Eating disorders are fairly common. We’ve all heard of anorexia and bulimia nervosa. Just this year a new diagnosis for eating disorders has been included in the Diagnostic and Statistical Manual that therapists and psychiatrists use to determine what psychiatric disorder a person has. The new disorder is called Binge Eating Disorder. Essentially it has many of the symptoms of bulimia, but does not include compensatory behaviors.
Here is a description of the three types of eating disorders (Actually there are two others, but they are more of a catch-all term for someone who doesn’t quite fit the criteria of anorexia, bulimia or binge eating disorder).
To be diagnosed as anorexic, a person must completely refuse to maintain a healthy weight. They must be clinically underweight (just how underweight determines what severity of anorexia they have), must have a fear of gaining weight, and must have a distorted view of their body size. It used to be that they had to lose their period as well, but this has since been removed from the criteria; there is a greater number of males who have anorexia now as well as females.
Bulimia nervosa is also marked by a fear of gaining weight and a distorted view of body size. However, someone with bulimia is often an appropriate weight and quite possibly even a little bit overweight. This person gets caught in a frustrating cycle of trying various methods to lose weight. When the person becomes hungry or upset though, they will binge on an extraordinary amount of food. Feelings of shame, guilt and disgust creep in and the person then feels a strong compulsion to make up for the over-eating. This is called purging. Purging takes on many forms including vomiting, laxatives, diuretics, over-exercising and fasting.
Binge eating disorder is diagnosed by a person who is triggered to eat excessive quantities of food. This is almost always in conjunction with an emotional trigger. This isn’t just a person who consistently overeats a little bit too much at each meal. The person with binge eating disorder then feels shame and guilt along with disgust. However, they don’t try and compensate for the binge.
Eating disorders are common in teenagers. They are often very dangerous, and need to be addressed right away. Someone with anorexia is quite literally starving her/himself to death. There is a high death rate among people with anorexia because their nutrition can get so out of whack that their body can no longer handle it. People who have bulimia are also at risk of life-threatening electrolyte imbalance. In fact, the therapist who supervised me through my interning years was helping a teenage girl with her grief because she lost her best friend to a heart-attack. Her best friend died after purging by vomiting.
If you are concerned about your daughter or son, please ask for help as quickly as you can get it. Go talk with their pediatrician about whether they are healthy. Call a counselor to ask for a plan on how to help your child. Take action. Please understand that if you feel incompetent as a parent in this situation, so does every other parent who faces it. Eating disorders are stubborn. However, they are not your child. Your wonderful child is still underneath all this and you can find help. Also please know that this is not your fault. The newer research is showing the majority of eating disorders are caused by genetics, not bad parenting.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT