In this article, we’ll answer questions such as how to recognise eating disorders, what are their causes and symptoms, and what kind of treatment options are there.

What are Eating Disorders?

The contemporary standard of beauty causes many people to view their own body image as a problem, which can consequently lead to unhealthy eating habits, such as obsessively weighing food and counting calories, or eliminating valuable products from the daily diet simply because they have a lot of calories. These types of unhealthy relationships with food, sometimes lead to eating disorders, especially if they persist for an extended period of time.

Eating disorders (also referred to as “food disorders” and “nutritional disorders”) are a set of conditions characterised by abnormalities in food intake, which lead to various compensatory or atypical behaviours. A person’s appearance isn’t always at the core of these disorders, and not only teenagers suffer from them – adults and the elderly can also experience these types of disorders.

Are Eating Disorders an Illness?

In psychiatry and psychology, there is no consensus on the difference between an illness and a disorder. But it’s important to remember that eating disorders are serious disruptions to a person’s eating patterns and daily life, and sometimes also to physical health (e.g., extremely low body weight leads to numerous negative consequences). Additionally, some eating disorders, such as anorexia, bulimia, and binge eating disorder, can be fatal – the patient dies because of physical exhaustion or suicide. Anorexia, in particular, is considered to be a disease with a high mortality rate. What isn’t an eating disorder? Read about this here.

What Conditions Occur with Eating Disorders?

Unfortunately, eating disorders often occur with other mental health difficulties. Statistics and clinical experience show that a patient with an eating disorder may also suffer from depressive disorders, anxiety disorders, or personality disorders. Treatment then becomes more complicated and requires both stabilisation of physical health and the consideration that the patient's symptoms may not only result from eating disorders.

What are the Types of Eating Disorders?

Anorexia and bulimia – undoubtedly, these two diseases come to mind when we think of eating disorders. However, the classification of eating disorders (e.g., ICD-10) lists many more disorders related to eating.

Specific Eating Disorders

Specific eating disorders include anorexia (a psychogenic loss of appetite) and bulimia (psychogenic overeating). Diseases in this group most commonly occur among teenagers and young adults, and gender also plays a significant role – women are much more likely to be affected (statistics show that 90% of cases of anorexia and bulimia occur in females). Regardless of who is affected, male or female, both conditions pose a serious threat to health – anorexia is even considered to be one of the most fatal mental illnesses.

Someone who has never experienced problems with eating may wonder what an eating disorder looks like. Anorexia is a disease in which the patient has a distorted image of their body – they’re thin, but they consider themselves overweight. There are two types of the disorder – with binge eating and purging or without such episodes and compensatory behaviours. Bulimia, on the other hand, is a disease in which binge eating takes place and the patient engages in compensatory actions to prevent weight gain (e.g. taking laxatives).

Nonspecific Eating Disorders

The group of so-called nonspecific eating disorders includes conditions such as:

pica – consuming inedible substances, e.g. plastic
binge eating disorders – episodes of eating similar to bulimia, but the patient doesn’t attempt to compensate for them, e.g. through intense physical exercise,
rumination disorder – the person consumes food, then regurgitates it and eats it again,
avoidant/restrictive food intake disorder – eating too little, leading to a lack of weight gain or weight loss.

Other health disorders caused by poor nutrition are also indicated, which are not necessarily reflected in diagnostic units, e.g., diabulimia (affects people with type 1 diabetes who intentionally skip insulin doses to lose weight), orthorexia (an excessive focus on eating only healthy food), drunkorexia (alternatively: alcorexia; limiting food intake in favour of consuming alcohol), gourmet syndrome (alternatively: Gourmand syndrome; an atypical interest in food, a preference for exquisite food).

Psychogenic Eating Disorders

Sometimes psychogenic eating disorders are mentioned, but it’s important to remember that there is no separate diagnostic category. Research shows that many eating-related disorders have a psychological factor in their etiology, meaning they have developed on a psychogenic basis. Recently, it has been suggested that obesity is a disease that develops and is maintained partly because of emotional problems. On the other hand, a pathological lack of appetite may occur, for example, in elderly people experiencing depression.

The Symptoms of Eating Disorders

The symptoms of eating disorders depend on the type of disorder – for example, anorexia, bulimia, and binge eating disorder are similar in some aspects, but not in all of them. Weight loss or a focus on appearance aren’t common to all disorders.

Symptoms of anorexia:

body weight is already low, yet the patient continues to limit the number of meals and calorie intake,
excessive concern over an increase in body weight,
a distorted perception of one’s own body,
binge eating episodes and related compensatory behaviours may occur (not in all patients).

Symptoms of bulimia:

loss of control over eating – consuming large meals,
controlling body weight through behaviours, such as excessive physical activity, vomiting, or taking weight-loss medications,
there is no distorted image of one’s own appearance.

Bulimia is more common in patients who need to maintain a slim figure for reasons such as professional sports (e.g. gymnasts).

Symptoms of Binge Eating Disorders:

loss of control over consumed food – at least one episode per week,
during an episode, eating too much and too quickly until full despite not feeling hungry,
feelings of guilt due to episodes,
no compensatory behaviours to prevent weight gain.

The Consequences of Eating Disorders

Regardless of the type of eating disorder, the patient's health is at risk – the medical consequences of restrictions or eating episodes can be severe. The consequences that most often affect people with eating disorders include:

loss of muscle mass,
significant weight loss or gain,
heart rhythm disorders,
fertility disorders,
refeeding syndrome (electrolyte imbalance),
amenorrhoea,
poor skin appearance,
hair loss,
problems with the digestive system,
weakness and drowsiness,
poor dental health,
increased risk of osteoporosis.

