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You are here: Home Eating Disorders Symptoms

Symptoms

 

The most commonly used criteria for diagnosing mental illness are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD). All eating disorders are characterised by an abnormal obsession with food and weight; the more specific symptoms vary considerably across disorders. Below is a list of the most common psychological, physical and social symptoms that eating disorders can cause. A diagnosis of any eating disorder from a healthcare professional will be guided by the manuals identified above; the descriptions below identify common indications of the disorders. A sufferer may experience all or none of these.

Anorexia Nervosa

Physical Symptoms

- Noticeable weight loss or, in children and teenagers, inadequate weight gain in relation to their growth

- Fatigue and lack of energy, cold hands and feet due to poor circulation

- Amenorrhea (loss of menstruation), loss of interest in sex and possible infertility

- Skin problems, hair loss and/or downy hair on the body (lanugo)

- Dizziness and headaches, shortness of breath, chest pain and irregular heartbeats

- Stomach pains, constipation and/or bloated stomach, puffy face and ankles due to water retention (oedema)

- Muscle weakness

- Decreased metabolic rate

- Insomnia

- Loss of bone mass and eventually osteoporosis (brittle bones)

- Kidney and liver damage

- Electrolyte imbalances

- Cardiac arrest and death

Psychological Symptoms

- Becoming withdrawn

- Perfectionist attitude

- Depression, irritability, mood swings

- Changes in personality

- Feelings of self worth determined by what is or is not eaten

- Guilt or shame about eating

- Obsession with food, calories, recipes

- Intense fear of gaining weight and obsessive interest in what others are eating

- Distorted perception of body shape or weight

- Denial of the existence of a problem

- Becoming aware of an 'inner voice' that challenges your views on eating and exercise

Behavioural Symptoms

- Excessive exercise

- Excuses for not eating meals (i.e. ate earlier, not feeling well)

- Difficulty eating in public and/or secretive about eating patterns

- Cooking for others, but not eating themselves

- Restricting food choices to only diet foods

- Rigid or obsessional behaviour attached to eating, such as cutting food into tiny pieces

- Complaining of being "too fat", even when thin

- Evidence of vomiting, laxative abuse, diet pills or diuretics to control weight

- Wearing baggy clothes to hide weight loss

- Frequently checking weight on scale

Bulimia Nervosa

Physical Symptoms

Similarly to Anorexia Nervosa, sufferers may experience:

- Fatigue and lack of energy, cold hands and feet due to poor circulation

- Skin problems, hair loss and/or downy hair on the body (lanugo)

- Dizziness and headaches, shortness of breath, chest pain and irregular heartbeats

- Stomach pains, constipation and/or bloated stomach, puffy face and ankles due to water retention (oedema)

- Muscle weakness

- Decreased metabolic rate

- Insomnia

- Kidney and liver damage

- Electrolyte imbalances

- Cardiac arrest and death

Additionally, the following symptoms are commonly associated with Bulimia
Nervosa:

- Frequent weight fluctuations (usually with 10-15 lb range)

- Chronic sore throat, tooth decay, abrasions on back of hands and knuckles and bad breath caused by excessive vomiting

- Swollen salivary glands making the face rounder

- Broken blood vessels

- Irregular menstruation and/or loss of interest in sex

- Tears of the oesophagus, gastric dilation and rupture

- Development of peptic ulcers and pancreatitis (inflammation of the pancreas)

Psychological Symptoms

- Anxiety and depression; low self-esteem, shame and guilt

- Emotional behaviour and mood swings

- Severe self-criticism

- Self-worth determined by weight and self-deprecating thoughts following eating

- Uncontrollable urges to eat vast amounts of food and fear of not being able to stop eating voluntarily

- An obsession with food, or feeling 'out of control' around food

- Distorted perception of body weight and shape

- Isolation - feeling helpless and lonely

- Need for approval from others

Behavioural Symptoms

- Binge eating

- Vomiting

- Bathroom visits after eating in order to vomit food eaten

- Laxative, diet pill or diuretic abuse

- Periods of fasting

- Excessive exercise

- Food disappearing unexpectedly or being secretly hoarded

- Avoidance of restaurants, planned meals or social events

- Shoplifting for food; abnormal amounts of money spent on food

Eating Disorder Not Otherwise Specified

Conditions as complex as eating disorders inevitably mean that there are variations in the typical signs described in the diagnostic manuals, and not all symptoms will apply to all people. In fact many people find they have a diagnosis of an A-typical Eating Disorder or Eating Disorder Not Otherwise Specified (EDNOS).

