Classifying Eating Disorders
Eating disorders have been recognised by medical and mental health professionals since in early part of the 1970s as a formal diagnosis although the behaviours themselves have been present since the beginnings of civilisations. Symptoms and behaviours of anorexia are described in works from the 12th century and bulimia, binging and purging, was actually a routine activity of the wealthy during feasts in the Middle Ages.
With the development of specific diagnostic criteria specific medical and psychological treatment options were developed. Today, eating disorder treatment is seen as a team approach addressing the medical issues as well as the underlying psychological factors that are driving the behaviour.
Anorexia is perhaps the most commonly understood of the eating disorders. It can be found in both males and females from pre-teens to older adults and tends to be progressive in nature if not treated.
Anorexia is literally self-starvation where the individual becomes obsessed with their body shape, size and appearance. However, with the starvation also comes a distorted body image that doesn't allow the individual to see them as thin or anorexic, instead they see only a heavy person that needs to continue to restrict their food intake.
Anorexia can be fatal as the extreme caloric restriction leads to breakdown of all systems and organs in the body.
Bulimia is likewise a condition where the individual is obsessed with their body shape, size and their diet. However, a person with bulimia will diet and then binge, often eating thousands of calories in a single meal. Then, feeling extreme guilt, self-anger and shame, they enter the purge part of the cycle. This can include the use of laxatives, diuretics, self-induced vomiting or extreme exercising and fasting to try to offset the calories consumed.
Bulimia can also be a very serious medical condition. Often people with bulimia are not overly thin and may even be overweight or obese, which makes this an often overlooked eating disorder.
Binge Eating Disorder and Compulsive Overeating
Binge eating disorder or compulsive eating is different from bulimia in that there is no purge side to the eating cycle. Individuals that engage in compulsive eating often do so to numb themselves from negative emotions such as stress, anxiety, fear, depression and sadness. Often these feelings are brought on by their negative self-image and their desire to obtain a perfect body through diets that are unsuccessful or simply create more stress, anxiety and increase the risk of binging. People that have challenges with compulsive overeating feel out of control during the binge eating and, despite wanting to stop the behaviour, are unable to do so.
Binge eating typically includes hiding the amount of food consumed, eating only in private, eating very rapidly and consuming high calorie, fat and carbohydrate foods on the binges with chronic dieting between binges.
Eating Disorder Not Otherwise Specified (EDNOS)
Eating Disorder Not Otherwise Specified or EDNOS is the most common diagnosed eating disorder because it is a catch-all diagnosis. Individuals can have this diagnosis when there are some symptoms of anorexia or bulimia but not enough for a diagnosis. It is also the diagnosis if a patient were to have symptoms of both anorexia and bulimia or compulsive overeating.
EDNOS is also the diagnosis that occurs when a person has an atypical set of behaviours that are related to weight control, body image and behaviours that are not controllable by the individual.
As with all eating disorders, a diagnosis of EDNOS will require both psychological treatments to address the underlying mental health issues as well as medical support for current and future health conditions.