Almost 30 million people - ranging in age, gender, and race - suffer from an eating disorder. Most people are familiar with the more common diagnoses, like anorexia and bulimia, there are numerous other eating disorders that may surprise (and disgust) you. The following disorders are often unknown by most, they are very real and pose very serious threats to those suffering from them. If experiencing any alarming symptoms related to these (or any other eating disorder), do not be afraid to seek immediate professional help.
1. Selective Eating Disorder (SED)
It is more than likely that you have been called a “picky eater” at least once during your life. One is often identified by this term if they aren’t adventurous with their diet, prefer non-adventurous foods, or are just "high-maintenance." While this may be true of some, an eating disorder known as Selective Eating Disorder will make you think twice about what your pickiness truly means. Selective Eating Disorder (SED), is an eating disorder that causes individuals to truly believe there is only a certain amount of foods they can eat. Specialists typically associate SED with neo-phobia - a fear of the new. Selective Eating Disorder is often overlooked by therapists and doctors because they believe the patient to identify as a "fussy eater." According to The Heath Therapies, "Fussy eaters are often merely picky or play on the preferential treatment or special attention they get, but they are not phobic!"
Even though selective eaters are often considered "stubborn", research shows that individuals with this severe case of being a “picky eater” actually experience food differently than the rest of the population. If you suspect that you know someone dealing with Selective Eating Disorder, approach the topic with great sensitivity. Since this eating disorder is also identified as a phobia, it is more than likely that they associate certain foods with pain and debilitating fear. It is safe to assume that if an individual is suffering from SED, they are in some way malnourished. Granted, they may not be starving or dying, but healthy diets consist of variety. The longer and more severe these crippling thoughts become, the more serious the disorder is. If you believe that you may know someone who isn't just a "picky" or "fussy eater", it is important to seek professional help. Specialists use psychotherapy and often time various supplements in order to provide patients with coping mechanisms and a healthier lifestyle.
While regurgitation is normal in some animals (such as cows or birds), there are cases in which regurgitation does occur in otherwise healthy individuals. According to the National Eating Disorders Association, an eating disorder known as Rumination is defined as “The regurgitation of food that has already been swallowed. The regurgitated food is often re-swallowed or spit out.” According to Nicholas J. Talley (MD, PhD), an affected individual experiences related symptoms usually 1-2 hours after most meals. In the past, the majority of recorded cases occur in infants with disabilities, although the disorder can start anytime during one’s life, even if previously experiencing normal digestion. Specialists consider Rumination as a type of learned bodily function in which the body adapts to the repeated so-called “belch”, rather than a conscious decision made by an individual; however, when an individual makes the choice to either re-swallow or spit out the regurgitated food, it often leads to malnutrition. Due to a lack of field market research and studies, such symptoms are often mistaken for other digestion disorders like Gastroparesis, GERD, or Acid reflux.
The reason for common misdiagnoses is often due to a patient misinterpreting their own symptoms, explaining symptoms that define other, more common digestive disorders. Without such details, it is common for medical professionals to treat patients for “vomiting” (with medication or psychotherapy), assuming it is in their control. Medical professionals unanimously agree that the identifying symptom for Rumination is that when an individual “vomits” food or liquid back up, it is undigested and tastes good. When regurgitated food isn’t acidic or "gross-tasting", an individual suffering with Rumination will feel the need to either chew and re-swallow the food or spit it out. There are even some cases in which the act of re-swallowing this food provides the patient with a sense of pleasure. If experiencing such symptoms and you are concerned that you have been misdiagnosed, make sure that your doctor is well-aware of your entire medical history and asks for detailed explanations of your symptoms (i.e. how a patient identifies “vomiting”).
3. Muscle Dysmorphia
While most people are familiar with anorexia, its counterpart - Muscle Dysmorphia - tends to be overlooked. Also referred to as “bigorexia” or “reverse anorexia”, Muscle Dysmorphia causes individuals to have extremely distorted self-images that negatively impact their daily lives. When an individual is consumed with the obsession or fear that their body is undeveloped or too skinny, these feelings of inadequacy cause an individual to alter their diet and fitness routines. Due to the fact that there is limited research on this topic, medical professionals have been unable to determine the exact cause of this disorder. With this fact, the McCallum Place Eating Disorders Center explains several factors that increase the risk of suffering from muscle dysmorphia. Such factors include:
1. Work environments where weight, image, and appearance is an important factor, such as in modeling, acting, ice skating, dancing, or body building",
2. A history of being bullied or teased in childhood
3. Past trauma including seeing a mother experience domestic violence
Like all other eating disorders, it is extremely important to seek professional help. Seeking appropriate treatment for this disorder is important for both the mental and physical well-being of the patients. Similar to any other eating disorder, the symptoms associated with Muscle Dysmorphia effect the mindset of those suffering from it, impairing their mood, behavior, or ability to manage stress. Such changes often include an unhealthy increase in muscle-building exercises, excessive intake of diet supplements and steroids, wearing baggy clothes in order to hide the body, and showing signs of of avoiding social events. These lifestyle changes that result from long-term muscle dysmorphia have the potential to lead to damaged muscles, cartilage, tendons, ligaments, or joints. Muscle dysmorphia is classified as a muscle dysmorphic disorder, and can be cured with proper treatment that addresses its underlying issues and provides the patient with coping mechanisms.
