Most parents of kids and teens are aware of major eating disorders such as anorexia and bulimia, but are not always familiar with other types of disordered eating. Anorexia is defined by a pervasive pattern of restrictive eating, desire for thinness, fear of gaining weight, and low body weight. Bulimia is a cycle of eating large quantities of food until uncomfortably full (binging) and utilizing compensatory strategies to prevent caloric intake (purging). Overall, eating disorders are complex combinations of psychological and physical symptoms and approximately 9% of the US population, or 28.8 million Americans will struggle with an eating disorder in their lifetime (Deloitte Access Economics, 2020). This statistic encompasses many more presentations than anorexia and bulimia alone.
Feeding & Eating Disorders
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), eating patterns are found under the heading of “Feeding and Eating Disorders.” Feeding disorders are characterized by difficulty with food intake not related to appearance and weight concerns. Feeding Disorders include Pica (consumption of non-food substances), Rumination Disorder (repeated regurgitation of food) and Avoidant/Restrictive Food Intake Disorder (ARFID) (lack of interest in or fear of eating). Eating Disorders include Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge-Eating Disorder (BED) (repeated episodes of binge-eating without compensatory strategies). Patterns of eating that do not fit into the aforementioned categories are classified as Other Specified Feeding or Eating Disorders (OSFED). OSFEDs include Atypical Anorexia Nervosa (described below), Bulimia Nervosa (of low frequency and/or limited duration), Binge-Eating Disorder (of low frequency and/or limited duration), Purging Disorder (recurrent purging behavior in absence of binge-eating), and Night Eating Syndrome (described below).
Below are brief outlines of other eating disorder presentations for parents to be aware of:
Other Specified Feeding and Eating Disorders
Atypical Anorexia
Every criteria for Anorexia is met except for low body weight (BMI)
Stigmatization and perceived illness controllability are associated with this diagnosis due to lack of low body weight or appearance of “being sick.”
People with this presentation are less likely to be diagnosed with an eating disorder.
However, less than 6% of people with eating disorders are medically diagnosed as “underweight.”
Night Eating Syndrome
Not considered to be sleepwalking or a parasomnia
Waking up multiple times throughout the night with urges to eat
Feeling like you will not sleep if you do not get up to eat
Lack of control over urges to eat in the middle of the night
Other Recognized Patterns of Disordered Eating
“Diabulimia”
“Diabulimia” occurs in those who have Type 1 diabetes.
Purposeful insulin restriction for weight loss
Individuals may restrict only insulin (purging) or food and insulin (restriction and purging)
Causes many health complications including Diabetic Ketoacidosis or DKA (buildup of harmful acids in the blood)
“Drunkorexia”
Restricting or purging food to compensate for calories consumed in alcohol
Causes increased effects of alcohol
Can cause malnourishment and alcohol-related health conditions
Increased risk of sexual assault
“Orthorexia”
Pervasive preoccupation with eating certain foods (organic, non-GMO) and cutting out other foods (meat, dairy, high sugar content)
Inflexibility, food rules
Individuals experience distress over difficulty following food rules due to circumstantial or environmental factors
Individuals may criticize others’ eating habits
“Bigorexia”
Also called muscle dysmorphia
Preoccupation with diet and excessive exercise to increase muscularity
Feeling unmuscular despite having significant muscle mass
Skipping a workout may cause great distress
Co-occurring use of supplements and steroids
If you are interested in learning more about disordered eating and similar concerns, check out our other posts:
If your child struggles with feeding, disordered eating, or has been diagnosed with an eating disorder, it is important to seek professional help!
For more resources on Feeding and Eating Disorders check out:
At Balanced Minds Psychology & Wellness we specialize in assisting teens and children with navigating life’s challenges. To learn more about me and the services I provide, checkout my profile. If you are ready to start the therapy process, contact us today to start a free consultation, either over telehealth or in person!
Reference:
Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the
United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.