Eating Disorders

Eating disorders are a group of complex mental disorders that significantly impair physical and mental health and social functioning. Individuals with eating disorders suffer from serious disturbances in eating, such as extreme calorie restriction, overeating, and/or preoccupation with body image and weight. An eating disorder may also occur with an underlying psychological problem such as depression, anxiety, low self-esteem or suppressed trauma. Treatment from a multidisciplinary team of psychologists, psychiatrists and medical professionals is often necessary. Fortunately the team at The Midtown Practice is experienced in managing and treating eating disorders in children, adolescents, and adults.

It is estimated that about 30 million Americans (20 million women and 10 million men) struggle with eating disorders. Eight percent of females and 2% of males are affected at some point during their lives. Ninety five percent of eating disorders occur by age 25. Although eating disorders can occur across all demographics and socioeconomic groups, the prevalence of anorexia and bulimia is higher in women, while binge eating is found equally in men and women. However, men are less likely to seek treatment, suggesting a higher incidence than what has been reported.

There is a common misconception that eating disorders affect white adolescent and young women. In actuality, diverse groups of people are at higher risk for developing eating disorders. These include:

• Female athletes pressured to control weight and performance.
• College students. Studies report that 8-17% of college students have an eating disorder.
• 3.5% of women over age 40 and 1-2% of older men.
• LGBTQ+

Anorexia is an important cause of physical and psychological illness. Although it can be diagnosed at any weight or BMI, it is often characterized by a low body mass index (BMI) due to extreme dieting, fear of weight gain and a distorted body image. It affects 2% or less of young women. Comorbid psychiatric conditions may include depression, obsessive compulsive disorder, and anxiety.

Individuals with anorexia experience dramatic weight loss and an overwhelming preoccupation with feeling “fat.” Affected individuals resist or are unable to maintain an appropriate body weight for their age and height. Anorexics often engage in ritualized behaviors to prevent weight gain such as extreme exercise regimens and calorie restriction. They may also binge eat and purge. Anorexics share a consistent irrational fear of being overweight.

Genetic factors influence risk. Psychological and social factors and interpersonal factors can trigger onset; and changes in the brain can sustain the illness. It is treated with psychotherapy, psychopharmacology, and nutritional support.

Bulimia is a serious and potentially life-threatening disorder that involves cycles of binge eating and purging. A binge is defined as eating in a discrete period of time an amount of food that is definitely larger than what most people eat during a similar period, and a sense of lack of control during this period. This is typically followed by a purge, or compensatory behavior such as vomiting, taking laxatives, fasting, or excessive exercise to prevent weight gain. Lifetime risk ranges from 4% to 6.7%.

Bulimics are at risk for developing severe medical problems such as ulcers, sore throat, tooth decay, acid reflux, dehydration, intestinal distress, and stomach damage. Affected individuals often suffer from electrolyte disturbances as a result of excessive vomiting or purging, putting them higher risk for seizures. As with other eating disorders, bulimia is associated with malnutrition. Treatment for bulimia involves both psychotherapy as well as medication.

Binge eating disorder is the most common eating disorder in the United States with an estimated lifetime prevalence of 2.6%. It occurs equally among men and women. Binge eating is more common than either anorexia or bulimia, affecting 3.5% of women and about 2% of men. It co-occurs most commonly with mood, anxiety and sleep disorders; and is also associated with overweight and obesity.

Binge eating disorder is a serious eating disorder characterized by recurrent episodes of eating large quantities of food accompanied by feelings of loss of control but is not commonly followed by purging. Binges are often followed by negative emotions of depression, guilt or disgust at overeating. Binge eating is treated with psychotherapy and psychotropic drugs.