4. Night Time Eating Disorder
Sometimes at the end of a long day, a midnight snack is the perfect treat. While a midnight snack here or there isn’t frowned upon, the extreme urge to binge late at night is considered an eating disorder. The severity of Night Eating Disorder is diagnosed on a continuum. While some only experience this disorder a couple times a week, there are more severe cases in which some people deal with these urges every night. Unlike sleep walking, Night Eating Disorder occurs when an individual is fully awake. The urge to binge defining this eating disorder can either occur before falling asleep, or even cause an individual to wake up in the middle of the night with intense cravings that don’t subside until they ease those cravings. Depending on which study you read, the amount of people suffering from this disorder ranges from about 1.5 - 5% of the population.
Night Eating Disorder is more common than anorexia or bulimia. Onset of such cravings typically occurs in individuals in their late 20s to early 30s. Studies show that SED is most commonly brought on by a stressful event in which the individual turns to food as source of comfort. Recent trials used the medication sertraline to treat SED, approaching the urges to be connected to serotonin levels in the body. Studies suggest that SED is hereditary, and that both pharmacological and non pharmacological treatments are successful in reducing symptoms. According to Kelly C. Allison, Ph.D., individuals suffering from SED regularly consume at least 25% of her calories after a filling dinner. Often untreated due to embarrassment of the patient, it is important to manage the cravings and desires caused by SED with professional help!
5. Nocturnal Sleep Related Eating Disorder
Even though Nocturnal Sleep Related Eating Disorder (NSRED) also occurs during the night, several defining characteristics differ this disorder from the previously discussed Nighttime Eating Disorder (NED). Similar to NED, NSRED is classified as both a sleeping and eating disorder, affecting 1-3% of the general population. Research shows that like all eating disorders, NSRED is most common in women under the age 50; however, as age increases, so do the frequency of binging episodes during the night. While NED causes an individual to wake up from their cravings and desire to eat, NSRED binging episodes occur while an individual is either completely asleep, or somewhere between awake and asleep. These sleepwalking trips may occur only once during the night or numerous times; however, upon waking up, the individual will have little-to-no memory of the previous night's events. Due to this fact, the mess they left while eating will typically make individuals extremely worried and confused for both their safety and mental well-being.
Due to the fact that the individual is asleep and not aware of their actions, behavior during NSRED episodes tend to be fast, reckless, and messy. Studies show that in addition to this aggressive behavior, individuals will most likely consume unlikely items (i.e. butter and uncooked food), or even consume non-edible items (i.e. cigarettes, wood, trash, dirt, etc.) Detailed studies have also lead scientists to worry that such episodes have the potential to harm the individual or those around them in ways such as ingesting raw meat, or knocking over potentially flammable or toxic items around the kitchen. Knowing this, if an individual believes that he/she may be suffering from NSRED, they will most likely strategically hide the food away from the kitchen; however, studies show that nighttime binging episodes of NSRED do not cause individuals to solely sleepwalk to the kitchen, but instead travel to wherever they know food is located. Nocturnal Sleep Related Eating Disorder can be easily diagnosed; however, most people suffering from such symptoms do not seek medical help because they feel ashamed or embarrassed of their behavior. If left untreated, NSRED can lead to depression, Type 2 Diabetes, obesity, and hypertension. Believed to be caused by underlying issues, specialists approach NSRED with two forms of treatment. Specialists often prescribed medications that target the portion of the brain that focuses on appetite and satisfaction, in order to reduce any unconscious desire to snack while asleep. Cases have also been recorded that associate this nighttime binging with intense dieting, causing hungry dieters to binge while asleep, even if they are strong-willed and dedicated to their diets during the day. Psychotherapy is also suggested to overcome NSRED, aiming to address possible negative self-perceptions, thoughts, or behaviors that cause the body to secretly binge.
