Additional Eating and Feeding Disorders

     Additional eating and feeding disorders, is a term used to describe multiple eating and feeding disorders. Avoidant-restrictive food intake disorder, pica, rumination disorder, as well as unspecified feeding or eating disorder all fit into this category. As you read on, you will learn that these disorders are very unique from each other, containing their own symptoms.

     Avoidant-restrictive food intake disorder (AFRID), is a eating disorder in which the patient does not necessarily have any significant body distortions or fears of weight gain, but they do have a lack of interest in food or a poor appetite. People with AFRID may have fears about eating food, such as vomiting, choking or allergic reactions. It would not be uncommon to see a sufferer of AFRID with impaired psycho-social functioning or be dependent or nutritional supplements or tube feeding.
(Menzel)

prevalence of AFRID

     Pica is a disorder in which the individual consumes items that are not food, and have no nutritional value, for at least one month. Items ingested may include soap, paper, cloth, soil, chalk, charcoal, pebbles, ash, clay, starch, or talcum powder. Substances ingested may change depending on the persons age and what items are available to them. For the ingesting of non-food items to be considered pica, it needs to developmentally inappropriate. For example, for a toddler who is still learning touch and sensation, putting a toy or dirt in their mouth would not be considered a warning sign of pica. There is no concrete cause as to why pica happens, but it has been shown to have a possible link to autism spectrum disorder, intellectual disabilities and schizophrenia as well as medical occurrences, such as a iron deficiency or pregnancy. (Kelley)

video explaining pica

     Rumination disorder, is a condition in which  a person frequently regurgitates (brings up) the food from their stomach into the mouth, and then re-chews the food. This condition is usually found in infants, and most commonly starts after the age of three months. Rumination disorder can be linked to lack of stimulation, neglect and stressful family situations. The disorder is rarely found in older children, teenagers and adults. People who experience rumination disorder do not appear disgusted or disturbed while they regurgitate their food, and the process may appear to bring them pleasure.(Rumination)

     Finally, I will discuss unspecified feeding or eating disorder. This term may be used when the patients behavior does not meet full criteria for any other feeding or eating disorder, yet the symtoms still cause significant clinical issues. A Clinician may diagnose someone with a unspecified feeding or eating disorder if they are lacking information in a emergency situation. The diagnosis may also occur if the clinician is unable to evaluate whether the patient fits the criteria for a different feeding or eating disorder. (Additional)

   Once people learn about rumination disorder, pica, avoidant-restrictive food intake disorder, and unspecified feeding and eating disorders, hopefully they realize that eating disorders cannot be placed into one stereotype or schema. All of the disorders that fall under the category of additional feeding and eating disorders are vastly different and unique, just like the people who encounter them.

For any personal eating disorder concerns I recommend visiting NEDA's website for vast information and resources, as well as eating disorder screenings.

References:

"Additional Feeding or Eating Disorders." National Eating Disorders. 4girlsfoundation,

      Center for Discovery, Eating Recovery Center, Rosewood, McCallum Place, n.d. 

      Web. 17 Oct. 2016.

 Kelley, Urszula, MD. "Pica." National Eating Disorders. 4girlsfoundation, Center for
      Discovery, Eating Recovery Center, Rosewood, McCallum Place, n.d. Web. 17 Oct.
      2016.

Menzel, Jessie, PhD. "Avoidant-Restrictive Food Intake Disorder." National Eating
      Disorders. 4girlsfoundation, Center for Discovery, Eating Recovery Center,
      Rosewood, McCallum Place, n.d.Web. 17 Oct. 2016.

"Rumination Disorder." Medlineplus. ADAM, 27 Oct. 2015. Web. 17 Oct. 2016.

Bulimia Nervosa

     There is one eating disorder that is known for its viscous ups and downs, and its psychically and psychologically exhausting cycle. Bulimia Nervosa, "is a serious, potentially life-threatening  eating disorder, characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting, designed to undo or compensate for the the binge eating." (Bulimia). Bulimics may misuse laxatives and diuretics, as well as throw up their food. There is non-purging bulimia as well. In non-purging bulimia the person may use other methods to rid themselves of calories, including fasting, strict dieting and excessive exercise. (MayoClinic). As someone who is currently in my first couple years of recovery, I have felt the the reality of this cycle, and know very intimately what its like to fall victim to it.

