Insulin-dependent (Type 1) diabetes: Some patients with type 1 diabetes may learn to manipulate their body weight by skipping insulin injections. The irregular injection pattern can lead to diabulimia, a life-threatening condition. 

·       Psychological factors

 

o   A history of anxiety disorder: Research shows that eating disorders often are preceded by anxiety disorders.  Eating disorders may develop in patients whose anxiety is left unmanaged long-term

o   Behavioral rigidity: Most people who suffer from anorexia always obeyed rules as children. They felt that they had to do things in only one right way.

o   Negative body image: Body image is how you feel in and about your body. Having low self-esteem increases your dissatisfaction with your body and is a risk factor for developing an eating disorder.

o   Perfectionism: A significant risk factor for eating disorders is self-oriented perfectionism. It involves setting unrealistic expectations for yourself.

 

·       Social factors

o   Weight stigma: Societal stigma around body shape and size can be a factor in someone’s low self-esteem or negative body image.  This can be a contributing factor to both developing an eating disorder and also to difficulty recovering from one

o   Bullying or teasing: The damaging effects of teasing, bullying, and weight shaming during childhood or adolescence are significant risk factors.

o   Cultural adaptation: A rapid assimilation into a different culture can affect your body image negatively. There can be variation from culture to culture about the standard of beauty and this mixed messaging can be damaging.

o   Limited social support: A lack of social support is a major risk factor for not only developing an eating disorder but many other mental health issues as well.

 

·       Environmental factors: 

o   Dysfunctional family dynamics: Negative emotions arising from difficult family relations can lead you to seek solace in unhealthy eating behavior.

o   Careers and professions that promote weight loss and being thin such as modeling and ballet often enhance unhealthy food restrictions.

o   Sports with aesthetic orientation: Some types of competitive games emphasize on lean bodies to enhance performance. Such sports include diving, dancing, wrestling, gymnastics, and long-distance running.

o   Cultural and peer pressure:  Co-workers and friends can influence you to maintain a particular body shape or weight in order to belong or avoid being teased

o   Traumatic events in your childhood, such as sexual or physical abuse can trigger eating disorders. As a survivor, you may struggle with feelings of lack of control, body dissatisfaction, guilt, and shame. The disorder may be your way of attempting to manage these deep emotions and regain control. 

 

Symptoms of Eating Disorders

 

Eating disorders manifest in a range of symptoms. However, the majority of symptoms fall under bingeing, inappropriate purging, or severe food restriction. If you are battling an eating disorder, you may not experience all the symptoms, and they may vary across different conditions. Experiencing some of these symptoms is an indicator that you have a problem that needs to be taken seriously and addressed.

 

Symptoms of binging include:

·       Consuming excessive amounts of food at once

·       Switching between episodes of fasting and overeating

·       Being addicted to and having uncontrollable cravings for particular foods

·       Feeling a lack of control over the excessive eating

·       Hoarding food to consume later

·       Eating large portions of food even when you do not feel hungry

·       Eating until you become uncomfortably full

 

Signs of purging behaviour include:

·       Self-induced vomiting to prevent weight gain

·       Feeling a need to get rid of calories that you consume even after a regular meal

·       Frequent bathroom visits after meals

·       Excessive exercise

·       Using diuretics or laxatives

·       Feeling too full even when you consume very little food

·       Denying feelings of hunger even when you have not eaten anything

 

Restrictive behaviour involves:

·       Refusing to eat particular foods and eliminating entire food categories such as carbohydrates or dairy

·       Having unusual food rituals such as consuming only specific food groups, not allowing foods to touch, eating tiny bites at a time or excessive chewing

·       Feeling uncomfortable when eating with others 

·       Taking smaller food portions during regular meals or skipping meals entirely

·       Frequent dieting despite being dangerously underweight

·       Avoiding family, friends and social functions where food may be available

·       Obsession with your body image, weight, food, and calories

 

Treatment 

 

Eating disorders are treatable. With the right modality, you can overcome unhealthy eating behaviour and resume a healthy life. Treatment of eating disorders occurs at different levels of care. 

 

Inpatient care

 

Inpatient care is where you receive treatment in a care facility away from home. It is necessary when:

·       You are unstable, or your vital signs are compromised

·       Your laboratory tests show an acute health risk

·       You experience complications due to a coexisting illness

·       You are psychologically unstable and show symptoms of rapid deterioration or suicidal tendencies. 

The main objectives of inpatient treatment are:

·       Psychological and medical stabilization

·       Normalizing nutrition and interrupting disordered eating behaviour

·       Developing treatment goals and a plan to prepare you for a lower level of care

 

Depending on the severity of your symptoms, you can get any of the following inpatient treatment programs.

·       Hospitalization: This program may be necessary if you have severe mental or physical health problems. The goal is to start the process of normalizing your eating habits and weight as a way of stabilizing acute medical symptoms. 

·       Partial hospitalization: This treatment program will help you to transition between the hospital and your home successfully. It is an action plan that provides structured support and therapeutic care during daytime and fosters real-life experiences and independence in the evenings. It can also benefit you if you do not need hospitalization but require attention beyond what outpatient treatment can provide.

·       Residential treatment: The residential program involves living in a treatment facility for eating disorders temporarily. It is beneficial if you have been in hospital previously, but your physical or mental health has not improved. It is also suitable when you need long-term care to manage your eating disorder.

 

Inpatient care will help you to:

·       Eliminate your disordered eating behaviour such as bingeing, purging, and food restriction

·       Achieve an intuitive and mindful relationship with eating

·       Gain acceptance and peace with your body

·       Challenge aspects of your life that maintain the eating disorder

·       Deal with co-occurring conditions such as anxiety disorders and depression

·       Enhance your ability to cope with emotions and create relationships

·       Improve your perception of self-worth and develop a value-based lifestyle.

 

Outpatient care

 

Outpatient care is a critical component when you are tapering off from a higher level of care, and you need consistent support as you continue recovering, if you have previously been unsuccessful in-patient or your eating disorder symptoms are problematic but still allow you to function in your life.  The intensity of treatment will vary from case to case, it could be daily for some people, weekly for others or monthly for patients who are on well on their way to recovering. The treatment can involve medical care, therapy, nutrition education, and structured eating sessions. It specifically gives you the support system you need to make a full, sustainable recovery. 

 

Outpatient care is suitable when:

·       You are medically stable and do not need medical monitoring daily 

·       You are psychologically stable, and your symptoms are sufficiently under control. You can function in regular educational, social, and vocational settings and continue to recover.

 

Get Help for Your Eating Disorder

 

If you do not seek treatment, the physical, emotional, and mental symptoms of eating disorders can result in potentially fatal health problems. However, proper health care can help you to resume appropriate eating habits and restore your emotional, psychological, and physical health. Talk to an eating disorder expert who will guide you to manage your symptoms and focus on healthy living.