binge eating disorder essay

Essay on Eating Disorders

Students are often asked to write an essay on Eating Disorders in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Eating Disorders

Understanding eating disorders.

Eating disorders are serious health problems. They occur when individuals develop unhealthy eating habits that can harm their body. They often start with an obsession with food, body weight, or body shape.

Types of Eating Disorders

There are three main types of eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Each has different symptoms but all can be harmful.

Impact on Health

Eating disorders can damage important body parts like the heart and brain. They can also affect mental health, causing anxiety or depression.

Getting Help

If you or someone you know has an eating disorder, it’s important to seek help. Doctors, therapists, and support groups can provide treatment and support.

250 Words Essay on Eating Disorders

Introduction.

The most common types are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Anorexia is defined by a refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Bulimia involves frequent episodes of binge eating followed by behaviors like forced vomiting to avert weight gain. Binge Eating Disorder is characterized by frequent overeating episodes but without subsequent purging actions.

Sociocultural Influences

Sociocultural factors play a significant role in the onset of eating disorders. The media’s portrayal of an ‘ideal’ body size and shape can contribute to body dissatisfaction and consequently, disordered eating behaviors.

Health Implications

The health implications of eating disorders are severe, impacting both physical and mental health. These can range from malnutrition, organ damage, to increased risk of suicide.

Eating disorders, therefore, are serious conditions that require comprehensive treatment. Increased awareness, early diagnosis, and interventions can significantly improve the prognosis and quality of life for those affected.

500 Words Essay on Eating Disorders

Introduction to eating disorders.

Eating disorders represent a group of serious conditions characterized by abnormal eating habits that can negatively affect a person’s physical and mental health. These disorders often develop from a complex interplay of genetic, psychological, and sociocultural factors.

The Types of Eating Disorders

The underlying causes.

Eating disorders are typically multifactorial and can’t be attributed to a single cause. They often coexist with other mental health disorders such as depression, anxiety, and obsessive-compulsive disorder. Genetic predisposition plays a significant role, suggesting that eating disorders can run in families. Sociocultural factors, including societal pressures to be thin, can also contribute to the development of these disorders.

The Impact on Physical and Mental Health

The physical consequences of eating disorders are profound and can be life-threatening. They range from malnutrition, heart conditions, and bone loss in anorexia, to gastrointestinal problems and electrolyte imbalances in bulimia. Binge eating disorder can lead to obesity and related complications like heart disease and type 2 diabetes.

Treatment and Recovery

Treatment for eating disorders typically involves a multidisciplinary approach, combining medical, psychological, and nutritional therapy. Cognitive-behavioral therapy (CBT) is often effective, helping individuals to understand and change patterns of thought and behavior that lead to disordered eating.

Early intervention is crucial for recovery. However, stigma and lack of understanding about these disorders can often delay treatment. Therefore, raising awareness and promoting understanding about eating disorders is essential.

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The Most Common Eating Disorder in the U.S. Is Also the Least Understood

Binge eating disorder entered the diagnostic manual on mental health conditions 10 years ago. It’s still getting overlooked.

Credit... Laura Edelbacher

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By Dani Blum

• May 31, 2023

At 2 or 3 a.m., David Tedrow would hide the empty cardboard cereal box, shoving it into the bottom of the trash can or the back of the cupboard, where his wife wouldn’t notice it. Mr. Tedrow was in his 60s and retired, and he often slept until the afternoon so he could stay up late, after everyone else had gone to bed.

During frantic late-night bursts, he would eat an entire box of cereal — Oatmeal Squares, Frosted Mini-Wheats, whatever was around — and then dispose of the evidence. He had eaten compulsively throughout his life, he said, but after months of going through a box of cereal each night, he decided to try to get help.

In 2016, he left his home in North Carolina to seek treatment for what he thought was food addiction at a hospital in Wisconsin that specialized in eating issues. He was diagnosed with binge eating disorder.

“I had no earthly idea that it even existed,” he said. But the diagnosis gave him a sense of relief. “There was an explanation for this.”

Binge eating disorder is the most common eating disorder in the United States. Exact numbers vary , but according to the National Institute of Mental Health, nearly 3 percent of the U.S. population has had binge eating disorder at some point in their lives, more than double the reported numbers for bulimia nervosa and anorexia. Yet, the disorder is under-discussed and underrecognized by both the general public and those in the medical field, partly because many don’t know about the diagnosis or its potential severity.

Often, people will exhibit symptoms for decades before receiving a diagnosis, said Cynthia Bulik, the founding director of the University of North Carolina’s Center of Excellence for Eating Disorders. “For so long, they’ve been told things like ‘Oh, this is just emotional eating’ or ‘You’re out of control’ or ‘It’s because you have no willpower’ or ‘Gluttony’s a sin,’ or whatever these things are that people explain it away, without realizing that they have a treatable condition,” she said.

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Binge-eating disorder is a serious condition. It always involves feeling like you're not able to stop eating. It also often involves eating much larger than usual amounts of food.

Almost everyone overeats on occasion, such as having seconds or thirds of a holiday meal. But regularly feeling that eating is out of control and eating an unusually large amount of food may be symptoms of binge-eating disorder.

People who have binge-eating disorder often feel embarrassed or ashamed about eating binges. People with the disorder often go through periods of trying to restrict or severely cut back on their eating as a result. But this instead may increase urges to eat and lead to a cycle of ongoing binge eating. Treatment for binge-eating disorder can help people feel more in control and balanced with their eating.

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If you have binge-eating disorder, you may be overweight or obese, or you may be at a healthy weight. Most people with binge-eating disorder feel upset about their body size or shape no matter what the number on the scale is.

