What are eating disorders?
Eating disorders are real, complex and devastating conditions that can have serious consequences for health, productivity, and relationships. They are not a fad, phase or lifestyle choice and are often misunderstood. We discuss the general facts, causes, signs and statistics about eating disorders.
Eating disorders are:
Negative changes of eating habits that result in mental or physical harm
Often accompanied by concerns about shape and weight
Usually the result of deeper psychological turmoil
Serious illnesses that deserve considerable attention
Eating disorders are not:
A choice
A sign of vanity
Primarily caused by concerns about appearance
Only recognizable by low weight
Only experienced by young women
Types of Eating Disorders
Eating disorders are a change in an individual’s eating behaviours that negatively affect their health. It is possible to have more than one eating disorder at the same time. Below are the main types of eating disorders:
Anorexia Nervosa (Anorexia)
Refusing to eat or severely restricting one’s diet in order to maintain a low body weight.
Bulimia Nervosa
Eating large portions of food in a short period of time and then purging that food in an attempt to prevent weight gain (such as vomiting or excessive exercise).
Binge Eating Disorder (BED)
Eating excessive portions of food in a short period of time. This is not the same as overeating.
Avoidant/ Restrictive Food Intake Disorder (ARFID)
Refusing to eat certain foods due a negative past experience or an extreme dislike of the food's characteristics (appearance, smell, taste, texture, brand, presentation) to the point that nutrition needs are not being met.
Rumination Disorder
Bringing back up and re-chewing partially digested food that has already been swallowed.
Pica
Eating non-digestible items for at least one month.
Although this list contains all known eating disorders, not all eating disorders are the same and can have characteristics that are different than the types listed above. If a disorder does not fall into one of the above categories, there may be a diagnosis of “Other Specified Feeding or Eating Disorder (OSFED)” or “Unspecified Feeding or Eating Disorder.”
Based on the fact that earlier treatment for EDs is strongly correlated with more successful outcomes, it is an important shift that individuals can now receive a diagnosis of Atypical AN, Bulimia Nervosa (low frequency/limited duration), or even Binge Eating Disorder (low frequency/limited duration), and get professional help before they get “sick enough” to meet meeting dangerous weight or behaviour-related criteria.
More detailed definitions and descriptions of symptoms can be found on the NEDIC website.
*The DSM-5 is the manual used by healthcare professionals in Canada and the United States to diagnose mental illnesses.
Why people get eating disorders?
Eating disorders do not have a single cause and each case will be different. They are influenced by several biological, psychological, and/or environmental factors that may occur together.
Biological examples:
Irregular hormone functions
A genetic component has been identified in the development of eating disorders
Psychological examples:
Negative body image/body dissatisfaction
Internalization of the "thin" ideal
Poor self-esteem
Environmental examples:
Dysfunctional family dynamics
Professions, careers, or being involved in sports that promote weight loss
Excessive social media use
Exposure to the thin-ideal portrayed by the media
Body Image
Body Image is composed of:
1. The mental representation of our own physical body (e.g., size, shape, appearance), and
2. Our attitude towards our physical selves (e.g., thoughts, feelings, beliefs).
Body image is fluid and changes over time, based on culture, mood, societal norms, and interactions with family and friends. Body image is not dictated by physical measurements, it is dictated by how one feels about one's physical measurements. Body image is composed of attitudes, not tangible measurements or sizes. This explains why going on a diet or exercising to improve body image is not effective.
Many individuals experiencing an eating disorder attach their self-worth to their weight. This is important to acknowledge while providing support during recovery. Teasing can be especially destructive and should always be avoided.
Signs of eating disorders
It can be difficult to identify an eating disorder due to the secrecy and shame surrounding them. Though each eating disorder is different, there are signs that you can look for. This list of symptoms is directly from the Public Health Agency of Canada:
Irritability, depression and social withdrawal
Excessive preoccupation with calories, food or "healthy eating"
Frequent negative comments about their weight and shape
Restriction of food intake
Making excuses to avoid eating
Significant weight loss or weight gain (regardless of previous weight)
Compulsive exercising
Frequently eating excessive amounts of food in a short period of time
Consuming food alone, at night or secretly
Using laxatives or diet pills
Going to the bathroom immediately after eating
Does Weight Matter?
Individuals of all sizes, shapes, and weights can experience eating disorders. It is impossible to tell the acuity of this disease by simply looking at an individual. Most eating disorder treatment programs utilize a “Health at Every Size Approach,” which advocates for the fact that individuals of all weights, shapes, and sizes can be healthy if they are treating their bodies with care. For more information, please visit NEDA’s website.
Learn about weight in the context of the recovery process with registered dietician Jana Spindler. Watch the video here.
Health Consequences
Eating disorders are the leading cause of death among all mental illnesses. Yet, many deaths go unreported as they are caused by the health complications surrounding the eating disorder1. Below are some examples of these serious health concerns:
Electrolyte imbalances such as: Hypokalemia (low potassium) and hypochloremic (blood chloride) or metabolic acidosis (due to purging, acid unbalance).
Dehydration, edema (fluid in the skin or lungs), hypomagnesemia (magnesium imbalance), and hyperamylasemia (high amalyze levels which cause issues with digestion)
Cardiovascular problems: arrhythmias (irregular heartbeat), hypotension (low blood pressure), and bradycardia (slow heartbeat)
Gastrointestinal complications: esophagitis and parotitis (inflammation of the salivary glands) due to vomiting
Delayed gastric emptying due to starvation
Other: liver dysfunction, osteoporosis (brittle bones), respiratory failure, Alopecia, lanugo hair and oral complications with gums and teeth
Adolescents suffering from these disorders are often at an even higher risk of such complications since they are still in the early stages of physical development and unique clinical presentation
Eating disorders by the numbers
Eating disorders have the highest mortality rate of any other psychiatric disorder, with 10% dying within the first 10 years of the onset of their disorder. For young women between 15-24 years of age, the mortality rate associated with anorexia nervosa is 12 times higher than that of all other causes of death.
All of our statistics were compiled through secondary research. View our references and sources
Get An Informed Opinion
If you are seeking support for yourself or a loved one with an eating disorder, you can connect with our Community Navigator. You can book an appointment here to get expert guidance on next steps.
More Expert Information
Explore our Video Resource Library, a series of videos exploring themes related to eating disorder recovery with interviews from psychiatrists, psychologists, counsellors, social workers, nurses and dieticians who practice include EDs.
If you need help finding a specialist, check our our guide ‘how-to find a specialist’
Another helpful tool for parents navigating their child’s eating disorder:
mentalhealthfoundations.ca/ed-parent-webinar.