Signs and Symptoms

Anorexia Nervosa is characterized by weight loss and self-starvation.

Symptoms Include:

• Refusal to maintain body weight at or above a minimally normal weight for height, past weight history
  body type, age, and activity level
• Intense fear of weight gain or being “fat” and concern with body shape and weigh
• Feeling “fat” or overweight despite dramatic weight loss
• Loss of menstrual periods in some women
• Denial of seriousness of weight loss
• There may be periods of binge eating and/or purging by vomiting, exercsie, diet pills, laxatives, etc

Medical symptoms that occur in time:

• Thinning of the bones (osteopenia or osteoporosis)
• Mild anemia and muscle wasting and weakness
• Dry and yellowish skin
• Brittle hair and nails
• Growth of fine hair all over the body (lanugo)
• Severe constipation
• Low blood pressure, slowed breathing and pulse
• Damage to the structure and function of the heart
• Brain damage
• Multi-organ failure
• Drop in internal body temperature, causing a person to feel cold all the time
• Lethargy, sluggishness, or feeling tired all the time
• Infertility
• Apathy and Depression

Bulimia Nervose is described by secretive cycles of eating followed by purging.

Symptoms include:

• Repeated episodes of bingeing and purging varying in frequency from less than 1 a month to multiple times per day
• Binges may be a small amount of food or very large quantities of food during a short period of time
• Feeling out of control during a binge and eating, often, but not always, beyond the point of comfortable fullness
• Purging occurs through  self-induced vomiting, abuse of laxatives, diet pills, exercise, diuretics or fasting requent dieting
• Extreme concern with body weight and shape

Medical symptoms that develop over time include:

• Acid reflux
• Inflamed and sore throat
• Gastrointestinal distress
• Swollen glands in jaw and neck
• Intestinal irritation from laxative use and abuse  and potential for bowels to not be able to function without laxatives
• Dehydration from purging
• Decaying and sensitive teeth and worn tooth enamel from stomach acids
• Electrolyte imbalance which can lead to cardiac abnormalities and even heart attacks

For more information and visuals about Bulimia visit here.

EDNOS is basically a combination of anorexia without significant weight loss or low weight compared to height.

Can have any or all symptoms of anorexia as well as compensatory behaviors from bulimia.

Recurrent episodes of binge eating.

An episode of binge eating is characterized by both of the following:

• Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
• A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge eating episodes are associated with three (or more) of the following:
• Eating much more rapidly than normal.
• Eating until feeling uncomfortably full.
• Eating large amounts of food when not feeling physically hungry.
• Eating alone because of feeling embarrassed by how much one is eating.
• Feeling disgusted with oneself, depressed, or very guilty afterward.
  • Marked distress regarding binge eating is present.
  • The binge eating occurs, on average, at least once a week for 3 months.
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

WARNING SIGNS & SYMPTOMS OF BINGE EATING DISORDER

Emotional and behavioral

• Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food.
• Appears uncomfortable eating around others
• Any new practice with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
• Fear of eating in public or with others
•  Steals or hoards food in strange places
• Creates lifestyle schedules or rituals to make time for binge sessions
• Withdraws from usual friends and activities
• Frequently diets
• Shows extreme concern with body weight and shape
• Frequent checking in the mirror for perceived flaws in appearance
• Has secret recurring episodes of binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances); feels lack of control over ability to stop eating
• Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting
  • Developing food rituals (e.g., eating only a particular food or food group [e.g., condiments], excessive chewing, and not allowing foods to touch).
  • Eating alone out of embarrassment at the quantity of food being eaten
  • Feelings of disgust, depression, or guilt after overeating
  • Fluctuations in weight
  • Feelings of low self-esteem

Physical

• Noticeable fluctuations in weight, both up and down
• Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
• Difficulties concentrating

A few facts about binge eating disorder:

A 2007 study asked 9,282 English-speaking Americans about a variety of mental health conditions, including eating disorders. The results, published in Biological Psychiatry, found that 3.5% of women and 2.0% of men had binge eating disorder during their life.

• This makes BED more than three times more common than anorexia and bulimia combined.
• BED is also more common than breast cancer, HIV, and schizophrenia.

Hudson JI, Hiripi E, Pope HG Jr, and Kessler RC. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3):348-58. doi:10.1016/j.biopsych.2006.03.040. Combining information from several sources, Eric Stice and Cara Bohon found that:

• Between 0.2% and 3.5% of females and 0.9% and 2.0% of males will develop binge eating disorder
• Approximately 40% of those with binge eating disorder are male.
• Three out of ten individuals looking for weight loss treatments show signs of BED.

For further reading:
Westerberg, D. P., & Waitz, M. (2013). Binge-eating disorder. Osteopathic Family Physician, 5(6), 230-233.
All information compiled from: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

• To maintain basic level of functioning (to feel “okay”), feel you must exercise daily
• If unable to exercise a day or two, experience  minor  withdrawal    symptoms such as anxiety, shame or iritibility
• When not able to exercise for longer periods may experience loss of self-esteem, depression or lack of interest in other activities
• Exercise  against medical  advice
• Risk  physical   injury
• Denial of pain
• Life is scheduled around exercise
• Job or relationships are put after exercise
• Continuous striving with more exercise regardless of how “fit” or “healthy” one becomes
• The person maintains a high level of activity and is uncomfortable with states of rest or relaxation.
• The individual depends upon the activity for self definition and mood stabilization.
• There is an intense, driven quality to the activity which becomes self-perpetuating and resistant to change, compelling the person to continue while feeling the lack of ability to control or stop their behavior.
• Only the overuse of the body can produce the physiologic effects of deprivation, (secondary to exposure to the elements, extreme exertion, and rigid dietary restriction) which are an important component perpetuating the disorder.
• Although activity disordered individuals may have coexisting personality disorder, there is no particular personality profile or disorder which underlies an activity disorder. These persons are apt to be physically healthy, high functioning individuals.
• Activity disordered persons will use rationalizations and other defense mechanisms to protect their involvement in the activity. This may represent a preexisting personality disorder and/or be secondary to the physical deprivation.
• Although there is not particular personality profile or disorder, the activity disordered person’s achievement orientation, independence, self control, perfectionism, persistence, and well-developed mental strategies can foster significant academic and vocational accomplishments such that they are generally viewed as healthy, high functioning individuals.

Citation: De Coverley Veal, DMW:  “Exercise    Dependence”, British  Journal of Addiction
Volume 82, Issue 7,  pages 735–740, July 1987