Symptoms of binge-eating disorder vary but can include:

• Feeling that you don't have control over your eating behavior, for example, you can't stop once you start.
• Often eating much larger than usual amounts of food in a specific amount of time, such as over a two-hour period.
• Eating even when you're full or not hungry.
• Eating very fast during eating binges.
• Eating until you're uncomfortably full.
• Often eating alone or in secret.
• Feeling depressed, disgusted, ashamed, guilty or upset about your eating.

A person with bulimia nervosa, another eating disorder, may binge and then vomit, use laxatives or exercise excessively to get rid of extra calories. This is not the case with binge-eating disorder. If you have binge-eating disorder, you may try to diet or eat less food at mealtimes to compensate. But restricting your diet may simply lead to more binge eating.

How much eating binges affect your mood and ability to function in daily life gives an idea of how serious the condition is for you. Binge-eating disorder can vary over time. The condition may be short-lived, may go away and come back, or may continue for years if left untreated.

When to see a doctor

If you have any symptoms of binge-eating disorder, get medical help as soon as possible. Talk with your healthcare professional or a mental health professional about your symptoms and feelings.

If you're embarrassed by your eating and are worried about talking to your healthcare professional, start by talking with someone you trust about what you're going through. A friend, family member, teacher or faith leader can encourage and support you in taking the first steps to successful treatment of binge-eating disorder.

Talking with a professional with specialty training in eating disorders or reaching out to an organization specializing in eating disorders might be a good place to find support from someone who understands what you're going through.

Helping a loved one who has symptoms

Someone who has binge-eating disorder may become an expert at hiding behavior. This is usually because of feelings of shame and embarrassment about the symptoms. Hiding symptoms can make it hard for others to notice the problem. If you think a loved one may have symptoms of binge-eating disorder, have an open and honest talk about your concerns, but remember to approach the topic with sensitivity. Eating disorders are mental health conditions, and the behaviors are not the fault or choice of the person with this condition.

Give encouragement and support. Offer to help your loved one find a healthcare professional or mental health professional with experience in treating eating disorders. You may help make an appointment. You might even offer to go along.

There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

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The causes of binge-eating disorder are not known. But certain genes, how your body works, long-term dieting and the presence of other mental health conditions increase your risk.

Risk factors

Binge-eating disorder is more common in women than in men. People of any age can have binge-eating disorder, but it often begins in the late teens or early 20s.

Factors that can raise your risk of having binge-eating disorder include:

• Family history. You're much more likely to have an eating disorder if your parents or siblings have — or had — an eating disorder. This may point to genes passed down in your family that increase the risk of having an eating disorder.
• Dieting. Many people with binge-eating disorder have a history of dieting. Dieting or limiting calories throughout the day may trigger an urge to binge eat.
• Mental health conditions. Many people who have binge-eating disorder feel negatively about themselves and their skills and accomplishments. Triggers for bingeing can include stress, poor body self-image and certain foods. Certain situations also can be triggers, for example, being at a party, having downtime or driving in your car.

Complications

Mental health conditions and physical problems can happen from binge eating. Complications from binge-eating disorder may include:

• Not feeling comfortable or able to enjoy your life.
• Problems functioning at work, in your personal life or in social situations.
• Isolating or feeling isolated from others socially.
• Weight gain.
• Medical conditions related to weight gain. These may include joint problems, heart disease, type 2 diabetes, gastroesophageal reflux disease (GERD), poor nutrition and some sleep-related breathing disorders.

Mental health conditions that are often linked with binge-eating disorder include:

• Depression.
• Substance use disorders.
• Suicidal thoughts and behavior.

If you have a child with binge-eating behaviors:

• Model body acceptance, regardless of body shape or size. Make it clear that dieting or restricting food is not healthy unless there's a diagnosed food allergy.
• Talk with your child's healthcare professional about any concerns. The healthcare professional may be in a good position to identify early symptoms of an eating disorder and help get expert treatment right away. The professional also can recommend helpful resources you can use to support your child.
• Binge-eating disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. 5th ed. American Psychiatric Association; 2022. https://dsm.psychiatryonline.org. Accessed Dec. 8, 2023.
• Binge eating disorder. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/binge-eating-disorder. Accessed Dec. 8, 2023.
• Binge eating disorder. Office on Women's Health. https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/binge-eating-disorder. Accessed Dec. 8, 2023.
• Giel KE, et al. Binge eating disorder. Nature Reviews. Disease Primers. 2022; doi:10.1038/s41572-022-00344-y.
• Guerdjikova AI, et al. Update on binge eating disorder. Medical Clinics of North America. 2019; doi:10.1016/j.mcna.2019.02.003.
• Scrandis DA, et al. Binge-eating disorder. Nurse Practitioner. 2023; doi:10.1097/01.NPR.0000000000000125.
• Vyvanse (prescribing information). Takeda Pharmaceuticals; 2023. https://www.vyvanse.com. Accessed Dec. 11, 2023.
• Dietary supplements for weight loss. National Institutes of Health Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/. Accessed Dec. 13, 2023.
• Hewlings SJ. Eating disorders and dietary supplements: A review of the science. Nutrients. 2023; doi:10.3390/nu15092076.
• Ralph AF, et al. Management of eating disorders for people with higher weight: Clinical practice guideline. Journal of Eating Disorders. 2022; doi:10.1186/s40337-022-00622-w.
• Sysko R, et al. Binge eating disorder in adults: Overview of treatment. https://www.uptodate.com/contents/search. Accessed Dec. 14, 2023.
• Lebow JR (expert opinion). Mayo Clinic. Dec. 28, 2023.
• Atwood ME, et al. A systematic review of enhanced cognitive behavioral therapy (CBT-E) for eating disorders. International Journal of Eating Disorders. 2019; doi:10.1002/eat.23206.
• Peterson CB, et al. Comparing integrative cognitive-affective therapy and guided self-help cognitive-behavioral therapy to treat binge-eating disorders using standard and naturalistic momentary outcome measures: A randomized controlled trial. International Journal of Eating Disorders. 2020; doi:10;1002/eat.23324.
• Hope starts here. National Eating Disorders Association. https://www.nationaleatingdisorders.org/. Accessed Jan. 9, 2024.
• What is F.E.A.S.T? Families Empowered And Supporting Treatment for Eating Disorders (F.E.A.S.T.). https://www.feast-ed.org/what-is-feast/. Accessed Jan. 8, 2024.