According to the American Diabetes Association (ADA), individuals suffering from with Diabetes or any similar autoimmune disorder are 2.4 times more likely to develop an eating disorder - especially if diagnosed as an adolescent. Medical professionals associate this shocking statistic with the belief that the detailed list of dietary restrictions placed on Diabetics condition them to obsess about food, calories, and body image. One specific eating disorder has been known to effect the majority of Type 1 Diabetics - Diabulemia. An individual is said to be suffering from Diabulemia when - in addition to being diagnosed with Type 1 Diabetes - they manipulate insulin doses in order to lose weight or prevent weight gain. Clinicians often fail to diagnose or refuse to acknowledge the existence of this disorder, since medical schools do not provide them with a list of symptoms or behaviors that define Diabulemia. Even though most medical professionals fail to identify Diabulemia as an eating disorder, most specialists and endocrinologists follow guidelines which state an individual experiences "insulin reduction at least twice a week or of over one quarter of the prescribed insulin for the purpose of weight loss for more than three months" (ADA). Although the ADA has completed several comprehensive studies on the topic over the past decade, the term wasn't even acknowledged by the public until 2007, when it began receiving attention in various magazines and health journals.
To understand why altering one's prescribed hormone doses is a serious health risk, it is important to understand the importance of insulin in the body. Produced by the pancreas, insulin is an anabolic storage hormone that aids in fat storage, and manages the body's caloric use. Insulin allows the body to break down sugar to use for energy, rather than breaking down muscle tissue and necessary fat. When the body is unable to produce insulin, the body desperately begins to digest itself for energy, since it is unable to properly breakdown sugar in the bloodstream. It is extremely important to seek professional help if you, or someone you know is suffering from Diabulemia. If an individual does not receive the necessary amount of insulin, they drastically increase their risk for serious health complications. Families are often unaware of the negative effects that this debilitating disorder has on the body, since individuals suffering from Diabulemia display otherwise normal eating and exercise habits. In addition to fatigue, psychological harm, dehydration, muscle loss, and severe damage to organs, nerves, and eyesight, Diabulemia is known to speed up negative symptoms and results associated with Diabetes (i.e. limb amputation).
7. Orthorexia Nervosa
With easy access to comprehensive research regarding health, it is no secret that everyone should adapt a healthy diet. Countless magazines, television shows, medical journals, and advertisements focus on ways to live a healthy lifestyle through diet and exercise. While most people do their best to eat their fruits and veggies and avoid junk food, it is possible for people to take healthy eating so seriously that it becomes dangerous. Orthorexia Nervosa is an eating disorder that causes an individual to develop an overwhelming, unhealthy obsession to eat right. This eating disorder may begin with good intentions, as a simple diet due to religious beliefs, health concerns, or allergies; however, eating healthy becomes a concern when the obsession with the "right foods" begin to negatively impact other aspects of everyday life. The strict limits that an individual places on himself/herself come from foods that they individually believe are healthy or unhealthy, even if others do not. As the patient begins to see positive results from healthy eating, they begin to feel superior to others who don't maintain such a diet. While eating correctly pleases them, if an individual dealing with Orthorexia Nervosa experiences a slip-up, they will use tactics such as fasts, extreme exercise, and the installation of even stricter diet guidelines in order to punish themselves. If this disorder is not addressed and treated properly, the guidelines a patient sets will be come stricter, causing a patient to eat less and less.
In order to properly function, the body needs a sufficient amount of calories, coming from a variety of different foods. When individuals suffering from Orthorexia Nervosa only consume "the healthiest" calories, they are avoiding some necessary nutrients that are found in foods that they classify as "not-so-healthy." For example, if adapting an extreme vegan diet, one will not consume sufficient amounts of vitamin B12 (largely found in animal proteins), and as a result - the metabolism will not be able to function properly or efficiently. Even though such behaviors lead to malnutrition, Orthorexia Nervosa is even acknowledged by most medical professionals, who believe that the harmful obsessions are a result of Obsessive Compulsive Disorder (OCD) rather than an eating disorder. Due to this fact, accurate diagnosis of Orthorexia Nervosa largely depends on the honesty of the patient and the thoroughness of the doctor's observations. Like all other eating disorders, Orthorexia Nervosa is addressed with psychotherapy, and often times medication. It is important to seek professional help if suffering from Orthorexia Nervosa, in order to properly treat and heal both your mind and malnourished body.
As complicated and strange as it sounds, there is actually an eating disorder that causes individuals to want to have an eating disorder. Categorized by the National Eating Disorder Association as an "Eating Disorder Not Otherwise Specified" (EDNOS), Wannarexia is the obsessive desire to be considered anorexic by others. ENOS is not considered as dangerous as other eating disorders, but is identified by "a constant focus on weight, occasional bingeing and purging, and chronic dieting" (USAToday). "Wannarexics" undergo numerous crash diets or occasional fasting in order to fulfill the desire to appear underweight and skinny enough that people worry. Almost exclusively appearing in teenage girls, there is limited research done regarding these misguided beliefs and desires. Numerous stories online share the beliefs of those s dealing with Wannerexia, explaining that (in their opinion) anorexic is both controllable and contagious.
