Eating Disorders are generally defined as compulsive behavior with and around food as well as obsession with body image, shape and size. They run the gamut from ritualistic starvation to binging to the point of over-satiation and purging. Names of these disorders include Anorexia Nervosa, Orthorexia, Bulimia Nervosa and Compulsive Binging/Overeating.
Anorexia Nervosa is a well-known disorder in our society. Both men and women struggle with this disorder. Hallmark symptoms for Anorexia Nervosa include starvation behavior with the desired goal of body thinness and attractiveness. What many do not know is that Anorexia Nervosa also includes binging in response to hunger and the desire for certain tastes. These binges are often followed by bouts of self hatred and a belief that one is weak and loathsome. Further, purging by way of vomit, compulsive exercise diuretics and laxatives is part of this disease process. The experience of feeling “high” is one of the side effects of starving as well as feeling that one is better than others because of one’s will-power. For some who suffer from anorexia nervosa, boniness is the ultimate high. Anorexia has many distressing side effects including hair loss, heart issues, premature loss of the menstrual cycle which leads to premature osteoporosis [loss of bone, brittle bones] as well as premature aging and wrinkling of the skin. Anorexia, when untreated, leads to death.
Orthorexia is a form of anorexia nervosa but takes the form of eating only organic food, fruits and vegetables and can include the need to eat “freshly harvested” food or food that is harvested on the same day it is eaten. Most Vegans and vegetarians eat organic fruits and vegetables because of ethical concerns and/or because their bodies cannot process meat or do not react well to meat. This is not Orthorexia. Orthorexia is a disorder in which the individual must eat certain foods ritualistically in an attempt to be a healthy as possible yet are controlled by their rituals. When ritual controls choices and how one moves through one’s day the ritual becomes disorder.
Bulimia Nervosa is also well known in our world. Binging and purging is the hallmark of this disorder. Women and men have this disorder. Often, individuals who have this disorder use binging and purging to maintain a “normal body weight.” Researchers have found that binging on certain foods manage specific neurotransmitters tied to depression and anxiety. Note that both Anorexia and Bulimia have “Nervosa” in their official names! “Nervosa” refers to how a nervous system [mental state, mental capacity, thoughts and body/mind connection] is affected by something. Individuals with Anorexia Nervosa and Bulimia Nervosa are often greatly concerned about body size, how the individual compares to others or has met a specific set of beauty standards often drive the compulsive behavior. “Emotional eating” or Self-medicating one’s anxious and depressive symptoms are issues that can drive this disorder. Bulimic purging occurs after a binge [bulimia = eating like a bull] to either make space for more food or to offset the caloric intake of the binge. Purging includes vomiting, use of diuretics, laxatives, compulsive exercising, and starving. Consequences of these symptoms include enamel and tooth loss, hair loss, premature aging, acid reflux, electrolyte imbalance, constipation, weakened large colon, esophageal tearing and heart attack. Bulimia, when untreated, leads to death.
You may have noticed that both Anorexia Nervosa and Bulimia Nervosa have binging, purging and compulsive exercise. How do you tell the difference? Look at the intention of the behavior.
- Anorexics tend to focus on their body size, feeling obese when in truth they are too thin, as well as their strength of character in eating next to nothing and “looking good” regardless of the cost.
- Bulimics tend to focus on maintaining a “normal” body size and purge to compensate for calories taken in while binging. Binging occurs to manage anxiety, anger and sadness [neurotransmitters are released]. Over time, bulimics lose the ability to control purging and purging becomes reflexive.
Compulsive Binging, also known as Compulsive Overeating, has been recognized as an addiction by the American Medical Association. PET scans reveal that when individuals binged on high fat, high sugar foods their brain reacted exactly as the brain of an individual who has had cocaine. Neurotransmitters fire in patterns that we find in addicts. This has been an amazing shift in understanding compulsive binging. Hallmark symptoms of Compulsive Binging include binging, higher BMI, inaccurate body image, depressive and anxious symptoms and a variety of physical ailments brought about by diet and exercise habits. Compulsive bingers will often refer to emotional eating, “mood food,” comfort food and angry eating. Others reference automatic eating or grazing throughout the day in which food combinations such as crunchy/salty and sweet/salty are eaten. There are many debates about why our country has had an increase in obesity. One of the debates centers on the amount of sugar in packaged food such as high fructose syrup [glucose-fructose syrup in the UK]. High Fructose Corn Syrup is currently undergoing a name change to “Corn Sugar. “ Other debates center on the amount of physical activity children receive in their school day. Regardless of the debates, we understand that compulsive eaters crave sugar, high fat foods and salty/crunchy foods in much the same manner as drug addicts crave their drug of choice. Mood changes occur when deprived of the foods they crave and mood changes occur when the foods they crave are available.
Treatment for all eating disorders above must include strategies to manage the body/mind/spirit connection. This means working in tandem with an internist, nutritionist and endocrinologist as needed. Support groups such as ANAD, OverEaters Anonymous and others are often most helpful in conjunction with individual therapy. Individual therapy focuses on behavioral changes, body image issues, mood management, interpersonal issues that arise with recovery as well as psychological shifts that come into play as the individual begins to live life on life’s terms without the chemical management of binging, starving and purging.
The Body, Mind and Spirit are all connected and affected by addiction as well as recovery. When referring to Spirit, I am not referencing religion or God, so much as our basic human need to connect, have meaning and understand ourselves within the larger construct of Life. Using our very basic language system, this translates into Spirit. For some individuals, this work will include talking about God and religion. For others, this will include managing the larger, existential issues of Life and one’s relation to it with and without compulsive behavior. These dialogues are necessary for many since recovery from Eating Disorders includes a recommitment to living one’s life fully, rather than under the influence of one’s drug of choice and behaviors.