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Binge Eating Disorder

What is binge eating disorder.

Binge eating disorder is an illness that involves eating a lot of food in a short amount of time. The person with binge eating disorder feels out of control about how much he or she eats.  More food is eaten than others eat in the same amount of time, under the same circumstances. It differs from bulimia. People with binge eating disorder don't purge their bodies of the excess food via vomiting, laxative abuse, or diuretic abuse.

Who is affected by binge eating disorder?

People with binge eating disorder often:

Eat large amounts of food

Don't stop eating until they are uncomfortably full

Feel embarrassed by the amount of food they are eating

Have a history of weight gains and losses

Have more trouble losing weight and keeping it off than people with other serious weight problems

 About 1% to 2% of the population have binge eating disorder. It's seen more often in women than in men.

What are complications of binge eating disorder?

Complications from binge eating disorder include:

Overweight or obesity 

Increased risk for:

High cholesterol

High blood pressure

Gallbladder disease

Heart disease

Some types of cancer

Increased risk for psychiatric illnesses, particularly depression

People with binge eating disorder typically eat huge amounts of food at one time — often junk food — to reduce stress and relieve anxiety.

• Guilt and depression usually follow binge eating.
• People with binge eating disorder are at higher risk for depressive mood disorders, anxiety, and substance use disorder.

Biochemistry and eating disorders

To understand eating disorders, researchers have studied the central nervous and hormonal systems. This system regulates many functions of the mind and body. It has been found that many of the following functions may be, to some degree, disturbed in people with eating disorders:

Sexual function

Physical growth and development

Appetite and digestion

Heart function

Kidney function

Eating disorders and depression

Many people with eating disorders also appear to have depression. It is believed that there may be a link between these 2 disorders. For example:

Research has shown that some people with binge eating disorder may respond well to antidepressant medicine that affects serotonin function in the body.

Biochemical similarities have been discovered between people with eating disorders and obsessive-compulsive disorder (OCD), and people with OCD often have abnormal eating behaviors.

Genetic and environmental factors related to eating disorders

Eating disorders tend to run in families, and female relatives are the most often affected. That is why genetic factors are believed to play a role in the disorders.

But, other influences, both behavioral and environmental, may also play a role. Consider these facts from the American Psychiatric Association:

Most people with binge eating disorder are adolescent and young adult women. Yet this disorder can also affect older women and males of any age.

People pursuing professions or activities that emphasize thinness, like modeling, dancing, gymnastics, wrestling, and long-distance running, are more prone to this disorder.

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Eating Disorders in Children and Adolescents

Facts about Eating Disorders in Adolescents

Bulimia Nervosa in Adolescents

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Eating Disorders in Adolescents Essay

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Eating disorder as a severe health condition that can be manifested in many different ways may tackle a person of any age, gender, and socio-cultural background. However, adolescents, especially when it comes to female teenagers, are considered to be the most vulnerable in terms of developing this condition (Izydorczyk & Sitnik-Warchulska, 2018). According to the American Academy of Child & Adolescent Psychiatry (AACAP, 2018), 10 in 100 young women struggle with an eating disorder. Thus, the purpose of the present paper is to dwell on the specifics of external factors causing the disorder as well as the ways to deal with this issue.

To begin with, it is necessary to define which diseases are meant under the notion of an eating disorder. Generally, eating disorders encompass such conditions as anorexia nervosa, bulimia, binge eating, and avoidant/restrictive food intake disorder (ARFID) (AACAP, 2018). Although these conditions have different manifestations in the context of eating patterns, all of them affect teenager’s nutrition patterns and average weight. According to the researchers, there exist common external stressors that lead to an eating disorder, such as:

• Socio-cultural appearance standards. For the most part, modern culture and mass media promote certain body images as a generally accepted ideal, which causes many teenage girls to doubt their appearance and follow the mass trends.
• Biological factors. Some teenagers might have a genetic predisposition for certain disorders if anyone in the family struggled with the disease at some point in the past.
• Emotional factors. Children, who are at risk of being affected by such mental disorders as anxiety and depression, are likely to disrupt their nutrition patterns.
• Peer pressure. Similar to socio-cultural standards, peer pressure dictates certain criteria for the teenagers’ body image, eventually impacting their perception of food and nutrition (Izydorczyk & Sitnik-Warchulska, 2018).

With such a variety of potential stressors, it is imperative for both medical professionals and caregivers to pay close attention to the teenager’s eating habits. Thus, in order to assess the issue, any medical screening should include weight and height measurements. In such a way, medical professionals are able to define any discrepancies in the measurements over time and bring this issue up with a patient. When working with adolescents, it is of paramount importance to establish a trusting relationship with a patient, as teenagers are extremely vulnerable at this age. After identifying any issue related to weight and body image, nurses and physicians need to ask the patient whether they have any problems with eating. In case they are not willing to talk on the matter, it is necessary to emphasize that their response will not be shared with caregivers unless they want it. It is also necessary to ask questions regarding the child’s relationship with peers carefully, as they may easily become an emotional trigger.

