EATING DISORDERS

What is an eating disorder?

An eating disorder is a mental illness characterised by thoughts and emotions around food, weight, exercise and body size/shape that alter an individual's eating and exercise behaviour, often negatively affecting their life and relationships(1,2).

Eating disorders are caused by a range of biological, psychological and social factors(2). They affect individuals of all ages, genders, ethnicities and socio-economic backgrounds1. It is also very important to note that eating disorders can be present in individuals of any weight, shape and size(1).

Signs and symptoms

Below is a list of signs and symptoms compiled from National Eating Disorders Australia(3), Eating Disorders Victoria(4) and Mental Health First Aid Australia(1):

Physical:

Fluctuations in weight, both up and down
Gastro-intestinal complaints such as stomach cramps, constipation and acid reflux
Menstrual irregularities
Difficulty concentrating
Dizziness
Fainting
Increased cold sensitivity
Difficulties sleeping
Cuts and calluses across top of finger joints (as a result of induced vomiting)
Dry skin and hair
Lanugo - fine hair on body
Muscle weakness
Poor wound healing
Impaired immune function

Emotional and behavioural:

Preoccupation with weight, food, calories and dieting
Elimination of certain foods or entire food groups e.g. eliminating carbohydrates, veganism
Discomfort when eating around others
Withdrawal from social or recreational activities
Frequently checking body in the mirror
Hoarding food
Evidence of vomiting or laxative use, such as frequently going to the bathroom during or immediately following meals
Excessive or ritualistic exercise patterns
Routines and rituals around food selection, preparation and eating e.g. cutting food into small pieces, eating very slowly
Deceptive behaviour around food e.g. lying about food consumption, eating in secret
Heightened anxiety around meal times
Change in clothing style, such as wearing baggy clothes

Types of eating disorders

Anorexia Nervosa (AN)

Characterised by thoughts and behaviours around restriction of energy intake, often driven by a desire to lose weight or fear of gaining weight(5)

Binge Eating Disorder (BED)

Repeated episodes of binge eating, where an abnormal amount of food is consumed within a discrete time-frame, accompanied by a feeling of a lack of control and significant distress(5)

Bulimia Nervosa (BN)

Recurring episodes of binge eating, accompanied by a feeling of a lack of control. Compensatory behaviours to prevent weight gain will usually follow, including fasting, self-induced vomiting, excessive exercise and/or use of laxatives(5)

Other Specified Feeding and Eating Disorders (OSFED)

This diagnosis encompasses clinical presentations in which a feeding and eating disorder is present, but does not fully meet the diagnostic criteria for a specific disorder(5)
This includes presentations such as atypical anorexia nervosa, bulimia nervosa (of low frequency and/or limited duration), binge eating disorder (of low frequency and/or limited duration), purging disorder and night eating syndrome(5)

Avoidant/Restrictive Food Intake Disorder (ARFID)

Characterised by extremely selective eating behaviours, such as avoidance of specific food textures, smells or colours, general avoidance of food or slow eating, and is frequently accompanied by significant nutritional deficiencies(5)

Orthorexia Nervosa (ON)

An obsessive focus on "healthy" eating, characterised by significant emotional distress in relation to food that is perceived as unhealthy. These definitions, beliefs and self-imposed dietary choices around "healthy eating" can vary significantly between individuals(5)
Although weight loss may occur as a result of this disorder, it is not the principle goal(5)

Pica

Persistent ingestion of non-food substances, such as paper, hair, chalk, soap and string(5)

Rumination Disorder

Repeated regurgitation of food that is either re-chewed, re-swallowed or expelled from the mouth(5)

References

Mental Health First Aid Australia. Eating Disorders: Mental Health First Aid Guidelines. Mental Health First Aid Australia website. https://mhfa.com.au/sites/default/files/MHFA_eatdis_guidelines_A4_2013.pdf. Published April 2020. Accessed August 12, 2020.
National Eating Disorders Association. What are Eating Disorders?. National Eating Disorders Association website. https://www.nationaleatingdisorders.org/what-are-eating-disorders. Published 2018. Accessed November 21, 2020.
National Eating Disorders Association. Warning Signs and Symptoms. National Eating Disorders Association website. https://www.nationaleatingdisorders.org/warning-signs-and-symptoms. Published 2018. Accessed November 21, 2020
Eating Disorders Victoria. Eating Disorders Explained. Eating Disorders Victoria website. https://www.eatingdisorders.org.au/eating-disorders-a-z/. Published 2019. Accessed November 21, 2020.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington D.C.: American Psychiatric Association Publishing; 2013.