Different Types of Eating Disorders
Understanding eating disorders can be difficult unless you have been through one yourself. In most cases, the general public awareness regarding these psychiatric issues extends only to anorexia and bulimia. It fails to acknowledge the existence of multiple other types of eating disorders that continue to affect thousands of people worldwide. With up to 12 different types of eating disorders with overlapping symptoms, diagnosing a particular one often gets cloudy. Moreover, because eating disorders continue to morph and change with time, one person can move between multiple diagnoses at different points in life, especially if treatment is not undertaken.
Whether you are here to know more about your diagnosis or to support a loved one who has recently been diagnosed with an eating disorder, you have plenty to learn. Continue reading to learn about different eating disorders types and how to recognise them.
Mentioned below are the types of eating disorders UK as recognised by the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders.
Anorexia nervosa comes into most people’s minds when they hear the term “eating disorder.” As the most well-known type of eating disorder, it is characterised by restriction of food intake in several ways. For example, an individual may limit the amount of food or calories they consume or stick to only a particular type of food, like carrot sticks. People with anorexia are generally underweight; however, it is not a diagnostic criterion. Some may exhibit all typical behaviours of this issue without significant weight loss. Others often indulge in purging behaviours (a binge-purge subtype of anorexia) which means getting rid of the food after an overeating episode, usually by self-induced vomiting. Other symptoms of anorexia include:
- Intense fear of gaining weight
- Refusal to acknowledge how low body weight can harm the body and health
- Absence of menstruation in women due to low-fat content
- Increased strain on the cardiovascular system, leading to heart damage
- Association of body weight with self-esteem and self-image
Just like anorexia, bulimia tends to hit adolescents and young adults the most, specifically in women. The condition involves severe purging behaviours to reduce the number of calories consumed. This purging may occur through various compensatory behaviours, such as excessive exercise, self-induced vomiting, diuretics and laxatives, etc. It is important to remember that people with bulimia are different from the ones with binge-purge sub-type of anorexia since the former tend to maintain normal body weight while the latter is primarily underweight. Moreover, bulimics do not restrict their food intake regularly as anorexics.
Binge Eating Disorder (BED)
Binge eating disorder was formally introduced to the world by the DSM-5 in 2015. People suffering from BED tend to lose control over their eating. As a result, they frequently consume large quantities of food in one sitting, much more than an ordinary person. However, it is different from bulimia in that no compensatory behaviour is involved. As a result, most people with BED are overweight.
Contrary to most eating disorders, muscle dysmorphia affects men more than women. Characterised by a disruptive obsession with physique and musculature, it causes an individual to fixate on acquiring the perfect body through severe food modifications.
Other Specified Feeding or Eating Disorders
Also known as OSFED, other specified feeding or eating disorders include all other types of eating disorders that do not fit in any of the categories mentioned above. People with atypical bulimia or anorexia and other unofficial eating disorder diagnoses (described below) fall into this category.
Seven Unofficial Eating Disorders
In addition to the five official eating disorder diagnoses described above, seven additional “unofficial” types are yet to be recognised by any diagnostic manual. However, many psychologists and doctors continue using them to communicate more clearly with each other and patients. These include:
Compulsive Over Eating (COE)
COE is quite similar to BED, except that people with the former diagnosis do not binge in episodes. Instead, they are more likely to eat large quantities of food throughout the day.
Pregorexia describes the urge to lose weight during pregnancy. Sometimes, the weight loss plans can get too extreme that they endanger the life of the mother and the baby. Pregorexia can lead to coronary heart disease, stroke, depression, hypertension, and low birth weight if left untreated.
Drunkorexia combines an eating disorder with alcoholism. The affected individual attempts to restrict their food intake, indulges in frequent purging to save calories, and utilises this window to drink alcohol. Without treatment, drunkorexia often leads to severe malnutrition.
Prader Willi Syndrome
Characterised by compulsive eating and consequent obesity, Prader Willi syndrome is well-rooted in genetics. As an inherited disease, it includes symptoms such as poor feeding, weak muscles, and slow development in children. It also induces an insatiable hunger in many children, putting them at a high risk of developing diabetes.
Identified by Steven Bratman, orthorexia nervosa forces a patient to become overly obsessed with clean eating, sometimes to the extent that it starts affecting their life.
This occurs when someone who has diabetes uses their prescription insulin to try to induce weight loss.
Selective Eating Disorder
In simpler words, selective eating disorder describes picky eating to a debilitating level. It causes people to become so selective about their food that they only stick to one or two meals and eventually fall sick.