In order to avoid such complications as eating disorders, it is vital for caregivers to talk with their children on the topic of the aforementioned stressors. Firstly, they need to promote healthy eating patterns by explaining why it is important for one’s body instead of giving orders to the child. For additional support, they may ask a medical professional to justify this information. Secondly, the caregivers need to dedicate time to explain the inappropriateness of body standards promoted by the mass media and promote diversity and positive body image within the family. Lastly, caregivers are to secure a safe environment for the teenager’s fragile self-esteem and self-actualization in order for them to feel more confident among peers (Boberová & Husárová, 2021). These steps, although frequently undermined, contribute beneficially in terms of dealing with eating disorders external stressors among adolescents.

American Academy of Child & Adolescent Psychiatry [AACAP]. (2018). Eating disorders in teens. Web.

Boberová, Z., & Husárová, D. (2021). What role does body image in relationship between level of health literacy and symptoms of eating disorders in adolescents?. International Journal of Environmental Research and Public Health , 18 (7), 3482.

Izydorczyk, B., & Sitnik-Warchulska, K. (2018). Socio-cultural appearance standards and risk factors for eating disorders in adolescents and women of various ages. Frontiers in psychology , 9 , 429.

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Essay Examples on Eating Disorders

What makes a good eating disorders essay topic.

When it comes to selecting a topic for your eating disorders essay, it's crucial to consider a multitude of factors that can elevate your writing to new heights. Below are some innovative suggestions on how to brainstorm and choose an essay topic that will captivate your readers:

• Brainstorm : Begin by unleashing a storm of ideas related to eating disorders. Delve into the various facets, such as causes, effects, treatment options, societal influences, and personal narratives. Ponder upon what intrigues you and what will engage your audience.
• Research : Embark on a comprehensive research journey to accumulate information and gain a profound understanding of the subject matter. This exploration will enable you to identify distinctive angles and perspectives to explore in your essay. Seek out scholarly sources such as academic journals, books, and reputable websites.
• Cater to your audience : Reflect upon your readers and their interests to tailor your topic accordingly. Adapting your subject matter to captivate your audience will undoubtedly make your essay more engaging. Consider the age, background, and knowledge level of your readers.
• Unveil controversies : Unearth the controversies and debates within the realm of eating disorders. Opting for a topic that ignites discussion will infuse your essay with thought-provoking and impactful qualities. Delve into various viewpoints and critically analyze arguments for and against different ideas.
• Personal connection : If you possess a personal connection or experience with eating disorders, contemplate sharing your story or delving into it within your essay. This will add a unique and personal touch to your writing. However, ensure that your personal anecdotes remain relevant to the topic and effectively support your main points.

Overall, a remarkable eating disorders essay topic should be meticulously researched, thought-provoking, and relevant to your audience's interests and needs.

Popular Eating Disorders Essay Topics

Below, you will find a compilation of the finest eating disorders essay topics to consider:

• The Impact of Social Media on Eating Disorders
• The Role of Family Dynamics in the Development of Eating Disorders
• Eating Disorders in Athletes: Causes and Consequences
• The Effectiveness of Different Treatments for Eating Disorders
• Understanding the Psychological Underpinnings of Anorexia Nervosa
• Binge Eating Disorder: Symptoms, Causes, and Treatment
• The Relationship Between Body Dysmorphic Disorder and Eating Disorders
• Eating Disorders in Adolescents: Early Signs and Prevention
• The Influence of Culture and Society on Eating Disorder Prevalence
• The Connection Between Eating Disorders and Substance Abuse
• The Role of Genetics in Eating Disorders
• Men and Eating Disorders: Breaking the Stigma
• The Long-Term Health Consequences of Eating Disorders
• Orthorexia: When Healthy Eating Becomes a Disorder
• The Impact of Trauma and Abuse on Eating Disorder Development

Best Eating Disorders Essay Questions

Below, you will find an array of stellar eating disorders essay questions to explore:

• How does social media contribute to the development and perpetuation of eating disorders?
• What challenges do males with eating disorders face, and how can these challenges be addressed?
• To what extent does the family environment contribute to the development of eating disorders?
• What role does diet culture play in fostering unhealthy relationships with food?
• How can different treatment approaches be tailored to address the unique needs of individuals grappling with eating disorders?

Eating Disorders Essay Prompts

Below, you will find a collection of eating disorders essay prompts that will kindle your creative fire:

• Craft a personal essay that intricately details your voyage towards recovery from an eating disorder, elucidating the lessons you learned along the way.
• Picture yourself as a parent of a teenager burdened with an eating disorder. Pen a heartfelt letter to other parents, sharing your experiences and providing valuable advice.
• Fabricate a fictional character entangled in the clutches of binge-eating disorder. Concoct a short story that explores their odyssey towards self-acceptance and recovery.
• Construct a persuasive essay that fervently argues for the integration of comprehensive education on eating disorders into school curricula.
• Immerse yourself in the role of a therapist specializing in eating disorders. Compose a reflective essay that delves into the challenges and rewards of working with individuals grappling with eating disorders.

Writing Eating Disorders Essays: FAQ

• Q : How can I effectively commence my eating disorders essay?

A : Commence your essay with a captivating introduction that ensnares the reader's attention and provides an overview of the topic. Consider starting with an intriguing statistic, a powerful quote, or a personal anecdote.

• Q : Can I incorporate personal experiences into my eating disorders essay?

A : Absolutely! Infusing your essay with personal experiences adds depth and authenticity. However, ensure that your personal anecdotes remain relevant to the topic and effectively support your main points.

• Q : How can I make my eating disorders essay engaging?

A : Utilize a variety of rhetorical devices such as metaphors, similes, and vivid descriptions to transform your essay into an engaging masterpiece. Additionally, consider incorporating real-life examples, case studies, or interviews to provide concrete evidence and make your essay relatable.

• Q : Should my essay focus solely on one specific type of eating disorder?

A : While focusing on a specific type of eating disorder can provide a narrower scope for your essay, exploring the broader theme of eating disorders as a whole can also be valuable. Strive to strike a balance between depth and breadth in your writing.

