Eating is controlled by many factors, including appetite, food availability, family, peer, and cultural practices, and attempts at voluntary control. Dieting to a body weight leaner than needed for health is highly promoted by current fashion trends, sales campaigns for special foods, and in some activities and professions. Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Eating disorders often are long-term illnesses that may require long-term treatment. In addition, eating disorders frequently occur with other mental disorders such as depression, substance abuse, and anxiety disorders, and develop during adolescence or early adulthood.
According to the National Institute of Mental Health, adolescent and young women account for 90 percent of cases. But eating disorders aren't just a problem for the teenage women so often depicted in the media. Older women, men and boys can also develop disorders. And an increasing number of ethnic minorities are falling prey to these devastating illnesses.
People sometimes have eating disorders without their families or friends ever suspecting that they have a problem. Aware that their behavior is abnormal, people with eating disorders may withdraw from social contact, hide their behavior and deny that their eating patterns are problematic. Making an accurate diagnosis requires the involvement of a licensed psychologist or other appropriate mental health expert.
What medical problems can arise as a result of eating disorders?
Eating disorders can devastate the body. Physical problems associated with eating disorders include anemia, palpitations, hair and bone loss, tooth decay, esophagitis and the cessation of menstruation. People with binge eating disorder may develop high blood pressure, diabetes and other problems associated with obesity. Recognition of eating disorders as real and treatable diseases, therefore, is critically important. The earlier these disorders are diagnosed and treated, the better the chances are for full recovery. Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own. The main types of eating disorders are anorexia nervosa and bulimia nervosa.
An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime.
A person with anorexia will have many of these signs:
Warning signs of anorexia
People with this disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Unusual eating habits develop, such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight, such as intense and compulsive exercise, or purging by means of vomiting and abuse of laxatives, enemas, and diuretics. Girls with anorexia often experience a delayed onset of their first menstrual period.
What happens to someone who has anorexia?
Anorexia can be very harmful to the body. Anorexia can slow the heart rate and lower blood pressure, increasing the chance of heart failure. Those who use drugs to stimulate vomiting, bowel movements, or urination are also at high risk for heart failure. Starvation can also lead to heart failure, as well as damage the brain. Anorexia may also cause hair and nails to grow brittle. Skin may dry out, become yellow, and develop a covering of soft hair called lanugo. Mild anemia, swollen joints, reduced muscle mass, and light-headedness also commonly occur as a consequence of this eating disorder. Severe cases of anorexia can lead to brittle bones that break easily as a result of calcium loss.
Look at the picture to find out how anorexia affects your health.
The course and outcome of anorexia nervosa vary across individuals: some fully recover after a single episode; some have a fluctuating pattern of weight gain and relapse; and others experience a chronically deteriorating course of illness over many years. The mortality rate among people with anorexia is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population. The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide.
What should I do if I think someone I know has anorexia?
Follow these steps from the National Eating Disorders Association:
An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime.
Symptoms of bulimia nervosa include:
Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with their bodies. People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge.
A person with bulimia may also use these ways to prevent weight gain:
What are signs of bulimia?
People with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disorder. However, someone with bulimia may have these signs:
What happens to someone who has bulimia?
Bulimia can be very harmful to the body. The acid in vomit can wear down the outer layer of the teeth, inflame and damage the esophagus (a tube in the throat through which food passes to the stomach), and enlarge the glands near the cheeks (giving the appearance of swollen cheeks). Damage to the stomach can also occur from frequent vomiting. Irregular heartbeats, heart failure, and death can occur from chemical imbalances and the loss of important minerals such as potassium. Peptic ulcers, pancreatitis (inflammation of the pancreas, which is a large gland that aids digestion), and long-term constipation are also consequences of bulimia.
Look at the picture to find out how bulimia affects your health.
What should I do if I think someone I know has bulimia?
If you know someone with bulimia, you can help. Follow these steps from the National Eating Disorders Association:
Why is it important to seek treatment for these disorders?
Research indicates that eating disorders are one of the psychological problems least likely to be treated. But eating disorders often don't go away on their own. And leaving them untreated can have serious consequences. In fact, the National Institute of Mental Health estimates that one in ten anorexia cases ends in death from starvation, suicide or medical complications like heart attacks or kidney failure.
Wonder if you are dealing with disordered eating?
Think about this…
If you answered "yes" to any of these questions, you could be dealing with disordered eating. It is likely that these attitudes and behaviors are taking a toll on your mental and physical well being. It is important that you start to talk about your eating habits and concerns now, rather than waiting until your situation gets more serious than you can handle.
Parents, if you believe your child may be at risk of developing an eating disorder, click here 
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Talk about it! Tell a friend, teacher, parent, coach, youth group leader, doctor, counselor, or nutritionist what you`re going through. If that seems too scary or too difficult, you may want to check out the National Eating Disorders Association`s Sharing with EEEase handout. It will help you plan what to say the first time you talk to someone about your eating and exercise habits. It is important to get some support to change the thoughts and behaviors you are experiencing now. It could save your life - and isn`t your health and happiness worth it?
Eating disorders can be treated and a healthy weight restored. The sooner these disorders are diagnosed and treated, the better the outcomes are likely to be. Because of their complexity, eating disorders require a comprehensive treatment plan involving medical care and monitoring, psychosocial interventions, nutritional counseling and, when appropriate, medication management. At the time of diagnosis, the clinician must determine whether the person is in immediate danger and requires hospitalization. For more information about treatment strategies, click here 
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