Types of Eating Disorders

Anorexia Nervosa

A serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

Symptoms

• Refusal to maintain body weight at or above a minimally normal weight for height and age
• Intense fear of weight gain or being overweight even though underweight
• Undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight

Medical Complications

Medical complications could include:
• Impaired cognitive functioning;
• Compromised height and stature;
• Delayed puberty, lack of development;
• Hormonal imbalance;
• Gastrointestinal complications caused by malnutrition and/or underuse of GI tract;
• Stomach aches, bloating, constipation, reflux;
• Loss of and/or weakened heart muscle;
• Heart palpitations and chest pain;
• Bradycardia and tachycardia;
• Heart failure; and
• Edema.

Bulimia Nervosa

A serious, potentially life-threatening eating disorder characterized by a cycle of binge eating followed by compensatory behaviors, such as self-induced vomiting designed to undo or compensate for the effects of the binge eating.

Symptoms

• Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior
• Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting and/or compulsive exercise
• Extreme concern with body weight and shape

Medical Complications

Medical complications could include:
• Impaired cognitive function (ability to process, concentrate);
• Chronic dehydration and low potassium levels due to purging and/or diuretic abuse;
• Pancreatitis;
• GI Bleeding;
• Reflux;
• Gastric rupture;
• Constipation;
• Loss of bowel function;
• Infertility, miscarriage, premature birth, low birth-weight infants;
• Diminished gag reflex, difficulty swallowing, esophageal tears, Barrett’s esophagus;
• Swollen parotid glands;
• Cavities, extreme sensitivity of teeth due to enamel loss, damaged tooth appearance, bleeding gums;
• Calluses and/or scars on fingers;
• Broken blood vessels in eyes;
• Retinal detachment in severe cases and
• Electrolyte abnormalities that can lead to heart rhythm disturbances (sudden cardiac failure).

Binge Eating Disorder (BED)

An eating disorder characterized by recurrent binge eating without the use of inappropriate compensatory weight control behaviors.

Symptoms

• Frequent episodes of eating large quantities of food in short periods of time
• Feeling out of control over eating behavior
• Several other behavioral indicators of BED such as eating when not hungry, overeating to the point of discomfort and eating in secret

Medical Complications

Medical complications could include:
• Weight gain,
• High blood pressure,
• High cholesterol levels,
• Heart disease as a result of elevated triglyceride levels,
• Type II diabetes mellitus, and
• Gallbladder disease.

Other Specified Feeding or Eating Disorder (OSFED)

The majority of those with eating disorders do not fall within the guidelines for anorexia, bulimia and binge eating disorder and are classified as OSFED. If someone is diagnosed as OSFED, they have a combination of the symptoms of the disorders above.

OSFED is a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder. Eating disorders are not always black and white, and individuals can exhibit disordered eating patterns even if they don’t meet the threshold for a full-blown diagnosis.

OSFED has five subtypes:

1. Atypical Anorexia Nervosa: Restrictive behaviors and features without meeting the low weight criteria.

2. Bulimia Nervosa: Meets the criteria for Bulimia Nervosa but at a lower frequency and/or limited duration. Episodes of eating in a discrete period of time an amount of food that is larger than most individuals would eat with a feeling of lack of control. This is followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives and diuretics, excessive exercising and fasting.

3. Binge Eating Disorder: Meets the criteria for binge eating disorder but at a lower frequency and/or limited duration. Episodes of eating, in a discrete period of time an amount of food that is larger than what most individuals would eat with a feeling of lack of control.

4. Purging Disorder: Recurrent purging of calories by self-induced vomiting, misuse of laxatives and diuretics and excessive exercising. This subtype does not include binge eating.

5. Night Eating Syndrome: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. There is awareness and recall of the eating.
The risks associated with OSFED are severe. Individuals with OSFED will experience risks similar to those of the other eating disorders. Some previous studies show the mortality rate of OSFED as high as individuals who meet the thresholds for anorexia.
(source: ANAD)