The treatment program for an eating disorder varies depending on the type and severity of the issue at hand. However, a generic outline of what a typical treatment regimen would look like is mentioned below:
One of the earliest and the most important tasks of an eating disorder treatment program is to repair the lost weight and deteriorating health. To accomplish this, nutritional therapy is offered to all clients under the supervision of a registered dietician. A dietician assesses each client’s nutritional status, food preferences, and medical needs and collaborates with them to develop a meal plan. The characteristics of an ideal meal plan include its ability to provide the needed nutrition and exposure to the feared foods to improve flexibility.
A certified medical doctor handles medical interventions for clients with all eating disorders with special training in eating disorders treatment. This program aims to identify and address any physical issues induced due to altered and potentially unhealthy eating habits. Some common elements of medical treatment include:
- Monitoring of the vital signs
- Weight tracking
- Laboratory tests
- Additional testing to check the bone density and heart function
- Management of all physical issues, such as heart problems, digestive distress, etc.
While there are multiple psychological therapies for eating disorders, cognitive behavioural therapy (CBT) is the most popular. CBT has proven to be particularly effective for people with both types of anorexia, binge eating disorder, and other specified eating disorders. This therapy focuses on addressing the symptoms while inducing a patient’s behavioural change. Some common elements of CBT include:
- Meal planning
- Challenging dietary rules
- Self-monitoring, for example, through a food diary
- Establishment of regular eating
- Disruption of dangerous dietary behaviours, such as compensatory behaviours, binge eating, or crash dieting
- Addressing issues related to body image
- Relapse prevention
- Exposure to the “forbidden” food
- Reducing the over-evaluation of weight and shape
So far, CBT has provided excellent results in adults with eating disorders. When it comes to adolescents, especially the ones suffering from a particular type of anorexia, the treatment of choice often includes family-based treatment (FBT). FBT refers to manualised therapy provided in the form of weekly sessions with a trained psychotherapist in the presence of the entire family. Parents are particularly encouraged to actively participate in the treatment and support their children as they work on normalising their eating behaviours. In addition to FBT and CBT, some other forms of psychotherapy routinely used to manage different types of eating disorders include:
- Dialectical behaviour therapy
- Interpersonal therapy
- Mindfulness-based eating awareness training
- Special supportive clinical management
- Integrative cognitive-affective therapy
- Acceptance and commitment to therapy
- Guided self-help
The list mentioned above is not exhaustive; however, it successfully demonstrates that multiple psychotherapies are available for managing all types of eating disorders. So if you or a loved one are suffering from one, do not be afraid to seek help.
What are the possible medical issues related to an eating disorder?
Different people may develop various medical issues, depending on the type of their eating disorder, its duration, and its severity. However, some of the common ones may include the following:
Slowed down heart rate
Electrolyte imbalance, leading to increased stress on the heart
Intestinal tears or blockage
Pancreatitis, i.e., swelling of the pancreas
Vomiting and nausea
Type 2 diabetes
What is a refeeding syndrome?
Refeeding syndrome is a severe complication that arises during the initial management of a longstanding eating disorder. The problem begins when you start increasing your food intake after restricting it for a long time. During this period of restriction, your body does not have enough carbohydrates to extract energy from. Hence, it turns to fats and proteins to fulfil its energy needs. But once this restrictive period is over and you start consuming carbohydrates again, your body will use them for energy gain. This sudden shift in the energy source triggers an electrolyte imbalance that puts excessive strain on the kidneys and the heart, sometimes to the extent that the organs stop functioning. Due to this, the refeeding syndrome can be potentially deadly if treatment is not sought. If you start developing this complication, you will need to be under constant supervision of a doctor unless your organs resume working properly.
Are some personality traits more common in people with eating disorders?
People who suffer from eating disorders, especially with anorexia nervosa, usually tend to be perfectionists, sensitive to criticism, self-doubting, and people-pleasers. Most of them are routine-bound and find it challenging to adapt to changes. Such people are impulsive and find it difficult to maintain stable relationships.
When should I consider joining an eating disorder rehab?
You consider seeking help for your underlying eating disorder from a professional rehab if:
You wish to overcome the issue before your symptoms begin to worsen.
Your physical health is slowly taking a hit because of your altered dietary habits.
Your eating disorder is creating problems in your personal, academic, or work life.
Your disordered eating behaviours or the consequent mental stress is keeping you from performing most of your usual activities.
You are medically unstable.
What levels of care are available for the treatment of eating disorders?
Depending on your type of eating disorder and its severity, you may choose from one of the following levels of care to begin treatment:
Inpatient program for people who require medical stabilisation
Residential programs for treating medically-stabilized people as they live inside a rehab
Outpatient program including 3 hours of therapy per day up to 5 times a day
Partial hospitalisation program that includes onsite treatment during the day with offsite evenings
A virtual outpatient program that provides 3 hours of therapy up to 5 days a week through online mediums
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