The Ohio State University

Eating Disorders- Are you at risk?

Studies have found that 19 to 32 percent of college women show symptoms of eating disorders.

About 10 percent of people with eating disorders that come to the attention of mental health professionals are male.

Types of Eating Disorders

Anorexia Nervosa

Diagnostic criteria

1. Refusal to maintain a minimally normal body weight
2. Intense fear of gaining weight or becoming fat.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
4. Infrequent or absent menstrual periods (in females who have reached puberty)

Specify type:

Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime.

The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population. The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide.

Bulimia Nervosa

Diagnostic criteria

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
   1. eating, in a discrete period of time (within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
   2. a sense of lack of control over eating during the episode (a feeling that one cannot stop eating or control what or how much one is eating)
2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance dose not occur exclusively during episodes of Anorexia Nervosa.

Specify type:

Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime.

Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with their bodies. People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge.

Eating Disorder Not Otherwise Specified

The Eating Disorder Not Otherwise Specified category is for disorders of eating that do not meet the criteria for any specific Eating Disorder.

Examples include:

1. For females, 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 significant weight loss, the individual’s current weight is in the normal range.
3. All of the criteria for Bulimia Nervosa are met except that the binge-eating 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 behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).
5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
6. Binge-eating disorder; recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of Bulimia

Binge-Eating Disorder

Criteria:

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
   1. eating, in a discrete period of time (within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
   2. a sense of lack of control over eating during the episode (a feeling that one cannot stop eating or control what or how much one is eating)
2. The binge-eating episodes are associated with three (or more) of the following:
   1. eating much more rapidly than normal
   2. eating until feeling uncomfortably full
   3. eating large amounts of food when not feeling physically hungry
   4. eating alone because of being embarrassed by how much one is eating
   5. feeling disgusted with oneself, depressed, or very guilty after overeating
3. Marked distress regarding binge eating is present.
4. The binge eating occurs, on average, at least 2 days a week for 6 months.
5. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of Anorexia Nervosa or Bulimia Nervosa.

Community surveys have estimated that between 2 percent and 5 percent of Americans experience binge-eating disorder in a 6-month period.

Medical Complications

Not only do eating disorders cause emotional suffering, they can also lead to many serious medical complications and in some cases even death.

Medical Complications Seen in Anorexia Nervosa

• cardiac abnormalities (slow heart rate, disturbances in the heart's rhythm)
• dangerously low blood pressure
• dangerously low body temperature
• low white blood cell count
• chronic constipation
• osteoporosis (brittle, weak bones)
• for teenagers, slowed growth or development, short stature
• loss of menstrual periods
• infertility
• hair loss and nail destruction

Medical Complications Seen in Bulimia Nervosa

• electrolyte abnormalities that can lead to heart rhythm disturbances
• dehydration
• dangerously low blood pressure
• menstrual cycle abnormalities
• enlarged parotid glands
• destruction of dental enamel and cavities
• bowel abnormalities

  This list is not exhaustive, and the complications range in severity from minor to life threatening. Severe anorexia nervosa or bulimia nervosa often requires close medical monitoring or even hospitalization. The chief physical complication of binge eating disorder is obesity, which can lead to a variety of medical problems such as high blood pressure, diabetes, and heart disease.

  If you or a friend are experiencing any of these symptoms or you would like more information, go to www.ccs.ohio-state.edu to learn about campus resources for eating disorders and counseling.

  For more information check out these helpful webcites:

  • www.nlm.nih.gov/medlineplus/eatingdisorders.html
  • www.hedc.org/
  • www.edreferral.com/

  Related links:

  • www.eatright.org/Public/Other/index_adap0701.cfm
  • www.nimh.nih.gov/publicat/eatingdisorders.cfm