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FACT SHEET FOR PATIENTS AND FAMILIES

Eating Disorders

What are disorders? Eating disorders are dangerous and complex mental What do I need to do next? problems that often reflect how you feel and 1 Learn about the different types of eating how you think about yourself. Because they are disorders and the to often misunderstood and typically hidden, it can watch for in yourself or your family member be challenging to identify people affected by eating (page 2). disorders. 2 Review how eating disorders are diagnosed Treatment by a medical care team vastly improves the and treated on page 3. chances of recovery. If you think you or someone you 3 Check out the online and book resources care about might have an , reach out listed on page 4 to learn more about eating for help. Eating disorders can be overcome — leading disorders. to a happier, more hopeful life. 4 Ask your doctor for a copy of Eating Disorders: Conversation tips for friends and Anyone can develop an eating disorder. They families. This helps you start a conversation are most common in young women (teenagers and and make those conversations more young adults), but they can happen to people of any productive. gender, race, age, or weight. There are many types of eating disorders •• Often exercise obsessively to stay thin or to burn (see page 2). The most common areanorexia nervosa off what they eat [an-uh-REK-see-uh nur-VOH-suh] and [buh- •• Often have emotional issues such as LEE-mee-uh nur-VOH-suh]. These 2 disorders typically and involve periods of: What causes eating disorders? •• Dietary restriction — decreasing how much It’s not clear why some people have eating disorders someone eats by skipping meals or avoiding certain and others don’t. The cause is unique to each person’s foods and food groups. experiences, genetics, environment, and other •• (or binging) — eating an unusually personal factors. An eating disorder may stem from large amount in a short period of time. many factors, including: • Purging • — routinely throwing up or using •• A drive for perfection that can be fueled by media , enemas, or [die-uh-RET-iks] and cultural images of unrealistic thinness or by which are drugs that increase how much you family and friends who “fitting in” with a urinate (pee). certain body size, shape, or weight Eating disorders tend to occur in people who: •• Participating in sports that emphasize appearance •• Think about what they eat and their weight most (like gymnastics and figure skating) or where weight of the time gives a competitive advantage (like long-distance •• See themselves as fat, even when running and wrestling) •• Emotional and personality disorders, such as depression, anxiety, traumatic life events, and a desire for control or perfectionism 1 What are the types of eating How can eating disorders hurt disorders and signs to watch for? my life? The table below highlights the signs, types, and health In addition to the risks listed in the table below, risks of nervosa and bulimia nervosa. Other eating disorders can make school, work, and daily types of eating disorders vary greatly but can be just as tasks overwhelming. dangerous as anorexia or bulimia. Eating disorders can also cause you to have other Examples of other eating disorders include: serious health problems, such as: •• Binge-eating disorder (binge eating •• Mood disorders •• Obsessive-compulsive disorder without purging) •• Depression •• •• (purging without binging) •• Anxiety •• Suicidal thoughts •• Chewing (and then spitting out) large amounts of food Talk to your doctor about being checked for these other conditions.

Anorexia nervosa (involves self- and excessive )

Signs Types Health Risks

•• Low body weight •• Restricting calories by •• Slow heart rate and muscle loss, which leads •• Intense fear of gaining following drastic diets, to fainting, , weakness, and possible weight or becoming fat fasting, or exercising heart failure too much •• of the seriousness of •• Weakening bones (), which leads low body weight •• Binge-eating (eating an to bone breaks unusually large amount • Loss of menstrual periods •• Dehydration and loss of nutrients, which leads • in a short period of time) (for females) to irregular heartbeat, heart or kidney failure, and / or purging (throwing and sometimes death up or using laxatives, • Being depressed or anxious, having a sleep enemas, or diuretics to • disorder, or thinking about committing eliminate food)

Bulimia nervosa (involves secretive binge-eating followed by purging)