     My diet started out with normal intentions, to lose a few pounds to feel better about myself. Before I knew it, I was on a repetitive and exhausting cycle, usually starting with a strict diet, that I vowed to myself to stay on, it was usually unrealistic with very little food and a ridiculous amount of exercise. Eventually, something would happen to throw me off my plan, a simple slip on my diet quickly would quickly turn into a uncontrollable binge. My purge was sometimes throwing up, but mostly I would make up for my binges by even stricter dieting or fasting, exercising for hours on end or taking diuretics and large amounts of caffeine to rid myself of water weight. This cycle could be over the duration of a day or even a full week, but I never failed to find myself back at the beginning of it again.
   
      In my case, my eating disorder stemmed out of pure self-hatred, moving from state to state multiple times before I was fifteen and dealing with several mental health problems such as anxiety, depression and obsessive compulsive disorder since i was a child, the idea of dieting was very soothing to me as I became a teenager. My weight was something i had pure control of. This isn't uncommon at all, people with psychological disorders and emotional problems are more vulnerable to developing eating disorders. Being female, biology, media and societal pressure, sports, work and artistic pressures can all have the potential to put you at risk for bulimia.(MayoClinic)

       Bulimia nervosa effects up to as much as 1.5% of
American women, nearly half of these patients have
a co-occurring mood disorder and more than half have a co-occurring anxiety disorder. One in ten bulimics face a substance abuse disorder, usually alcoholism. (Hudson).

     Bulimia can inflict some extremely  dangerous health consequences, personally I experienced heart irregularities, but bingeing and purging has the potential to damage the entire digestive system. The chemical imbalances that purging leaves within your body can effect major organs as well as the heart. Other health consequences include irregular heartbeat, possible rupture of the esophagus from frequent vomiting, tooth decay and chronic irregular bowel movements and constipation due to abuse of laxatives. (Bulimia).

Video explaining the binge purge cycle more in depth

References:

"Bulimia Nervosa." National Eating Disorders. 4girlsfoundation, Center for Discovery, Eating     

      Recovery Center, Rosewood, McCallum Place, n.d. Web. 12 Oct. 2016.

Hudson J., and S. Ulfvebrand. "Eating Disorder Statistics." anad. N.p., n.d. Web. 12 Oct. 2016.

Mayo Clinic, Staff. "Bulimia Nervosa." Mayo Clinic. N.p., n.d. Web. 12 Oct. 2016

Other Specified Eating or Feeding Disorder

A person with an other specified eating or feeding disorder, previously called EDNOS, may show many symptoms of other eating disorders such as anorexia nervosa, bulimia nervosa or binge eating disorder but will not meet the full criteria for diagnosis of these disorders. (What is OSFED). Some physical, psychological and physical signs of OSFED may include but are not limited to:

Physical Signs:

• Fluctuating weight, weight loss and weight gain
• Absence of menstrual period in women, loss of libido in men
• Decreased immune system
• dizziness and fainting
• damage to throat, mouth, teeth and knuckles do to purging

Psychological Signs:

• Food and eating preoccupation
• Extreme dissatisfaction with body
• Depression, anxiety and irritable behavior
• "Black and white" thinking regarding food
• Distorted body image

Behavioral signs:

• Increased isolation
• Obsessive rituals around food preparation
• Compulsive or excessive exercise
• Frequent trips to the bathroom shortly after eating (could be evidence or laxative use or vomiting)
• Secretive behavior surrounding food (ex. saying they have eaten when they have not)
• Dieting behavior

(What is OSFED)

     It is not uncommon that OSFED is misinterpreted and misunderstood as a sub-clinical diagnosis which can mislead the understanding of its severity. Past studies have shown that people diagnosed with EDNOS (the former name for OSFED) experience eating patterns and medical consequences that are equally, if not more, severe as those who receive treatment for anorexia or bulimia. Another study showed that 75% of people with EDNOS had co-occurring psychiatric disorders and 25% showed suicidality. (A Closer Look).

     Not everybody who is diagnosed with OSFED is going to have the same symptoms, examples of OSFED include:

• Atypical anorexia nervosa ( not below a normal weight)
• Night eating syndrome (excessive eating during night time)
• Bulimia nervosa (with less frequent bulimic behaviors)
• Purging disorder (purging without binge eating)
• Binge-eating disorder (with less frequent occurrences)

(A Closer Look)

     There is a common ground with all of the disorders mentioned above with include psychological suffering and problems in multiple aspects of the persons life. Anyone who is concerned about their eating and exercise habits, and notice them having a negative affect in their life should seek out professional guidance. (Other Specified).