• Q : How can I conclude my eating disorders essay effectively?

A : In your conclusion, summarize the main points of your essay and restate your thesis statement. Additionally, consider leaving the reader with a thought-provoking question or a call to action, encouraging further reflection or research on the topic.

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Eating disorders are complex mental health conditions characterized by abnormal or disturbed eating habits that negatively affect a person's physical and mental health.

• Anorexia Nervosa: Characterized by an intense fear of gaining weight, a distorted body image, and severe restriction of food intake leading to extreme weight loss and malnutrition.
• Bulimia Nervosa: Involves cycles of binge eating followed by compensatory behaviors such as vomiting, excessive exercise, or laxative use to prevent weight gain. Sufferers often maintain a normal weight.
• Binge Eating Disorder: Marked by recurrent episodes of eating large quantities of food in a short period, often accompanied by feelings of loss of control and distress, but without regular use of compensatory behaviors.
• Orthorexia: An obsession with eating foods that one considers healthy, often leading to severe dietary restrictions and malnutrition. Unlike other eating disorders, the focus is on food quality rather than quantity.
• Avoidant/Restrictive Food Intake Disorder (ARFID): Involves limited food intake due to a lack of interest in eating, avoidance based on sensory characteristics of food, or concern about aversive consequences of eating, leading to nutritional deficiencies and weight loss.
• Pica: The persistent eating of non-nutritive substances, such as dirt, clay, or paper, inappropriate to the developmental level of the individual and not part of a culturally supported or socially normative practice.
• Rumination Disorder: Involves the repeated regurgitation of food, which may be re-chewed, re-swallowed, or spit out. This behavior is not due to a medical condition and can lead to nutritional deficiencies and social difficulties.
• Distorted Body Image: Individuals often see themselves as overweight or unattractive, even when underweight or at a healthy weight.
• Obsession with Food and Weight: Constant thoughts about food, calories, and weight, leading to strict eating rules and excessive exercise.
• Emotional and Psychological Factors: Associated with low self-esteem, perfectionism, anxiety, depression, or a need for control.
• Physical Health: Can cause severe health issues like malnutrition, electrolyte imbalances, hormonal disruptions, and organ damage.
• Social Isolation: Withdrawal from social activities due to shame, guilt, and embarrassment, leading to loneliness and distress.
• Co-occurring Disorders: Often coexists with anxiety, depression, substance abuse, or self-harming behaviors, requiring comprehensive treatment.
• Genetic and Biological Factors: Genetic predisposition and biological factors, like brain chemical or hormonal imbalances, can contribute to eating disorders.
• Psychological Factors: Low self-worth, perfectionism, body dissatisfaction, and distorted body image perceptions play significant roles.
• Sociocultural Influences: Societal pressures, cultural norms, media portrayal of unrealistic body ideals, and peer influence increase the risk.
• Traumatic Experiences: Physical, emotional, or sexual abuse can heighten vulnerability, leading to feelings of low self-worth and body shame.
• Dieting and Weight-related Practices: Restrictive dieting, excessive exercise, and weight-focused behaviors can trigger disordered eating patterns.

Treatment for eating disorders includes psychotherapy, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and family-based therapy (FBT), to address psychological factors and improve self-esteem. Nutritional counseling with dietitians helps develop healthy eating patterns and debunks dietary myths. Medical monitoring involves regular check-ups to manage physical health. Medication may be prescribed for symptoms like depression and anxiety. Support groups and peer support offer community and empathy, providing valuable insights and encouragement from others facing similar challenges.

• As per the data provided by the National Eating Disorders Association (NEDA), it is estimated that around 30 million individuals residing in the United States will experience an eating disorder during their lifetime.
• Research suggests that eating disorders have the highest mortality rate of any mental illness. Anorexia nervosa, in particular, has a mortality rate of around 10%, emphasizing the seriousness and potential life-threatening nature of these disorders.
• Eating disorders can affect individuals of all genders and ages, contrary to the common misconception that they only affect young women. While young women are more commonly affected, studies indicate that eating disorders are increasingly prevalent among men and can also occur in older adults and children.

Eating disorders are a critical topic because they affect millions of people worldwide, leading to severe physical and psychological consequences. Addressing eating disorders helps in understanding their complex causes and improving treatment options. Exploring eating disorders essay topics raises awareness, promotes early intervention, and encourages support for those affected, ultimately contributing to better mental health and well-being.

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. 2. Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731. 3. Brown, T. A., Keel, P. K., & Curren, A. M. (2020). Eating disorders. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (6th ed., pp. 305-357). Guilford Press. 4. Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407-416. 5. Herpertz-Dahlmann, B., & Zeeck, A. (2020). Eating disorders in childhood and adolescence: Epidemiology, course, comorbidity, and outcome. In M. Maj, W. Gaebel, J. J. López-Ibor, & N. Sartorius (Eds.), Eating Disorders (Vol. 11, pp. 68-82). Wiley-Blackwell. 6. Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358. 7. Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., & Agras, W. S. (2004). Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin, 130(1), 19-65. 8. Keski-Rahkonen, A., & Mustelin, L. (2016). Epidemiology of eating disorders in Europe: Prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29(6), 340-345. 9. Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414. 10. Stice, E., Marti, C. N., & Rohde, P. (2013). Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. Journal of Abnormal Psychology, 122(2), 445-457.

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Current approach to eating disorders: a clinical update

Phillipa hay.

1 Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney New South Wales, Australia

2 Campbelltown Hospital, SWSLHD, Sydney New South Wales, Australia

This article presents current diagnostic conceptualisations of eating disorders, including new disorders such as binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID). This is followed by contemporary findings in the epidemiology of eating disorders, their broad sociodemographic distribution and the increases in community prevalence. Advances and the current status of evidence‐based treatment and outcomes for the main eating disorders, anorexia nervosa, bulimia nervosa and BED are discussed with focus on first‐line psychological therapies. Deficits in knowledge and directions for further research are highlighted, particularly with regard to treatments for BED and ARFID, how to improve treatment engagement and the management of osteopenia.