Causes of Eating Disorders

The causes of eating disorders largely depend on the age of the patient or the context in which the disease appears. Specific eating disorders most often affect teenagers.

Eating Disorders in the Elderly

The health of older adults is still too rarely addressed and researched by clinicians. In the elderly, health conditions related to eating are usually not diagnosed as eating disorders. In this case, we are dealing with, for example, malnutrition, which arises as a result of medical, social, and psychological causes, such as certain somatic diseases, poor financial status, lack of social support, dementia, or depression.

Eating Disorders in Children and Adolescents

Children and adolescents are a specific group considered to be most at risk for eating disorders. The peak incidence of disorders such as anorexia or bulimia occurs during adolescence. A child or teenager lives at the intersection of several environments – family, peers, and school – and also spends a lot of time on the internet or on social media. Due to the specifics of this period, the risk of mental health difficulties increases. Possible causes of eating disorders in children and adolescents include:

genetic factors,
neurotransmitter disorders,
personality factors, e.g. excessive self-control or lack of self-control, low self-esteem,
family issues, e.g. conflicts between parents, parents’ divorce,
overprotectiveness of parents, excessive expectations of guardians towards the child,
the image of the ideal body shown in the media.

Some of the causes remain undefined, and we're not sure what has an impact on the eating disorder and why it has occurred in that particular person.

If a parent notices abnormalities in their child's eating patterns or excessive interest in their weight and attempts to search for information on how to induce eating disorders, it’s a good idea to schedule a visit with a mental health specialist. Signals like these do not necessarily mean clinical disorders, but they’re alarming and require discussion with a therapist or psychiatrist.

Eating Disorders During Pregnancy

Eating disorders during pregnancy are particularly dangerous for the mother and the developing foetus. When an eating disorder occurs in a pregnant woman, it’s especially important to seek treatment quickly to avoid serious health consequences. The treatment is determined by the doctor, but a psychologist or psychiatrist specialising in these problems can also be helpful. Sometimes women suffer from so-called pregnancy anorexia, or pregorexia.

Eating Disorders - Treatment

Who Treats Eating Disorders?

In the first step, patients and their families wonder who diagnoses eating disorders – a psychologist or a psychiatrist. In the case of mental health disorders, only a psychiatrist can make a formal diagnosis. However, a psychologist has the necessary knowledge to notice alarming signals. They can also perform a screening test for eating disorders. Regardless of who diagnoses the disease, it’s essential to start treatment as soon as possible.

How to treat eating disorders depends on their type and severity. A psychiatrist should be involved in the therapy (and often an entire medical team, as in the case of anorexia or advanced bulimia), as well as a psychotherapist and a psychodietitian.

Where to Treat Eating Disorders

Eating disorders, such as anorexia or bulimia, should never be underestimated. Treatment often takes place on an outpatient basis – at the patient's home and in doctors’ and therapists’ offices. In the case of anorexia and bulimia, outpatient treatment, i.e., a psychiatric hospital, is sometimes recommended. There are also private eating disorder treatment centres that resemble hospital wards.

Eating Disorder Therapy

The most well-known and researched therapeutic approaches used in the case of eating disorders are cognitive-behavioural therapy, acceptance and commitment therapy, systemic therapy, and psychodynamic therapy.

The most important questions that arise in the therapist's office concern how to overcome eating disorders and how to cope when we or our child fall ill. Psychotherapy is an extremely important part of treatment that allows patients (and their families) to get to the root of their problems. After stabilising the general medical condition, psychotherapy should be the basis for recovering from eating disorders.

How to Cure Eating Disorders on Your Own

Proven treatment methods include psychiatric care, psychotherapy, and sometimes also the care of other doctors and specialists – especially in the case of disorders that negatively affect physical health. Such conditions as bulimia or anorexia should not be treated on your own – they require professional help.

However, if you suspect that you or someone close to you is struggling with an eating disorder, you can take some steps to support the process:

1. **Educate Yourself**: Learn about eating disorders, their symptoms, and consequences. This will help you understand what the person is going through.

2. **Encourage Open Communication**: Encourage the person to talk about their feelings and concerns. Be supportive and non-judgmental.

3. **Encourage Professional Help**: Encourage the person to seek professional help. Offer to help find a therapist or accompany them to appointments.

4. **Be Patient and Supportive**: Understand that recovery from an eating disorder can be a long process. Be patient and offer your support throughout.

5. **Create a Healthy Environment**: Encourage a balanced approach to eating and exercise. Avoid making negative comments about body image or weight.

6. **Stay Informed on Treatment Progress**: If the person is undergoing treatment, stay informed about the progress and participate if necessary.

7. **Take Care of Yourself**: Supporting someone with an eating disorder can be emotionally draining. Make sure to take care of your own mental health as well.

Eating disorders are serious mental health conditions that can have severe consequences for physical health and quality of life. They often co-occur with other mental health disorders such as depression and anxiety. It’s crucial to recognise the symptoms of eating disorders early and to seek professional help. Treatment usually involves a combination of psychotherapy, medical monitoring, and sometimes medication. Family and friends can play a vital role in supporting someone with an eating disorder by encouraging open communication, promoting a healthy environment, and encouraging the pursuit of professional help.