There are 4 main types of eating disorders that are recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the handbook used by physical and mental health care professionals for the purpose of diagnosing individuals. The four main types are: Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, and Avoidant Restrictive Food Intake Disorder (ARFID). There are other socially recognized forms of eating disorders, like Orthorexia (a preoccupation or obsession with “clean eating” and exercise), that you won’t find in the DSM, but that doesn’t mean they can’t be treated. Professionals who are specialized in treating eating disorders understand that eating disorders are nuanced and, while there are many shared behaviors amongst them, they aren’t all exactly the same. To learn about eating disorder subtypes, go to: https://www.montenido.com/6-lesser-known-eating-disorders/
Contrary to common belief, Binge-Eating Disorder (BED) is the most common eating disorder type in the United States. BED is characterized by eating an unusually large amount of food in a specific amount of time. The eating happens regardless of fullness, and is often met with a significant amount of shame. Food might be consumed at a fast pace and in secrecy. Someone who suffers with BED might be known for dieting but may not show a significant amount of weight loss. For those who haven’t suffered from BED, it can be easy to assume that the sufferer has the ability to stop eating at any point and control their portions. Like all eating disorders, it’s far more complex than that. BED is often a result of a restrictive diet or a desire to restrict (i.e portion control). While the behaviors of BED differ greatly from that of someone with Anorexia Nervosa, what fuels the disorder shares notable similarities. For more information about BED, go to: https://www.montenido.com/myths-about-binge-eating-disorder/
Bulimia Nervosa is similar to BED but has a compensatory aspect that differentiates it. A compensatory behavior might look like purging (vomiting), unnecessary laxative use, and over-exercising. People with Bulimia don’t always experience a binge before utilizing compensatory behaviors–restriction is still an element of Bulimia, so any food intake may trigger a behavior though binging is common. Other signs you might notice in someone who may be struggling with Bulimia includes quickly leaving after meals, hiding food, over-exercising before or after meals, frequent bathroom visits, Russell’s sign (a physical sign of purging (vomiting) located on the knuckles), and red and irritated eyes. For more information about Bulimia Nervosa, go to: https://www.montenido.com/bulimia-nervosa/
Anorexia Nervosa is what comes to mind when most people hear the words “eating disorder”. It’s not uncommon to associate this diagnosis with a thin or underweight body frame, but less than 6% of people with eating disorders are underweight (https://www.feast-ed.org/). While the severity of Anorexia Nervosa is often determined by BMI, and other factors, weight is not indicative of how severely the eating disorder is impacting one’s physical or mental wellbeing. For this reason, getting a diagnosis of Anorexia Nervosa can be difficult for many, which limits access to higher levels of treatment, especially for those in larger bodies. Anorexia Nervosa is characterized by restriction of food often leading to weight loss, intense fear of weight gain, discomfort with one’s body, and denial of the seriousness of the condition. For more information about Anorexia Nervosa, go to: https://www.montenido.com/anorexia-nervosa/
The final diagnosis we’ll be covering is Avoidant Restrictive Food Intake Disorder (ARFID). Unlike most other eating disorders, it is not rooted in body-image issues or a desire to lose weight. It is most commonly diagnosed in children and young adolescents and affects adults at a lower rate. Many professionals have identified a potential correlation between Autism Spectrum Disorder (ASD) and ARFID but more research is needed to draw any major conclusions. ARFID is characterized by restrictive eating due to lack of interest in food; avoidance of certain textures, smells, appearance and flavor; and fears of consequences associated with eating like choking, vomiting, or having an allergic reaction. People experiencing ARFID may only have a few foods they feel safe eating, which can lead to serious health complications like malnutrition, stunted growth, and more. To learn more about ARFID, go to: https://www.montenido.com/food-intake-disorder-arfid/
Eating disorders are complex mental health disorders that require treatment tailored to the individual and often consists of working with a qualified therapist, dietitian, primary care provider, and psychiatrist. Eating disorders are typically co-occurring, meaning there are other mental health disorders that are affecting and being affected by the eating disorder, such as anxiety, depression, bipolar disorder, OCD, and more. Eating disorders are not a choice and are complicated by both genetic and environmental factors, and those who struggle with them deserve equitable access to quality care.
For those who are not yet in recovery, and in recovery alike, you are not alone. Your battle is real, it is hard, and can feel isolating. Everything we do in recovery feels counterintuitive and scary but that doesn’t mean it’s wrong. The risks we take in pursuing recovery are worth the pain we must feel as we journey toward a life not ruled by our eating disorders. We are more resilient than we know and we are capable of experiencing life to the fullest. Your darkest days may not yet be behind you, but I can assure you that, if your commitment to recovery is persistent (not perfect) and rooted in living according to your values, your lightest days are ahead of you.
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