Introduction

The conceptualisation of eating disorders has expanded rapidly in the last 10 years to include binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID) in addition to anorexia nervosa and bulimia nervosa. These are now recognised as four well‐conceptualised disorders, which have been reclassified as Feeding and Eating Disorders (FEDs) in the 5th revision of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) published in 2013 and in the 11th revision of the World Health Organisation's International Statistical Classification of Diseases and Related Health Problems published in 2019. 1 , 2 The common key diagnostic features of the main disorders of both schemes are shown in Table ​ Table1. 1 . The vast majority of research and clinical understanding is with anorexia nervosa, bulimia nervosa and BED, and thus this paper will focus on these.

Key diagnostic features of the main feeding and eating disorders

Anorexia nervosa and bulimia nervosa are eating disorders characterised by the internalisation of the thin ideal and extreme weight‐control behaviours. In both, overvaluation of weight and shape – where such body image concern is of major or paramount importance to self‐view – is a mandatory criterion. Anorexia nervosa is distinct as a condition of self‐starvation, where people are underweight and engaged in behaviours to prevent weight gain. It includes people who do and do not binge eat or purge (induce vomiting or laxative/diuretic misuse). People with bulimia nervosa are not underweight, and are in a cycle of binge eating and purging and/or fasting/compulsive exercise. In contrast, BED and ARFID are the first FEDs that do not have body image concerns as core diagnostic criteria. They are distinguished by being disorders of eating behaviours, the former of recurrent binge eating without regular purging and the latter of avoidance and aversion to food and eating. All eating disorders occur across the age spectrum although anorexia nervosa and ARFID more commonly present in childhood and adolescence years, whereas bulimia nervosa and BED are uncommon in paediatric populations.

Advances in diagnosis and classification

The changes to diagnostic criteria for anorexia nervosa in DSM‐5 and ICD‐11 are subtle but important. Although physical consequences of starvation such as amenorrhea and osteopenia still occur, the former is no longer a mandatory criterion to diagnose anorexia owing to its frequent lack of applicability, for example in men and women who are taking hormonal contraception. In DSM‐5, there are also severity criteria based on body mass index (BMI; kg/m 2 ) levels or their equivalent in children but no upper BMI, and whether a person is underweight (needed for a diagnosis of anorexia nervosa) is a clinical judgement. People with a BMI in the normal range but who otherwise resemble those with anorexia nervosa may be given the DSM‐5 diagnosis of Atypical Anorexia Nervosa – a type of Other Specified Feeding or Eating Disorder (OSFED).

Another change to anorexia nervosa in both schemes is to no longer require the person to report a ‘fear of fatness’ or weight gain – regarded often as a culturally specific phenomenon. However, if this is not reported, evidence of weight prevention/loss behaviours is required to confirm a diagnosis of anorexia nervosa. Overvaluation and other body image concerns may occur in people with BED but are proscribed for individuals with ARFID in both schemes.

Bulimia nervosa has changed little, but the criteria have broadened, and binge eating (overeating on contextually large amounts of food over which the person has lost control of eating) with compensatory weight loss behaviours may now occur as little as once a week, but this must be for 3 months in DSM‐5 or 1 month in ICD‐11. Similarly, a minimum frequency of weekly binge eating over several months is required for a diagnosis of BED in both schemes. However, although overvaluation is not required in either scheme, marked distress associated with binge eating is mandatory for BED. In the DSM‐5, 3/5 additional features associated with binge eating are also required for BED. These additional features are: (i) eating rapidly than normal; (ii) eating when not hungry; (iii) eating until uncomfortably full; (iv) eating alone; and (v) negative emotions of depression, guilt or disgust following overeating. 1 Both bulimia nervosa and BED occur evenly across the weight spectrum, from normal to above normal bodyweights. In clinical settings, the diagnosis of bulimia nervosa is commonly made in the context of purging behaviours such as self‐induced vomiting and laxative misuse for weight control. However, people with bulimia nervosa can also present without purging, but with extreme dietary restriction/fasting and/or driven exercise regimens. This non‐purging form of bulimia nervosa is more common in the community 3 and may differ from BED only in the manifestation of regular compensatory behaviours. ICD‐11 differs from DSM‐5 with regard to defining BED, in neither requiring the amount of food consumed in a binge to be unusually large – that is subjective binge episodes are included – nor requiring the 3/5 additional features of binge eating. 2 These broader criteria are likely to increase the clinical utility of the ICD scheme compared with DSM and are in line with the lived experience of BED, whereby it is the loss of control and perception of overeating that is the distressing quality of the binge episode, much more so than the amount of food eaten.

People with eating disorders that do not meet the behavioural frequency or other criteria of one of the main eating disorders and whose problems are less well conceptualised, previously termed as Eating Disorder Not Otherwise Specified, may be now classified as OSFED or Unspecified FED (UFED) in the DSM‐5, 1 or as the poorly specified Other Feeding or Eating Disorder in ICD‐11. 2 OSFED includes atypical anorexia nervosa, subthreshold bulimia nervosa and BED, purging disorder and night eating syndrome.

Atypical anorexia nervosa, that is anorexia nervosa where BMI may be in the ‘adequate’ range of 20–25 kg/m 2 or higher, is probably becoming more common as the mean weight of the general population shifts to the right. Management is similar to anorexia nervosa. Night eating syndrome often presents in the context of sleep disturbance. It is similar to BED in assessment and management. Purging disorder (without regular binge eating) is not very common, and its management is similar to that for bulimia nervosa.