References:

"A Closer Look at Other Specified Eating and Feeding Disorder (OSFED)." Eating Disorder. The Center For Eating Disorders at Shepard Pratt, n.d. Web. 9 Oct. 2016.

"Other Specified Eating or Feeding Disorder." National Eating Disorders. 4girlsfoundation, Center for Discovery, Eating Recovery Center, Rosewood, McCallum Place, n.d. Web. 9 Oct. 2016.

"What Is OSFED?" Nedc. Butterfly Foundation for Eating Disorders, 26 Sept. 2016. Web. 9 Oct.          2016.

Binge Eating Disorder

     Binge eating disorder (BED) is a eating disorder that is characterized by a persons inability to control, or stop themselves, from eating large amounts of food. More often than not, this person eats to the point of extreme discomfort. "unlike anorexia or bulimia, binge eaters do not throw up their food, exercise a lot, or eat only small amounts of food. Because of this binge eaters are often overweight or obese." (Binge Eating Disorder Fact). Everyone overeats occasionally, but BED is different. For people who suffer from this condition, compulsive overeating becomes something that happens frequently and a lot of times, daily. The sufferer finds it almost impossible to stop eating.

     Most of the time people who suffer from this eating disorder are overweight or obese,  but people can suffer at a normal weight as well. (Turner, Chevese). It may surprise you that binge eating disorder is actually the most common eating disorder in the united states.(Binge Eating Disorder Fact). Characteristics of this disorder include:

• Eating in secrecy
• Feel intense amounts of guilt and shame related to eating habits
• Exclaim that they have "no control" or "cant stop"
• Eat very fast during a binge episode, without taking time to chew food completely or listen to their hunger cues.
• Hiding wrappers or hiding evidence that they have eaten
• Eating until the point of extreme fullness or even pain   
• Bingeing during certain time frames (ex. over a two hour time frame)
• Depression ,shame, anxiety

(BingeEatingDisorder)

Many people suffer in silence with binge eating disorder, they may feel ashamed about the amount of food they eat, or depressed. People suffering have the right to know that what they are enduring is, a eating disorder, and that there is treatment available. (BingeEatingDisorder).  According to Chevese Turner, the founder, president and CEO of BEDA, approaches to treatment in binge eating disorder can include "cognitive behavioral therapy, dialectical behavioral therapy, interpersonal behavioral therapy, trauma therapy, medication and health at every size ."(Turner, Chevese)

Some statistics on binge eating disorder include:

• BED affects 1-3% of children
• 2.2-5.5%  of adults have the disorder
• 40% more prevalent in males than other eating disorders
• 19% are normal weight, 36% overweight and 45% obese

 (Turner, Chevese)

One woman's journey with BED

   Penn State Football player opens up about his BED

what is binge eating disorder-video

Citations:

"Binge Eating Disorder Fact Sheet." Womenshealth.gov. U.S Department of Health and Human                Services, 16 July 2012. Web. 04 Oct. 2016.         

Staff, Mayo Clinic. "Binge-Eating Disorder." Mayo Clinic. Mayo Clinic, n.d. Web. 4 Oct. 2016.    

Turner, Chevese. "Understanding, Treating and Coping with Binge Eating Disorder." National Eating      Disorders. N.p., 07 Mar. 2016. Web. 4 Oct. 2016. 

                    

"Binge Eating Disorder." National Eating Disorders. 4girlsfoundation, Center for Discovery, Eating Recovery Center, Rosewood, McCallum Place, n.d. Web. 5 Oct. 2016.

   

Anorexia Nervosa

     Anorexia nervosa is one of the most common eating disorders, and according to the staff at the American Psychological Association "people with anorexia nervosa have a distorted body image that causes them to see themselves as overweight even when they are dangerously thin, they often refuse to eat, exercise compulsively, developing unusual habits such as refusing to eat in front of others, they lose large amounts of weight and may even starve to death." It is apparent that people that suffer from this disease are not just trying to lose weight, they are suffering from multiple factors that make up the entirety of the disorder. Anorexia is unique from other disorders and according to the expert medical staff at Mayo Clinic, anorexia nervosa is "characterized by abnormally low weight, intense fear of gaining weight and distorted perception of body weight."

