Eating disorders include extreme emotions, attitudes, and behaviors surrounding weight and food issues by both women and men. They include anorexia nervosa, bulimia nervosa, and binge eating disorder. All are serious emotional and physical problems that can have life-threatening consequences.

ANOREXIA NERVOSA is characterized by self starvation and excessive weight loss.

Symptoms include:

• Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level
• Intense fear of weight gain or being "fat"
• Feeling "fat" or overweight despite dramatic weight loss
• Loss of menstrual periods
• Extreme concern with body weight and shape

BULIMIA NERVOSA is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food--more than most people would eat in one meal--in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse, or over-exercising.

Symptoms include:

• Repeated episodes of bingeing and purging
• Feeling out of control during a binge and eating beyond the point of comfortable fullness
• Purging after a binge, typically by self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, or fasting
• Frequent dieting
• Extreme concern with body weight and shape

COMPULSIVE OVEREATING is characterized by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge. People who overeat compulsively may struggle with anxiety, depression, and loneliness which can contribute to their unhealthy episodes of binge eating. Body weight may vary from normal to mild, moderate, or severe obesity.

OTHER EATING DISORDERS can include some combination of the signs and syptoms of anorexia, bulimia, and/or compulsive overeating. While these behaviors may not be clinically considered a full syndrome eating disorder, they can still be physically dangerous and emotionally draining. All eating disorders require professional help.

Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

• Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level.
• Intense fear of weight gain or being "fat."
• Feeling "fat" or overweight despite dramatic weight loss.
• Loss of menstrual periods in post-puberty women and girls.
• Extreme concern with body weight and shape.

• Approximately 90-95% of anorexia nervosa sufferers are girls and women (Gidwani 1997).
• Between 1-2% of American women suffer from anorexia nervosa (Zerbe, 1995).
• Anorexia nervosa is one of the most common psychiatric diagnoses in young women (Hsu, 1996).
• Between 5-20% of individuals struggling with anorexia nervosa will die.  The probabilities of death increases within that range depending on the length of the condition (Zerbe, 1995).
• Anorexia nervosa has one of the highest death rates of any mental health condition.
• Anorexia nervosa typically appears in early to mid-adolescence.

Anorexia nervosa involves self-starvation.  The body is denied essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy.  This "slowing down" can have serious medical consequences:

• Abnormally slow heart rate and low blood pressure, which means that the heart muscle is changing. The risk for heart failure rises as the heart rate and blood pressure levels sink lower and lower.
• Reduction of bone density (osteoporosis), which results in dry, brittle bones.
• Muscle loss and weakness.
• Severe dehydration, which can result in kidney failure.
• Fainting, fatigue, and overall weakness.
• Dry hair and skin, hair loss is common.
• Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

The chances for recovery increase the earlier anorexia nervosa is detected.  Therefore, it is important to be aware of some of the warning signs of anorexia nervosa.

• Dramatic weight loss
• Preoccupation with weight, food, calories, fat grams, and dieting.
• Refusal to eat certain foods, progressing to restrictions against whole categories of food (i.e., no carbohydrates, etc.)
• Frequent comments about feeling "fat" or overweight despite weight loss
• Anxiety about gaining weight or being "fat"
• Denial of hunger
• Development of food rituals (i.e., eating foods in certain orders, excessive chewing, rearranging food on a plate)
• Consistent excuses to avoid mealtimes or situations involving food
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, and injury, the need to "burn off" calories taken in
• Withdrawal from usual friends and activities
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns

Bulimia Nervosa is a serious, potentialy life-threatening eating disorder characterized by a secretive cycle of bingeing and purging.

• Eating large quantities of food in short periods of time, often secretly, without regard to feelings of "fullness" or "hunger," and to the point of feeling "out of control" while eating.
• Following these "binges" with some form of purging or compensatory behavior to make up for the excessive calories taken in:  self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
• Extreme concern with body weight and shape.

• Bulimia nervosa affects 1-3% of middle and high school girls and 1-4% of college age women.
• Approximately 80% of bulimia nervosa patients are female (Gidwani, 1997).
• People struggling with bulimia nervosa will often appear to be of average body weight.
• Often, people struggling with bulimia nervosa will develop complex schedules or rituals to provide opportunities for binge-and-purge sessions.
• Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. The electrolyte imbalances are caused by losses of potassium and sodium from the body and dehydration as a result of purging behaviors.
• Inflammation and possible rupture of the esophagus from frequent vomiting.
• Chronic irregular bowel movements and constipation as a result of laxative abuse.
• Tooth decay and staining from stomach acids released during frequent vomiting.
• Peptic ulcers and pancreatitis.
• Potential for gastric rupture during periods of bingeing.

The chances for recovery increase the earlier bulimia nervosa is detected  Therefore, it is important to be aware of some of the warning signs of bulimia nervosa.

• Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating consumption of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
• Excessive, rigid exercise regimen--despite weather, fatigue, illness, and injury, the need to "burn off" calories taken in.
• Unusual swelling of the cheeks or jaw area.
• Calluses on the back of the hands and knuckles from self-induced vomiting.
• Discoloration, staining of the teeth.
• Creation of complex lifestyle schedules or rituals to make time for binge-and-purge-sessions.
• Withdrawal from usual friends and activities.
• In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Binge Eating Disorder is a relatively newly recognized eating disorder characterized by frequent episodes of uncontrolled eating of large amounts of food. Researchers are just beginning to understand the causes and health consequences of binge eating disorder.

• Frequent episodesof eating large quantities of food in short periods of time often secretly, without regard to feelings of "hunger" or "fullness."
• Frequent feelings of being "out of control" during binges.
• Eating large quantities of food rapidly, without really tasting the food.
• Eating alone.
• Feelings of shame, disgust, or guilt after a binge.

• The prevalence of binge eating disorder in the general population is still being researched. Researchers estimate that approximately 25% of obese individuals suffer from frequent episodes of binge eating (Fariburn, 1998).
• Binge eating disorder does affect women slightly more often than men--estimates indicate that about 40% of people struggling with binge eating disorder are males (NIH, 1993).
• People who struggle with binge eating disorder can be of normal or heavier than normal weight.
• Many people who suffer from binge eating disorder have a history of depression (NIH, 1993).
• People struggling with binge eating disorder often express distress, shame, and guilt over their eating behaviors.

Binge eating disorder often results in some of the health risks associated with clinical obesity.  Some of the potential health consequences of binge eating disorder include:

• High blood pressure
• High cholesterol levels
• Heart disease as a result of elevated triglyceride levels
• Secondary diabetes
• Gallbladder disease