bulimia by compensatory behaviors in response to eating, such as inducing vomiting or overusing laxatives. Binge eating disorder is when an individual eats more food than is normal and with a sense of being out of control.
Eating behaviors can also represent disordered eating, which doesn’t meet the criteria for diagnosis, but still indicates an abnormal relationship with food that can be detrimental to health and well-being.
Eating disorders signal emotional dysregulation; food and eating (or not eating) becomes a dysfunctional coping mechanism for dealing with difficult emotions.
There are many contributors to eating disorders, including genetics; and biochemical, psychological and cultural factors. There is no “eating disorder” gene, but a person who develops anorexia, for example, inherits a particular personality, which may put him or her at increased risk of the disorder. This risk can be heightened by trauma, such as sexual or emotional abuse, bullying, dysfunctional family dynamics, or simply not having important emotional needs met during childhood.
Culture is also a significant factor. This includes, for example, the high value we place on thinness, beauty ideals that are unattainable by the vast majority of the population and our notions of foods that are allowed or not allowed.
You should seek help for an eating disorder if you feel constantly plagued by thoughts about food, weight, body size or shape, and/or exercise, or you realize the extent to which these thoughts are ruling your life.
The first step in getting help is to see a registered dietitian and/or therapist who specializes in eating disorders.
It’s usually a good idea to make an appointment with your primary care physician as well, depending on the severity and duration of the disordered behaviors. Ideally, this health care team of physician, registered dietitian, and therapist or counselor will work closely together in care of the patient with one of these very difficult disorders.
Jeannie Sykes, PhD, RD, LDN, is a registered dietitian at Cone Health Family Medicine Center and a member of Cone Health Medical Group. She received a Bachelor of Science in nutrition from the University of Vermont in 1976, and a Master of Public Health Nutrition from the University of North Carolina at Chapel Hill in 1980. Sykes earned a PhD in nutrition from the University of North Carolina at Greensboro in 1986. She has worked at Cone Health Family Medicine Center since 1990.