Signs Types Health Risks

•• A lack of control during •• Purging in an attempt to •• Dehydration and loss of chemicals that control binge-eating lose weight after binge- the fluids in your body (), which •• Secrecy about binge-eating eating can lead to irregular heartbeat, heart or and purging •• Non-purging methods like kidney failure, and sometimes death •• Eating an unusually large exercising too much or not •• to the digestive system (esophagus, amount of food without eating to lose weight after stomach, and intestines), leading to bleeding gaining weight a binge ulcers, bloating, and pain •• Episodes of not eating, •• decay due to stomach acid (when binge-eating, and purging ) eroding tooth enamel •• Going to the bathroom after meals to self-induce vomiting •• Complaining of and from

2 How are eating disorders diagnosed? How are eating disorders treated? Doctors make a medical diagnosis related to eating Intermountain uses a team-based approach to disorders by gathering information about your treatment. Different team members treat the various symptoms and evaluating findings from a physical aspects of an eating disorder (see the table below). exam and lab tests Your doctor may: The care team works to treat the physical, emotional, and nutritional aspects of eating disorders. Each care •• Talk with you about food intake, behaviors like fasting and self-induced vomiting, weight and body plan is tailored to the needs of the patient. image, exercise, and family background. You are the most important member of the team. •• Talk with your family about your behaviors and The more you follow your care plan, the better the family history. outcomes. •• Take a medical history including information Your family members (parents, spouses, siblings, about past health, diseases, treatments, and other and others) can provide critical support and factors that may contribute to an eating disorder. participate in appointments with the care team •• Do a physical exam to assess current health and when needed. identify any concerns. •• Order blood and urine tests to assess how your body is functioning and identify problems.

Care Team

Mental health Registered dietitian Doctor Care manager specialist nutritionist (RDN)

•• Monitors overall health. The therapist or •• Provides information •• Helps coordinate and about a healthy . •• Treats medical counsels on: support treatment. conditions. •• Emotional issues. •• Constructs a plan for •• Connects the patient healthy eating and •• Prescribes medicine With eating disorders, to resources. as needed. Although feelings tend to drive exercise patterns. there is no medicine eating behaviors. •• Addresses to cure an eating •• Life events. Current concerns and disorder, the doctor events and past physical needs. can prescribe medicines traumas can contribute •• Addresses thoughts that treat health to eating disorder and behaviors around problems resulting behaviors. eating. from the eating •• Other behavioral disorder. Medicine may disorders. Depression, also ease symptoms anxiety, or obsessive- of other related compulsive disorder can conditions. cause eating disorders or make them worse.

3 Where can I learn more? Websites Books •• Intermountain Healthcare patient information: •• Wasted: A Memoir of Anorexia and Bulimia, by IntermountainHealthcare.org Marya Hornbacher

•• The National Eating Disorders Association •• Life Without ED: How One Woman Declared (NEDA) advocates on behalf of and supports Independence from Her Eating Disorder and individuals and families affected by eating How You Can Too, by Jenni Schaefer and Thom Rutledge disorders: NationalEatingDisorders.org •• : Saving the Selves of • Eating Disorders booklet provided by the • Adolescent Girls, by Mary Pipher National Institute of : nimh.nih.gov/health/publications/eating- •• to Perfection: The Still Unravished disorders/index.shtml Bride, by Marion Woodman •• Intuitive Eating: A Revolutionary Program that • Support programs provided by the National • Works, by Evelyn Tribole and Elyse Resch Alliance on Mental Illness (NAMI): nami.org/ Learn-More/Mental-Health-Conditions/Eating- •• Eating Mindfully: How to End Mindless Eating Disorders/Support and Enjoy a Balanced Relationship with Food, by Susan Albers, PsyD •• Video series from the National Institute of •• The Food & Feelings Workbook: A Full Course Mental Health entitled, 9 Eating Disorders Myths Meal on Emotional Health, by Karen Koenig Busted: nimh.nih.gov/news/science-news/2014/9-

eating-disorders-myths-busted.shtml S

N Q U O E S T I Questions for my doctor

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