Bridget Engel, Psy.D., edited by Kathryn Patricelli, MA
There are three primary eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder. Each disorder is characterized by a distinctive pattern of disordered and harmful eating behavior.
Anorexia generally involves the severe and extreme restriction of eating to lose weight. Because of this restriction, those with anorexia are typically underweight. This means that they weight 85% or less of the expected weight for their height and gender.
Bulimia is characterized by the presence of binges, which are when someone eats an abnormally large amount of food in a short period of time. These binges are often followed by purge behaviors that are an attempt to get rid of the consumed calories. This might include vomiting, taking a laxative, or exercising excessively. These actions are all done in an effort to prevent weight gain.
Binge and purge behavior may happen with anorexia as well as bulimia. However, extreme eating restriction is always present in anorexics and rarely in bulimics.
Binge-Eating Disorder is similar to Bulimia because both conditions share binge-eating behavior. However, individuals with Binge-Eating Disorder do not purge or get rid of what they have consumed, unlike those with Bulimia.
Harmful eating behavior may start as single attempts with food restriction or binge/purge behaviors that gradually progress to become ongoing issues. Disordered eating becomes an ongoing problem, one that often rises and falls in intensity over time. Those with eating disordered behaviors who successfully manage to restrict and control what they eat may feel a short-term sense of power and accomplishment over their body. These positive feelings do not tend to last very long, however. A bad day at school or work, a conflict with another person, or simply reading a fashion magazine or watching television may trigger renewed feelings of self-hatred and disgust. These bad feelings lead to consumption of "banned" foods. This breakdown in willpower leads to the person feeling weak and like they are unacceptable. This motivates further food restriction. Endless cycling of dysfunctional eating behaviors creates conditions for a disorder to develop.
Things all eating disorders have in common:
All three eating disorders are serious mental and physical conditions with potentially life-threatening consequences. These disorders can affect daily functioning and destroy general health. Individuals typically experience painful emotions before, during and after the eating behaviors. In addition, people with eating disorders are generally obsessed about their weight. They often fear gaining any weight, and their self-esteem is highly affected by their weight. This focus can develop into a distorted body image.
Body image has to do with how people interpret images of their bodies, including literal images (such as happens when looking in a mirror), and remembered images (such as happens when thinking about what you look like). Most of those suffering from eating disorders feel badly about their body image. They are not able to accurately see themselves as others see them. Even when friends, family and coworkers worry about an individual's weight loss and painfully thin appearance, these individuals still consider themselves fat, and ignore the value and worth of other's opinions. Rejecting other people's opinions allows those with eating disorders to maintain their negative opinion of themselves, as well as their distorted sense of body image.
People diagnosed with eating disorders tend to be anxious about and sensitive to acceptance from others. They tend to measure their success against unrealistically high standards that are almost impossible to meet. They are often very aware of their failure to reach these self-imposed standards. They believe that they have let down their community and themselves as a result. Frequently, this sense of failure drives them to work harder toward reducing the difference between their current weight and their idealized weight. This drive can be so strong that some people abuse their bodies to the point of serious illness and even death.