blog #3- “Does Family or Culture have more of an influence on the occurrence of eating disorders?”

Blog #3- “Does Family or Culture have more of an influence on the occurrence of eating disorders?”

As mentioned in my project plan, this post will be an explanation of the different types of eating disorders, and why is it important to differentiate them.  In order to further dive into the occurrence of eating disorders, I believe addressing that eating order comes in different shapes and sizes is important because it’s not as simple as being anorexic.

“Feeling guilty for eating when you’re hungry is like feeling for breathing when your lungs need oxygen. We’ve literally been taught to be ashamed or our basic human needs. Refuse to feel the shame. You are allowed to eat.”  [1]

Eating disorders are mental illnesses.

This had been recognized by the Diagnostic and Statistical Manual of Mental Disorders) since the 1980s. [2] Moms often tell their child, “if you don’t eat, your brain cannot work properly!”. Our brain’s function is impacted, showing signs of problems physically and mentally when we’re struggling with an eating disorder. Eating disorder looks different in everyone. It’s not guaranteed that you’ll experience all the signs and symptoms, but generally speaking, they look like this: [3]

Anorexia Nervosa:

This is likely the most well-known eating disorder. It usually develops during the preteen stages, more common in females than males. [4]

• Limiting food intake, leading to low body weight for one’s age and height [3]
• Extreme fear of fat gain and weight gain [3]
• Over relying on numbers and scales to prevent the increase of weight, even though the individual is underweight [3]
• Severe struggle with body image, denial that they are underweight [3]
• restricted eating pattern, comparing one’s body to another of the same age group [4]
• Unwillingness to maintain a healthy weight [4]

2 subtypes of anorexia: [4]

• Restricting
  • Individual lose weight only through dieting, fasting, excessive exercise 
• Binge eating + Purging
  • individuals will binge on a large amount of food or eat very little
  • after both cases, they purge: vomiting, laxative, diuretic, excessive exercising

Bulimia nervosa : 

Another well-known eating disorder. [4]

• Huge amount of calorie intake, usually till an individual is painfully full [4]
• Feels out of control during a binge episode [3]
• usually occur with foods individual would normally avoid [4]
• Purge attempt after episode to compensate and relieve gut discomfort [4]
• Purge: fasting (not eating for a period of time, and then eat within a set period of time), laxatives, diuretic, excessive exercise [4] often happens a least once a week for 3 months [3]
• overly obsessed with body weight and shape [3] which affects self-esteem

While Bulimia appears similar to the binge-eating/ purging subtype of anorexia nervosa, one with bulimia usually maintains a relatively normal weight rather than underweight.

Binge eating disorder: 

This is one of the most common eating disorders, especially in the States. It can develop after adolescence and the early adulthood period. Symptoms are fairly similar to bulimia and binge/ purge subtype of anorexia nervosa.

• happens at least once a week for 3 months [3]
• eating more food in a specific period than feel out of control of overeating behaviour [3]
• feels distressed: shame, disgust, guilt [4]
• they DON’T restrict calories or purge to compensate [4]

What does an episode look like (at least 3/5) [3]

1. eating much fast than normal

2, eating until uncomfortable full

3. eating a huge amount of food even when not feeling hungry

4. eating secretly/ alone out of shame

5. feeling disgusted, depressed, extreme guilt after bingeing.

People with this disorder often have overweight or obese.

Purging disorder: 

• purging behaviours: vomiting, laxatives, diuretics, or excessive exercising, to control their weight or shape [4]
• they DON’T binge

Pica: 

This involves eating things that are not considered food. There’s no cause of pica, in some cases, iron deficiency, zinc deficiency or other nutrients may be associated with pica. This can occur at any age. [4]

• crave non-food substances: ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent, or cornstarch. [4]
• increased risk of poisoning, infections, gut injuries, and nutritional deficiencies.[4]
• Pica may be fatal [4]

Rumination disorder: 

This is a newly recognized eating disorder [4], a rare behavioural disorder in which food is brought back up from the stomach either rechewed, reswallowed or spit out [5]. Can be developed any time, but tend to develop between 3-12 months of age and often disappear on it’s own. As you get older, it usually requires therapy to solve it. [4]

• happens within 30 minutes after a meal, it’s voluntary. [4]
• The food will describe normal tasting, which means it’s undigested [5]
• It’s not a conscious action [5]
• will result in weight loss, possibly fatal.

