Causes and Treatments for Eating Disorders

Eating disorders are serious mental illnesses beyond just food, encompassing conditions like anorexia, bulimia, BED, ARFID, and OSFED. They stem from a mix of genetic, biological, psychological, and socio-cultural factors. Diagnosis involves medical and psychological evaluations. Treatment includes therapies (CBT, FBT, DBT), medical care, and nutritional guidance.

Imagine feeling either guilty or ashamed every time you eat something, or feeling a compulsive need to exercise all the time. This is a common experience for those suffering from eating disorders. 

An eating disorder is a serious mental health condition that not only affects your relationship with food but also affects physical, mental and emotional health. It affects almost every aspect of your life, including your confidence, relationships, body image and the choices you make on a daily basis.  

Most of us think that eating disorders are only associated with food, eating habits and exercise. But the truth is, eating disorders are much more complex and have various types. 

The common types of eating disorders are: 

1. Anorexia Nervosa: 

This type is characterised by excessive food restrictions and an intense fear of gaining weight, along with a distorted body image. This can lead to extremely low body weight and numerous health conditions.  

2. Bulimia Nervosa

This is characterised by patterns or repetitive cycles of binge eating followed by compensatory behaviours, such as self-induced vomiting, excessive exercise, or misuse of laxatives. 

3. Binge Eating Disorder (BED)

This type is characterised by cycles of binge-eating without the compulsory behaviour such as vomiting or excessive exercise but paired with intensive feelings of guilt, distress and shame. 

4. Avoidant/Restrictive Food Intake Disorder (ARFID):

This type involves limited food consumption because of causes other than a desire to lose weight. These could include sensory sensitivities, fear of choking, or lack of interest in eating. 

5. Other Specified Feeding or Eating Disorder (OSFED) 

This is a category of disorders that don’t necessarily fit strictly into any of the above diagnoses. It can include atypical anorexia nervosa, bulimia nervosa of low frequency and/or limited duration, binge-eating disorder of low frequency and/or limited duration, purging disorder, and night eating syndrome.

What causes eating disorders​

Eating disorders can affect anyone regardless of their age or cultural background. While there are numerous causes of eating disorders, what can cause eating disorders is difficult to pin down. It usually involves a complex combination of causes such as: 

1. Genetic and Biological Factors 

Those with a family history of eating disorders are at an increased risk of developing eating disorders. This suggests that certain genetic predispositions might influence neurological functions and personality traits that contribute to eating disorders. There are other biological contributors, such as hormonal imbalances or imbalances in brain chemicals, such as serotonin and dopamine, which regulate mood and appetite, that may contribute to the development of eating disorders.

2. Psychological and Emotional Factors

Mental health conditions such as obsessive-compulsive disorder (OCD), anxiety, and depression can aggravate or coexist with eating disorders. Perfectionism, low self-esteem, and body image issues can also be associated with eating disorders. Difficulty coping with emotions and managing stress can also be contributing factors.

3. Environmental and socio-cultural factors 

Unrealistic beauty standards and the amplification of that through social media can significantly contribute to eating disorders. The pervasive promotion of dieting and weight loss can normalise restrictive eating practices and create a preoccupation with food and weight. Family dynamics, including parental attitudes toward food and weight, can influence a person's relationship with food. Experiencing traumatic and stressful events can also be a large contributing factor. 

How to get a diagnosis for eating disorders? 

There are various ways to get a diagnosis for an eating disorder, but it isn’t as simple as a blood test. A diagnosis requires a comprehensive evaluation by a qualified professional.

Here's how eating disorders are assessed:

1. Physical and Medical examination

A doctor will conduct a thorough test to identify physical signs of eating disorders, such as weight changes and blood pressure, and may even perform a blood and urine test to assess deficiencies. The doctor will also gather information on your and your family’s medical history in relation to eating disorders. 

2. Psychological Evaluation:

This evaluation is conducted by a mental health professional through an interview where they assess your thoughts and feelings towards food and evaluate your behaviours towards the same. They will ask about your eating habits, any history of dieting or weight loss, and any symptoms of anxiety, depression, or other mental health conditions. They will refer to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to diagnose eating disorders.   

Treatment for eating disorders 

Navigating eating disorders can feel extremely overwhelming. The good news is that there are multiple eating disorder treatment options available to you and recovery is possible. Treatment for eating disorders is usually multifaceted, involving a combination of therapies and support systems such as: 

1. Psychotherapy: 

Therapy is central to the treatment plan for eating disorders. Some types of therapy that can help are:  

• Cognitive Behavioural Therapy (CBT): This therapy helps individuals identify and change negative thought patterns and behaviours related to food, weight, and body image.   
• Family-Based Therapy (FBT): This approach involves family members in the treatment process. It focuses on helping families support their loved ones in restoring healthy eating habits.
• Dialectical Behaviour Therapy (DBT): DBT helps individuals regulate emotions, manage stress, and improve interpersonal skills.  

2. Medical Care, Monitoring and Medication:

Regular medical checkups are extremely important to address any complications arising from the eating disorder. This may include monitoring vital signs, electrolyte levels, and organ function. While medication is not a cure for eating disorders, it can help manage symptoms and improve overall well-being.

3. Nutritional Counselling:

A registered nutritionist can play an important role in helping people with eating disorders develop and maintain healthy eating habits. 

4. Hospitalisation or Residential Treatment:

In certain severe cases, hospitalisation may be necessary to provide intensive care needed to stabilise the individual's health. This level of care is recommended for individuals with severe malnutrition, medical complications, or suicidal ideation.

How to support someone with eating disorders 

Supporting and caring for someone with an eating disorder can be challenging but your support can make a huge difference. Here are a few ways you can help: 

1. Educate yourself about eating disorders 

Learn about eating disorders and the types of eating disorders. They are complex mental health conditions, and understanding their causes can help you empathise and avoid misconceptions. 

2. Encourage Professional Help and offer support 

Let them know you're there for them and that you want to help them get the help they need.

Eating disorders require specialised care. While encouraging professional mental health care, provide information about therapists, treatment centres, and support groups.

3. Avoid Triggering Behaviours:

Unintentionally, our words and actions may trigger someone struggling with an eating disorder. There are certain things you can do to make sure this happens. For example, refrain from talking about your weight or dieting habits or avoid making negative comments about food or eating.

Recovery from an eating disorder is possible. With the right support and treatment, individuals can reclaim their lives and build a healthier relationship with food and their bodies. Early intervention can make a big difference. If you or someone you know is struggling, remember that help is available, and healing is possible.