Although evidence is limited, the addition of these previously unrecognised eating disorders, such as BED and ARFID, has implications for clinicians, jurisdictions and more broadly public health. Prevention initiatives, clinician awareness and health service infrastructure may need to be expanded to ensure adequate identification and management of the now diverse spectrum of eating disorders.

Epidemiology including distribution and determinants

A systematic review reported weighted population means (and ranges) of lifetime prevalence as: (i) anorexia nervosa 1.4% (0.1–3.6%) for women and 0.2% (0–0.3%) for men, (ii) bulimia nervosa 1.9% (0.3–4.6%) for women and 0.6% (0.1–1.3%) for men and (iii) BED 2.8% (0.6–5.8%) for women and 1.0% (0.3–2.0%) for men. 4 There are few studies on the general population prevalence of DSM‐5 eating disorders. An Australian adult general population study included cases of OSFED and ARFID. 3 It found a 3‐month prevalence of bulimia nervosa (1.2%) and BED (1.5%) respectively. (Note that the study did not, however, apply the DSM‐5 3/5 binge eating specifiers.) The study also examined ARFID and OSFED and found a prevalence of 0.3% and 3.2% respectively. The majority of OSFED had atypical anorexia nervosa. 3 Many people (around 10%) reported weekly binge eating but without marked distress, these were placed in UFED – however, this group did not have high levels of health impairment, casting some doubt on the clinical significance of this group. 3

The true community incidence of eating disorders is unknown. However, cohort and clinical incidence studies suggest a community‐wide increase in bulimia nervosa and in BED.

Increases in anorexia nervosa also have occurred and are greatest in young women. 5 , 6 All three main disorders are also associated with moderate to high levels of psychosocial and work impairment. 3 , 6

The prevalence of eating disorders is higher in women and in young people. However, BED is more common in men. All problems may be more prevalent across socioeconomic groups and in First Australians than previously thought. 7 Risk minimisation may be achieved with improved media literacy, reduced thin idealisation and promoting a positive/healthy relationship with weight and eating. 8 Bulimia nervosa and BED shared intersecting risk factors for overweight/obesity (e.g. a child history of trauma). Therefore, weight loss management, if required, is best in a supervised environment where care can be taken to address and prevent emergence of eating disorders and other psychological co‐morbidities. 9

Management of eating disorders – overview

For all eating disorders (including ARFID), the main treatment as delineated in the current national and international guidelines is a form of psycho‐behavioural therapy which can most usually be provided on an outpatient basis. 9 , 10 , 11 People with more severe symptoms, or who are not improving with less restrictive care may be treated in a partial (day) or full hospital specialist programme. 11 , 12 Evidence‐based therapies delivered by an eating disorders‐informed clinician are considered most efficacious, and are preferred by people with eating disorders. 12 This approach may also be more cost‐effective and reduce hospitalisations. 12

In addition to specific psychological therapy, treatment needs to address important nutritional, physical and mental health co‐morbidities and thus is ideally from a multi‐disciplinary team. These teams at a minimum would comprise a psychological therapist and a family doctor. In more complex cases of eating disorders, such as most people with anorexia nervosa, more severe cases of bulimia nervosa and BED, and those requiring hospital care, additional interdisciplinary supports are required. These include a registered dietitian, specialist physician/paediatrician, psychiatrist, nurse(s), an exercise therapist, activity/occupational therapist and social worker or family therapist. 9 , 10 , 11

Psychological therapies

Specific psychological therapies like the trans‐diagnostic Cognitive Behaviour Therapy – Enhanced (CBT‐E) are the first‐line treatment for all eating disorders with the greatest impact on symptom reduction and other outcomes. 13 This is usually delivered in 20 weekly sessions for bulimia nervosa and BED and in 40 sessions for anorexia nervosa.

Briefer forms (e.g. 10 sessions of online guided self‐help CBT) as a first step in care or for people with less severe illness have been developed. 9 These have a moderate evidence base, comparable to CBT delivered by an eating disorder informed therapist, but many people continue to be symptomatic and require further sessions. ‘Pure’ self‐help, where there is no guidance, is not recommended except as a first step while waiting for care.

The most major recent advances in treatments for eating disorders have come from psychological therapy trials of child/adolescent and adults with anorexia nervosa supported by several systematic reviews and network and other meta‐analyses. 14 In children and adolescents, an atheoretical family‐based treatment (FBT) is the leading modality of care. FBT may be delivered in whole family as well as separated family (where the parents are seen apart from the child). 15 Family therapy has also been adapted for bulimia nervosa. 9 An alternative, but with a weaker evidence base to FBT, is a form of CBT‐E that has been modified to have additional brief family sessions. 16 Similarly, adolescent focal psychotherapy can be used for younger people with anorexia nervosa. 9

Although there is no similar leading therapy for adults with anorexia nervosa, CBT is the most commonly practised therapy in Australia. Other evidence‐based psychological therapies for anorexia nervosa are the Maudsley Anorexia Nervosa Therapy for Adults (MANTRA), 17 Specialist Supportive Clinical Management (SSCM) 18 and Focal Psychodynamic Therapy (FPT). 19 Table ​ Table2 2 summarises the key elements of the main evidence‐based therapies for adults and a good description of all psychological therapies is found in the NICE guidelines. 10 All therapies provide psychoeducation and aim to restore the person's physical health with weight monitoring, nutritional counselling and meal planning, often alongside sessions from a registered dietitian. They were developed for individual outpatient care over 8 months or longer. CBT has been adapted for delivery in group settings, which is usual in hospital programmes. All have manuals to provide guidance for therapies and which are used in training. In Australia, the most accessible training is for CBT, followed by SSCM and MANTRA. All have moderate levels of attrition.