Avoidant/ Restrictive food intake disorder: (ARFID)

This is to replace what was called “selective eating disorder”. [6] It’s similar to anorexia as both involved the limitation of food consumed. AFRID DOES NOT involve any distress about body size, fear of fatness etc.

• disturbed eating due to lack of interest in eating or distaste for certain smells, taste, colour etc. [4]
• avoidance of food
• eating habits interfere with normal social functions: eating with others
• dependence on supplements or tube feeding
• usually happens to children under 7 [4], results in a calorie deficit and growth problems [6]

Other Specified Feeding or Eating Disorder (OSFED): 

A class of eating disorders does not meet the full criteria of other eating disorders mentioned above. [7]

• Atypical Anorexia Nervosa:
  • The individual is within or above the normal weight range
  • All criteria for anorexia nervosa are met.
• Binge eating disorder of low frequency/ limited duration
  • Lower frequency and/or for less than three months
  • All of the criteria for binge-eating disorder are met.
• Bulimia Nervosa of low frequency and/or limited duration
  • binge eating and inappropriate compensatory behaviour occurs at a lower frequency and/or for less than three months
  • All of the criteria for bulimia nervosa are met.

Night Eating Syndrome: 

The need to compulsively eat at night. Most of the calories consumed during the night. [7] People who exhibit night eating syndrome experience clinically significant distress and impairment.

• lack of appetite in the morning [8]
• a strong urge to eat between dinner and sleep [8]
• insomnia 4-5 nights a week [8]
• thinks eating is necessary in order to sleep
• depressed mood that worsens during the evening [8]

Orthorexia Nervosa: 

This disorder involves an unhealthy obsession with healthy eating. [9] Usually happens to healthcare workers, opera singers, ballet dancers, athletes regardless of age and gender.

• quality matters more than quantity
• extreme fixation with the “purity” of their food
• risk: tendencies towards perfectionism, high anxiety, need for control

It’s important to know the differences between different eating disorders because treatment is crucial if you figure you have an ED. It can be detrimental to your physical as well as mental health. Treatments for different ED are different, therefore it’s important that we can differentiate them. for ourselves as well as people around us. It’s also important that we avoid mentioning one’s appearance, weight as well as dieting, food, exercises in front of a person who’s recovering from an ED. It triggers their ED into a relapse, just like a drugs/ alcohol relapse, because having an ED can be just as addicting as substance abuse.

1. https://www.healthyplace.com/insight/quotes/quotes-on-eating-disorders
2. https://www.waldeneatingdisorders.com/blog/are-eating-disorders-mental-illnesses/
3. https://www.psycom.net/depression.central.eating.html
4. https://www.healthline.com/nutrition/common-eating-disorders#anorexia
5. https://www.cedars-sinai.org/health-library/diseases-and-conditions/r/rumination-syndrome.html#:~:text=Rumination%20syndrome%20is%20a%20rare%20behavioral%20disorder%20in%20which%20food,means%20it%20is%20still%20undigested.
6. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid
7. https://breakbingeeating.com/types-of-eating-disorders/#Other_Specified_Feeding_or_Eating_Disorder_OSFED
8. https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/what-is-night-eating-syndrome
9. https://www.healthline.com/nutrition/orthorexia-nervosa-101#:~:text=Orthorexia%2C%20or%20orthorexia%20nervosa%2C%20is,on%20losing%20weight%20(1).