Types of Eating Disorders
An eating disorder is more than just a diet, more than wanting to be fit and healthy, more than starting an exercise regime.
Eating disorders are moderate to severe mental illnesses characterized by disturbances in behaviour and thinking around food, eating, weight and/or shape. They comprise a wide spectrum of illness and are serious, potentially-life threatening, mental health problems; they are not a lifestyle choice. Eating disorders affect people of all ages, from all cultural backgrounds and may arise in response to a range of risk factors.
Eating disorders are often a way of dealing with underlying personal, emotional and psychological difficulties. They can begin at any age, but usually begin in adolescence. While people tend to think that they are rare, they are not – eating disorders affect 2-3% of the population. While the majority of sufferers are female, males can also suffer from eating disorders and body image related issues.
Even though everyone’s experience of an eating disorder is different, it can be helpful to know something about the broad diagnostic ‘categories’ that are used within the health system. Eating disorders are classified into four different types, depending on the kind of symptoms and frequency of behaviours.
Anorexia Nervosa is characterised by extreme food restriction, low body weight and an intense fear of gaining weight. As they become more unwell, people with anorexia nervosa develop more obsessive or rigid ways of thinking and behaving, and become more committed to extreme dieting - for example meticulous calorie counting, refusing food or fluids and having extremely strict ‘food rules’. Weight loss may be viewed as an achievement, while weight gain is seen as an unacceptable failure of self-control. People who experience this type of eating disorder commonly exercise excessively and may also engage in other dangerous behaviours that they believe will assist them to lose weight (for example, self-induced vomiting or laxative use).
Anorexia Nervosa has the highest mortality rate of any mental illness – even higher than depression - and it leads to a whole range of physical and psychological health problems. The good news is that recovery from anorexia is not only possible, it is to be expected, providing the person receives timely and appropriate treatment.
Bulimia Nervosa is characterised by repeated episodes of binge eating, followed by behaviours that the person believes will compensate for the food they have eaten (for example self-induced vomiting or excessive exercise) – called ‘compensatory behaviours’.
People commonly misuse the term ‘binge’ to describe mild over-eating, or even normal eating. In reality, during a binge eating episode, the person will consume a large amount of food in a relatively short period of time. They will experience a sense of loss of control and then engage in compensatory behaviours as a result of intense feelings of guilt and shame.
People who experience bulimia nervosa typically maintain an average, or slightly above or below average, weight, which makes the disorder more difficult to detect compared to the severe weight loss seen in people who have anorexia nervosa. Bulimia nervosa generally develops in the late teens and is experienced by men as well as women. People with bulimia nervosa place extreme importance on their body shape and weight in determining their self-worth. Like anorexia nervosa, bulimia nervosa is a treatable illness and there is a lot of evidence about the treatments that work. The sooner someone gets help, the better.
Binge Eating Disorder is a common eating disorder characterised by repeated episodes of binge eating. Binges often occur in response to emotions, rather than hunger. Binge eating can be a way of coping with emotional difficulties – including boredom, loneliness, anxiety etc - providing a way of avoiding thinking about the real issues. Binges are followed by feelings of guilt, shame, disgust and depression. Most people who experience binge eating disorder are overweight and they might present to health professionals to discuss weight management.
Eating Disorder Not Otherwise Specified (EDNOS) is a term used to describe the different types of abnormal eating behaviours that are not able to be classified as one of the eating disorders described above. That is not to say that they are less serious or less detrimental to a person’s health – in fact, EDNOS can be just as dangerous as anorexia nervosa or bulimia nervosa, depending on the individual. The diagnostic category of EDNOS simply reflects the many different ways in which eating disorders can appear in different people. Descriptions of eating disorders that fit into the ‘EDNOS’ category include:
- Early stages of an eating disorder, or when someone is in recovery
- People who experience eating problems related to other mental health disorders
- Binge Eating Disorder (BED)
- People whose quality of life is impaired by dissatisfaction with weight, shape and appearance.