Eating disorders such as anorexia nervosa and bulimia nervosa threaten the livelihood of an alarming number of women in our society. Although the medical community has recognized eating disorders for centuries, only in the past 30 years has research been dedicated to the causes and treatment of eating disorders. Bulimia nervosa was only distinguished as a separate disorder in the past 20 years. (Brownell & Fairburn, 1995)
Anorexia nervosa is an eating disorder which primarily strikes adolescent women, but can occur in women of all ages. Men can also suffer from anorexia. Sufferers willfully lose weight to the point of extreme starvation due to an abnormal fear of becoming fat and have a severely distorted body image. "The hallmark of anorexia is denial" (Hamburg, Herzog & Brotman, 1996) and many times people with anorexia may not be aware they have a problem. The fact remains that anorexia has a significant mortality (5-15%).
Bulimia nervosa is another eating disorder primarily found in young women. It is characterized by a binge-purge cycle of behavior whereby an excessive amount of food is ingested over a short period of time followed by some sort of compensatory behavior in order to prevent weight gain (e.g. vomiting, excessive use of laxatives, overexercising). Bulimics generally recognize that they have a problem due to the extreme behaviors that characterize the disorder and often seek help.
The signs of anorexia are:
Anorexia is further classified into two sub-types.
The signs of bulimia are:
Two sub-types of bulimia are included in the diagnostic criteria based on the type of compensatory behavior.
Although the symptoms of anorexia and bulimia are important to recognize for diagnosis of an eating disorder, it may be more helpful to think about eating disorders existing on a continuum (Rodin, Silburstein, & Streigal-Moore, 1985). At one end of the continuum, there is no concern with weight and normal eating patterns, while at the other extreme exist anorexia or bulimia. In between these two extremes are unhealthy behaviors such as bingeing or purging alone, fasting, and chronic dieting (Mintz & Betz, 1998).
Estimates on the prevalence of eating disorders are 0.5-1% for anorexia nervosa and 1-3% for bulimia nervosa. These estimates may appear low but it is important to remember that only those individuals who exhibit all diagnostic features with sufficient severity are included in these prevalence rates. The number of individuals who exhibit atypical weight control behaviors such as caloric restriction, binge eating, and purging is much higher, ranging from 15-40% (Johnson, Tsoh, & Varnado, 1998). When eating disorders are conceptualized as a continuum of behaviors, prevalence rates rise even higher. In a sample of over 600 non-anorexic, non-obese college women, Mintz and Betz (1988) found 61% to have some intermediate form of an eating behavior problem. In the same study, only 33% of the subjects reported what could be considered normal eating habits. According to their data, "eating disordered behavior is the rule rather than the exception." (p. 470).
Although the information above might be helpful in understanding or distinguishing the behaviors of eating disorders, it is not meant to replace a formal assessment by a professional. Counselors, psychiatrists, psychologists, and dieticians who are trained in the evaluation and treatment of eating disorders are some of the professionals who can facilitate diagnosis and treatment. If you think you may have an eating disorder or are concerned about someone who might have one, you can contact the University Counseling Center for a one-on-one meeting with a staff member. Also, the University Counseling Center has an Eating Concerns Group that allows you to meet with other individuals who are struggling with similar thoughts, feelings, and experiences. The number to call is 275-3113 or 275-2361.
Compiled by Vince Kiefner, M.Ed. for the University Counseling Center.