     Many people, who are not Doctors or Psychologist, might find themselves in a situation where they need to know the warning signs of  anorexia to help a loved one, or even themselves. The National Eating Disorder Association (NEDA) proposes that warning signs of the disorder include, but are not limited to "preoccupation with food, calories, fat grams, dieting, restrictions against entire food groups, frequent comments about feeling fat despite weight loss, anxiety about weight gain, denial of hunger and the development of food rituals."There are many negative symptoms associated with anorexia nervosa which may include muscle loss and weakness, dehydration, heart and blood pressure problems, fainting, malnutrition, mental health problems organ failure and even osteoporosis. It is clear the anorexia is a serious disorder, but that doesn't mean that there is no hope for the people that have to suffer from this disease.

    As someone who recovered from this disease, I understand what its like to live a day in the life of the disorder. Someone with anorexia may start their day on the scale, writing down their weight and possibly taking body measurements to make sure that your size has not increased. Then, they may plan out their allowed calories for the day, most likely it is a fraction of what someone their height and age needs to eat to maintain their weight. They may continue the rest of the day trying to achieve their daily tasks, just like anyone else, such as school or work, or they may be unable to function in normal activities due to the severity of their disorder, weighing themselves multiple times or exercising multiple times throughout the day is not uncommon. Hopefully, the person suffering anorexia will have to opportunity to seek treatment, it may be a personal decision or a decision urged by friends or family. There are many ways to get treatment and it is common that there will be a doctor, psychologist and dietitian working with the patient. Being a anorexia sufferer is not a death sentence, many people fully recover from anorexia, and with information on the disease out now than ever before, people are able to access on accurate information on the disorder and are able to helps loved one's early on.

Article and video on the danger of Pro anorexia websites

                                                       More information on recovery
                                the connection between eating disorders and substance abuse

Works Cited:

"Anorexia Nervosa." National Eating Disorders. 4girlsfoundation, Center for Discovery, Eating Recovery Center, Rosewood, McCallum Place, n.d. Web. 2 Oct. 2016.

Staff, Mayo Clinic. "Anorexia Nervosa." Mayo Clinic. Mayo Clinic, n.d. Web. 2 Oct. 2016.

What is an Eating Disorder?

      Not all eating disorders are the same. But generally, it is known that to have an eating disorder, is to have some type of pattern of extreme disordered eating. Eating disorders are serious psychiatric and physical illnesses. Mayo Clinic suggests that eating disorders "lead to complications including, significant medical problems, depression and anxiety, suicidal thoughts and behavior, problems with growth and development, social and relationship problems, substance use disorders, school and work problems and death." Eating habits may be extreme and dangerous. People with these disorders may have specific and strict rules related to the food they eat. Most of time these habits are hard to break and interferes with the persons life in a negative way.

     To have an eating disorder means a lot more than eating unhealthy or dieting. Tendencies of those suffering from eating disorders are severe. The person may refuse to eat, self induce vomit after eating or uncontrollably eat to the point of discomfort. A person might also eat non-food items that are damaging to ingest, or strictly only eat one type of food. Strict rules related to what they eat and how they manage weight may also be present. Refusing to allow yourself to eat during certain hours of the day, compulsively weighing yourself and scaling food, exercising off all calories consumed, are all examples of behavior that someone with an eating disorder may engage in. Punishing oneself for breaking food and diet rules through self harm or experiencing intense guilt may also come along with the symptoms of an eating disorder.

          When someone is experiencing symptoms of an eating disorder, they are being negatively affected mentally and emotionally. In the past, when diagnosed with anorexia and bulimia, I had already been struggling for a while beforehand. Emotionally unable to place any importance on anything else but my eating disorder, the only things that mattered to me was the weight on the scale every morning when I woke up, or if I would be able to cut my calories more than then the day before. According to the National Institute of Mental Health, eating disorders "are associated with a wide range of adverse psychological, physical, and social consequences." This was absolutely true in my situation. My eating disorder made me stray away from things I would normally be passionate about like school and my friends. Physically drained, I frequently got dizzy and suffered from heart palpitations. Stomach and throat pain where to be expected after a binging and purging cycle. Until I overcame my disorder, I managed to remain loyal to the commands my disorder pushed upon me. My symptoms were unique, Each type of eating disorder has there own physical and mental side affects that vary from person and diagnosis.

NEDA referral helpline 1-800-931-2237

Citations:

"Eating Disorders: About More Than Food." National Institute of Mental Health. NIH Publication No. (TR 14-4901), 2014.

https://www.nimh.nih.gov/health/publications/eating-disorders-new-trifold/index.shtml.Accessed 26 Sept.2016.

Staff, Mayo Clinic. "Symtoms and Causes." Mayo Clinic. Mayo Clinic, n.d. Accessed 26 Sept. 2016.
www.mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/dxc-20182875.