These are disorders where you have some but not all of the diagnostic signs for anorexia or bulimia. For example, a person who shows almost all of the symptoms of anorexia nervosa, but who still has a normal menstrual cycle and/or body mass index, can be diagnosed with EDNOS. A sufferer may experience episodes of binging and purging, but may not do so frequently enough to warrant a diagnosis of bulimia nervosa. People diagnosed with EDNOS may frequently switch between different eating disorders, or may with time fit all diagnostic criteria for anorexia or bulimia. A diagnosis of EDNOS encompasses Binge Eating Disorder, Compulsive Overeating and Orthorexia, which are terms used to refer to specific sets of behaviour not yet recognised as individual diagnoses. More information on these terms can be found below.

EDNOS is a serious eating disorder, like anorexia and bulimia, and can have long-term consequences on the individual's physical health. The criteria stipulated by the diagnostic manuals are as follows:

1. All of the criteria for anorexia nervosa are met except that the individual has regular menses.

2. All of the criteria for anorexia nervosa are met except that, despite substantial weight loss, the individual's current weight is in the normal range.

3. All of the criteria for bulimia nervosa are met except that binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months.

4. The regular use of inappropriate compensatory behaviour by an individual of normal body weight after eating small amounts of food

5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

6. Recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviours characteristic of bulimia nervosa.

Binge Eating Disorder (BED) and Compulsive Overeating
(CO)

Both of these disorders are classified under the diagnostic criterion Eating Disorder Not Otherwise Specified (EDNOS) but share several common characteristics, including episodes of 'binge eating'.

At first a binge may be an attempt to cope with emotional difficulties or to ease tension, but this can rapidly get out of control. Typically the foods consumed during a binge-eating episode are high in calories, carbohydrates and fat. In some circumstances the sufferer may resort to eating things like uncooked pasta, partially defrosted frozen food or condiments, or retrieve and eat previously discarded food. When the sufferer starts to feel full, feelings of guilt and shame come into their mind and, in desperation; they may vomit or take laxatives to purge everything consumed. At this point, some people describe feeling emotionally relieved and physically light-headed. This cycle can keep inner pain and unhappiness at bay - but only for a brief time.

The frequency of these bulimic cycles will vary from person to person. Some people may suffer from an episode every few months whereas those who are more severely ill may binge and purge several times a day. Some people may vomit automatically after they have eaten any food. Others will eat socially but may be bulimic in private. Many people do not regard their illness as a problem, whilst others despise and fear the vicious and uncontrollable cycle they are trapped in.

Other symptoms common to both BED and CO are:

Physical Symptoms

- Weight gain and/or experiences fluctuations in weight

- Obesity

- Menstrual irregularities

- Varicose veins

- Diabetes

- High blood pressure and cholesterol

- Osteoarthritis

- Decreased mobility and sciatica

- Loss of sexual desire

- Shortness of breath

- Heart disease

- Liver and kidney problems

- Cardiac arrest and/or death

Psychological Symptoms

Similarly to sufferers of Bulimia Nervosa symptoms include:

- Anxiety and depression; low self-esteem, shame and guilt

- Emotional behaviour and mood swings

- Severe self-criticism

- Self-worth determined by weight and self-deprecating thoughts following eating

- Uncontrollable urges to eat vast amounts of food and fear of not being able to stop eating voluntarily

Sufferers of both BED and OC also may experience the following:

- Belief that life will be better if they lose weight

- Social and professional failures attributed to weight

- Suicidal thoughts

Behavioural Symptoms

- Eating much more rapidly than usual

- Eating until feeling uncomfortably full

- Eating large amounts of food when not physically hungry

- Eating alone because of embarrassment at the quantities of food consumed

- Food disappearing unexpectedly or being secretly hoarded

- Avoidance of restaurants, planned meals or social events as self conscious eating in front of others

- Going on many different diets

The distinction between BED and CO is drawn in terms of quantities of food consumed during a discrete amount of time. In addition to binge eating, compulsive overeaters can also engage in grazing behaviour, during which they return to pick at food over and over throughout the day. This will result in a large overall number of calories consumed even if the quantities eaten at any one time may be small. When a compulsive eater overeats primarily through binging, he or she can be said to have binge eating disorder. Where there is continuous overeating but no binging, then the sufferer has compulsive overeating disorder.

Orthorexia Nervosa

Orthorexia Nervosa is a term coined by Dr. Steven Bratman, an eating disorder specialist, to denote what he considers to be a disorder characterized by a 'fixation' on eating healthy food. It describes an obsession with a 'pure' diet, where it interferes with a person's life. It becomes a way of life filled with chronic concern for the quality of food being consumed. When the person suffering with Orthorexia Nervosa slips up by wavering from their 'perfect' diet, they may resort to extreme acts of further self-discipline including even stricter regimens and fasting. Such 'anorexic orthorexia' is just as dangerous as anorexia. However, the underlying motivation is quite different. While an anorexic wants to lose weight, an orthorexic wants to feel pure, healthy and natural.

 

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