In an article posted online several years ago by USAToday, Dr. Richard Kreipe shares a story in which helped a teenager overcome anorexia. After this teenager finished treatment, another girl from the same high school "wanted to know how much weight she would have to lose to be anorexic, just like the wealthy, thin, popular — and very sick — girl who had entered into treatment." Kreipe recalled that this same question had been asked of him several times before, by teenage girls who longed to be considered anorexic. Information provided from the limited research done on this topic shows that Wannarexia will most likely go away without any medical attention. Patients explain that either their lack of strong-will, boredom, or satisfaction from temporary dieting had caused them to "give up." Although research proves that almost all individuals suffering from Wannerexia will resolve their unhealthy choices on their own, symptoms of Wannerexia most likely indicate a greater underlying issue. The best way to address concerning thoughts and behaviors that may be related to Wannarexia (in addition to every type of eating disorder) is to seek professional help.
It is not uncommon for people to turn to food in order to ease stress, anxiety, depression, or other negative thoughts. If asked to define an eating disorder, most people would say something along the lines of being addicted to food or not eating; however, most people don’t realize that eating disorders do not have to be related to food. Specifically, one eating disorder known as Tricophagia, is defined by "compulsive eating of one’s hair” (trichstop.com). Several informational websites that discuss the signs and symptoms of this disorder make sure to inform readers that an individual does not have Trichophagia if they chew on the ends of their hair- which is a common habit in children. When medical literature explains this disorder, they identify it as a rare symptom of compulsive disorder known as Trichotillomania. Trichotillomania is "a disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to stop” (Mayo Clinic). Individuals suffering from both Trichotillomania and Trichophagia explain that they behave accordingly in order to cope with stress or anxiety - similar to any other addiction. A large number of cases regarding this hair-eating disorder discuss how patients sought comfort in this behavior by viewing it as sort of a “ritual”. For example, some explain touching the root bulb to the lips, tasting the hair, and occasionally chewing on the strand before swallowing it.
Although Trichophagia used to considered a symptom of a psychological disorder rather than an eating disorder, most medical professionals today understand its severity as both a psychological and eating disorder. After diagnosis, medical professionals recommend that the patient undergo psychotherapy sessions in order to identify any underlying psychological issues and learn coping mechanisms for the future. If not treated, the prolonged eating of hair can be harmful within the body. Although a healthy digestive system is able to pass hair within a few days, severe Trichophagia (consuming significant amounts of hair in a short period of time) can cause the hair to collect within the digestive tract, creating hairballs - or trichobezar. If the trichobezoar is extremely severe - known as “Rapunzel Syndrome” - the ends of the hair collect in the intestine and must be surgically removed in order to avoid death. It is important to seek professional help if you believe someone you know is suffering from Trichotillomania or Trichophagia as soon as possible.
Recently receiving attention from the public on television shows like “TLC’s My Strange Addiction”, many are common with this eating disorder; however, even though the symptoms may sound familiar, it is important to learn the potential harm associated with this eating disorder. If an individual suffers from the compulsive need to eat non-edible items that hold no nutritional value, they are said to be suffering from Pica. Mainly developed in young children, The Handbook of Clinical Child Psychology states that about 4-26% of the population suffers from this eating disorder. Some rare cases have been documented in which Pica is actually caused by pregnancy, malnutrition, and iron-deficient anemia. Although Pica sufferers have been known to consume countless types of inedible objects, studies reveal that it is most common to be addicted to eating chalk, dirt, lead, and sand. Due to the young age of the child or lack of honesty from older patients, Pica often times can’t be officially diagnosed without a proper medical evaluation. If such symptoms and related behaviors are ignored, often times the items being ingested have been contaminated with bacteria known to cause infection.
Although a doctor will only diagnose a patient with Pica if they have been experiencing its symptoms for at least a month, it is important to seek medical attention as soon as symptoms of Pica are expressed. A doctor will often prescribe a panel of tests (i.e. blood tests, x-rays, colonoscopy) in order to test for anemia, digestive issues, intestinal blockages, or toxicity in the bloodstream. If a patient possesses any of these symptoms, a doctor will continue with a physical exam, followed by learning about the patient’s full medical history and eating habits.In young children being tested for Pica, it is normal for a doctor to check for any signs of other disorders the patient may be suffering from. Disorders such as mental retardation, autism, anxiety, or obsessive-compulsive disorder have been known to cause irregular patterns in behavior or diet in order to cope with their overwhelming feelings. Proper treatment of is accomplished with help from both an eating disorder specialist and mental health team with experience in dealing with Pica; however, co-exisiting disabilities or disorders that a patient may be suffering from can make treatment difficult.
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