Comparative features of evidence based therapies for adults with anorexia nervosa

CBT‐E, Cognitive Behaviour Therapy – Enhanced; FPT, Focal Psychodynamic Therapy; MANTRA, Maudsley Anorexia Nervosa Therapy for Adults; SSCM, Specialist Supportive Clinical Management.

Pharmacological therapies

In contrast to psychological care, there have been fewer advances in pharmacological treatments for anorexia nervosa. There are several small trials now of second‐generation antipsychotics, such as olanzapine for anorexia nervosa with mixed results. 11 A recent large ( n = 152) 16‐weeks outpatient placebo‐controlled trial of olanzapine (mean dose 7.77 mg/day) as a primary treatment for adults with anorexia nervosa found a moderate effect size on weight gain favouring the active drug. 20 However, the rate of weight gain was very small (approximately 0.7 kg/month) and negligible with placebo. There were no other significant differences on primary outcomes and only one secondary outcome difference for shape concerns favouring the placebo arm. Importantly, there were no differences on metabolic outcomes. Other psychotropic agents, such as antidepressants, have little direct role or evidence for treatment in anorexia nervosa, but antidepressants may be used where there is co‐morbid major depression. 14

There are several trials supporting agents for the treatment of BED and bulimia nervosa. Since the early trials of higher dose‐selective serotonin reuptake inhibitors (e.g. fluoxetine 60 mg daily), there has been a small number of trials of topiramate and (for BED) lisdexamfetamine. 11 , 21 Meta‐analyses support a role for the second‐generation antidepressants and lisdexamfetamine but not as standalone treatments as effect sizes are small to medium and attrition may be higher than with psychological therapies. 21 Most use in Australia is also ‘off label’, with the exception of lisdexamfetamine which is approved for BED that is moderate to severe and under specialist psychiatrist management. The longer term safety of lisdexamfetamine is considered commensurate with that found for its use in attention‐deficit/hyperactivity disorder.

Refeeding and osteopenia

The risks of refeeding too quickly and the refeeding syndrome are now well‐recognised, but programmes may have become overcautious. Research supports optimising hospital care to allow more rapid weight regain protocols and more assertive refeeding protocols have been demonstrated to be safe when combined with assertive medical monitoring and nutritional supplementation of, for example phosphate. 22 However, such regimens need to monitor psychological distress as this may be higher with more rapid weight gain.

Osteopenia in people with sustained periods of low weight and sex steroid suppression continues to be a known medical risk for which treatment remains an ‘unmet critical need’ (Schorr et al ., p. 78). 23 Bone loss may be irreversible, especially if this occurs during the critical growth period of post‐pubertal bone accretion. People with anorexia nervosa thus may not reach their peak bone mass and hence later in life more quickly reach osteopenic levels, especially women in their post‐menopausal years. Thus, there is both increased risk of fracture in youth as well as older age. Management relies on weight restoration and normalisation of endocrine homeostasis. There is a small number of trials of anti‐resorptive and anabolic agents. There has been one positive trial of transdermal oestrogen physiological replacement and teriparatide respectively. Studies into raloxifene, denosumab and other parathyroid hormone analogues, such as abaloparatide, are lacking or are limited to case reports. Most success has been reported for bisphosphonates. However, safety concerns and potential teratogenicity caution against the use of bisphophonates in young women. 23

Outcomes and prognosis

Research supports cautious optimism for recovery from an eating disorder, albeit it may be slow. A recent, large 22‐year follow‐up study of 228 women with anorexia nervosa or bulimia nervosa treated in a specialist centre found the majority (around two‐thirds) recovered, and that most with bulimia nervosa achieved this within 9 years, but only about half of those with anorexia nervosa achieved recovery within 9 years. 24 This is consistent with the body of outcome literature. 6 Less is known about long‐term outcomes for BED and other eating disorders, but treatment is important as spontaneous remission appears to be low and early symptom change is the best predictor of outcome across all eating disorders. 25

A meta‐analysis has reported the presence of binge eating and purging behaviours, lower BMI, early stage of change (low motivation), concurrent depressed mood and other co‐morbidities, higher body image concerns and poorer quality of current relationships to be consistently associated with poorer treatment outcomes both in the medium to longer term across all eating disorders. Attrition was also associated with binge eating and purging behaviours and low motivation to change. However, effect sizes varied highly across studies and were small to moderate indicating many people recover despite having negative prognostic features. 25

A major challenge in improving treatment outcomes is to close the ‘treatment gap’. A majority of people with anorexia nervosa and a large majority with bulimia nervosa and BED delay seeking care for a decade or longer. 10 Many factors contribute to this problem, but important issues are low levels of health literacy, help‐seeking for weight loss management rather than the eating disorder, stigma, shame and poor affordability and access to evidence‐based psychological therapies.

Eating disorders are common in Australians and may be increasing. Effective psychological therapies are the first‐line in care and most people recover in the medium to longer term. Hospital care can be life‐saving and efficient access to care is important – the major challenge is the wide treatment gap and delays. Few pharmacologic agents are helpful in the management of bulimia nervosa and BED. Further research is needed particularly in the management of osteopenia, achieving earlier treatment engagement, an improved understanding of which therapies work best for whom, prognostic factors and outcomes. Research is urgently needed for the newer eating disorders, BED and ARFID.

Funding: Disclosure: P. Hay has received in sessional fees and lecture fees from the Australian Medical Council, Therapeutic Guidelines publication, and New South Wales Institute of Psychiatry and royalties from Hogrefe and Huber, McGraw Hill Education, and Blackwell Scientific Publications, and she has received research grants from the NHMRC and ARC. She is Chair of the National Eating Disorders Collaboration in Australia. In July 2017, she provided a commissioned report for Shire Pharmaceuticals on lisdexamfetamine and binge eating disorders and has received Honoraria from Shire for teaching at educational events for Psychiatrists.

Conflict of interest: None.