It seems like everyone wants to lose a few pounds these days, even people who are thin to begin with. Eating disorders are a dangerous problem in America, with the highest mortality rate of any mental illness. An estimated 20% of people suffering from anorexia nervosa will die from complications related to their eating disorder, including suicide and heart problems. The problem is most prevalent in adolescents and young women, with 95% of those who have eating disorders being between the age of 12 and 25. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate associated with all causes of death for females 15-24 years old. Yet only 1 in 10 people with eating disorders receive treatment.

There are three clinical diagnoses for eating disorders. First is anorexia nervosa, which is characterized by emaciation, intense fear of gaining weight, a distorted body image, and extremely restricted eating. The second classification is bulimia nervosa, which involves frequent recurrent episodes of binge-eating and purging. The third classification is Eating Disorder Not Otherwise Specified, and can include binge-eating disorder and other instances that do not meet the clinical qualifications for anorexia or bulimia.

These disorders can result in long term health problems. Anorexia nervosa can cause osteopenia, osteoporosis, dry and yellowish skin, brittle hair and nails, mild anemia, low blood pressure, damage to the structure and function of the heart, brain damage, multi-organ failure, infertility, and death, among other things. Bulimia nervosa can result in chronically inflamed and sore throat, worn tooth enamel, acid reflux disorder, severe dehydration, electrolyte imbalance (which can cause a heart attack), and intestinal distress from laxative abuse. Binge-eating disorder can lead to obesity, cardiovascular disease, and high blood pressure. Besides physical health problems, almost 50% of people with eating disorders meet the criteria for depression.

Treating eating disorders involves a combination of psychological and nutritional counseling. Sometimes, medication can be used to treat other mental disorders that are often found in those with eating disorders, such as depression or anxiety. For anorexia nervosa in adolescents, the Maudsley approach has been particularly effective. Parents of adolescents with anorexia nervosa assume responsibility for feeding their child in this approach.

Cognitive behavioral therapy is well suited to those suffering from bulimia nervosa. This technique teaches the patient to change their attitudes and beliefs to create a healthier thought process. Fluoxetine (Prozac) is the only FDA approved drug for treating bulimia nervosa. It may be helpful for those who also suffer from anxiety or depression. However, it may have side effects such as increased chance of suicide in adolescents when treatment first begins. Therefore, patients should be carefully monitored whenever starting a regiment.

Although eating disorders are commonly thought of as affecting women, an estimated 10%-15% of those suffering from anorexia nervosa or bulimia nervosa are men. Additionally, men may develop a disorder called muscle dysmorphia. This involves an unhealthy concern with developing muscle mass. People suffering from muscle dysmorphia are more likely to use steroids or dangerous drugs to increase muscle mass.

If you suspect that you or a loved one may be suffering from an eating disorder, you can take the free, anonymous, self-test EAT-26. A link is provided bellow. It measures eating attitudes, but does not constitute a professional diagnosis. It is meant to raise red flags for when you need to consult a physician.

Additional Resources

National Institute of Mental Health, Eating Disorders: http://www.nimh.nih.gov/health/publications/eating-disorders/eating-disorders.pdf

The Mayo Clinic, Eating Disorders: http://www.mayoclinic.com/health/eating-disorders/DS00294

National Association of Anorexia Nervosa and Associated Disorders, Eating Disorders Statistics: http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

Brown University, Culture and Eating Disorders: http://brown.uk.com/eatingdisorders/miller.pdf

DSM IV-TR, Eating Disorder Diagnostic Criteria: http://casat.unr.edu/docs/eatingdisorders_criteria.pdf

Journal of Social and Personal Relationships, “You’re going to eat that?” http://spr.sagepub.com/content/early/2012/07/09/0265407512451199.full.pdf+html

Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1435625/?report=printable

Eating Attitudes Test: http://www.eat-26.com/