Eating Disorders

Typology of Eating Disorders

Three primary types of eating disorders have been described: anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia nervosa is defined by significant weight loss, refusal to maintain a healthy weight for one's height, an obsession with food, acute anxiety about gaining weight, irregular or absent menstrual periods in females, and a distorted body image. In addition to restricting consumption, anorexics often focus their diets on a few food items that they eat in limited quantities. Sufferers report self-medicating their anxiety and relishing the feeling of control that accompanies food restriction.

Anorexia is one of the most deadly mental illnesses, with a morbidity rate as high as 10% of sufferers. It is estimated that 2.5 million Americans experience anorexia, including 0.5% to 3.7% of girls and women. Onset is most frequent during the early or middle years of adolescence, a period of rapid physical and emotional change. While anorexics restrict food intake, they report being preoccupied with it, frequently thinking, dreaming, and talking about it, while obsessively watching others eat or preparing food that they themselves avoid.

Bulimia nervosa is estimated to affect 1.1% to 4.2% of females in the United States. The disease is defined by episodes of binge eating followed by purging. Binges are characterized by the consumption of double or triple the amount of daily needed calories but can involve consuming as many as 20,000 calories at a time. Purging usually involves regurgitation but can include excessive exercise, enemas, and laxative and diuretic abuse. It is used by sufferers as a symbolic emotional cleansing or outpouring of feelings that otherwise remain silenced. While some sufferers purge to rid themselves of excess calories, the cycle is almost always triggered by emotional stress. The binge-purge cycle becomes fixed as an emotional coping method, albeit an unhealthy one, to which most of a bulimic's day is devoted.

[Page 294]Binge eating disorder, although not a psychiatrically affirmed illness, has been widely described and is characterized by a continued pattern of intensive eating episodes over which the sufferer experiences little control. Eating during a binge tends to be rapid, occurs when the sufferer is not physically hungry, and leads to feeling painfully full. Sufferers, who commonly feel self-distain for their behavior, often hide obsessive eating patterns, but unlike bulimics do not engage in purging. Studies have shown that 2% to 5% of the U.S. population suffers from this condition.

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