Eating Disorders: The Need-to-Know Facts

Eating Disorders: The Need-to-Know Facts

Worldwide, some 70 million people suffer from an eating disorder. Anorexia nervosa has the highest mortality rate of all the emotional/mental disorders. In addition to those facts, there’s huge comorbidity with the mood and anxiety disorders. Definitely Chipur discussion material…

Laxative Abuse: Repeated, frequent use of laxatives to eliminate unwanted calories, lose weight, ‘feel thin,’ or ‘feel empty.’ Reference Karen Carpenter’s cause of death.

I loved Karen Carpenter – still do. Karen died in 1983 at the age of 32. Her death was attributed to emetine (a drug used to induce vomiting, produced from the ipecac root) cardiotoxicity as a consequence of anorexia nervosa. (True confession: To this day I choke-up when I hear the Carpenters song, “Rainy Days and Mondays.”)

Given the eating disorders’ relationship with the mood and anxiety disorders, it’s been on my mind for some time to post a general need-to-know piece. It’s my hope that the exposure and information will motivate those who know, or suspect, they need treatment to step forth from the shadows and get the help they need – deserve.

This is going to be a longie, but it needs to be. Go ahead and print it. It’ll make for easier reading and you’ll have it handy for future reference. And pass the article along to a friend or loved one in need.

Speaking of reference, I turned to the National Eating Disorders Association (NEDA).

Eating Disorders: What Are They?

The eating disorders are in many ways serious business, and they can impact people of every age, sex, gender, race, ethnicity, and socioeconomic group. Though the cause is unknown, the convergence of a range of biological, psychological, and sociocultural factors is likely involved. That’s sort of how it goes with the emotional/mental disorders, isn’t it?

Disorder by disorder, let’s do the highlights…

  • Anorexia Nervosa: Weight loss (or lack of appropriate weight gain in growing children); trouble maintaining an appropriate weight for height, age, and stature; and, in many, distorted body image. Common are calorie and food types restriction, purging (vomiting, laxative use), compulsive exercise, and binge eating.
  • Bulimia Nervosa: A cycle of binge eating and compensatory behaviors, such as self-induced vomiting, designed to undo or compensate for the effects of binge eating.
  • Binge Eating Disorder: Recurrent episodes of eating large quantities of food; a feeling of loss of control during the binge; experiencing shame, distress or guilt when it’s over; and not regularly using unhealthy compensatory measures to counter the binge eating. It’s the most common eating disorder in the US.
  • Orthorexia: An obsession with proper or “healthful” eating.
  • Other Specified Feeding or Eating Disorder (OSFED): Includes those who don’t meet strict criteria for anorexia or bulimia, but still have a troubling eating disorder.
  • Avoidant Restrictive Food Intake Disorder (ARFID): Limitations in the amount and/or types of food consumed, but doesn’t involve distress about body shape or size, or fears of fatness.
  • Pica: Eating things that aren’t typically thought of as food and don’t contain significant nutritional value (hair, dirt, paint chips, etc.).
  • Rumination Disorder: Regular regurgitation of food. The regurgitated food may be re-chewed, re-swallowed, or spit-out.
  • Unspecified Feeding or Eating Disorder: Symptoms characteristic of a feeding and eating disorder that cause significant distress or impairment, but don’t meet full criteria for any of the feeding and eating disorders.
  • Laxative Abuse: Repeated, frequent use of laxatives to eliminate unwanted calories, lose weight, “feel thin,” or “feel empty.” Reference Karen Carpenter’s cause of death.
  • Compulsive Exercise: Extreme, excessive exercise that significantly interferes with routine functioning. 

Eating Disorders: Risk Factors

how do you fix mental illnessIf any of us are to be proactive in addressing that which ails us, we need to know about risk factors. For the eating disorders we’ll categorize them into biological, psychological, and social…

  • Biological: Having a close relative with an eating disorder or any emotional/mental health condition, history of dieting, negative energy balance (burning-off more calories than taken-in), type 1 diabetes (diabulimia: coexisting eating disorder and diabetes, typically type 1, in which the individual restricts insulin to lose weight).
  • Psychological: Perfectionism, body image dissatisfaction, personal history of an anxiety disorder (there’s that comorbidity), behavioral inflexibility (always following the rules, as there’s only one “right way” to do things).
  • Social: Exposure to weight stigma, bullying, teasing; buying-in to the socially-defined “ideal body,” acculturation (e.g.: undergoing rapid Westernization), loneliness and isolation, trauma history.

Eating Disorder: Treatment

There are a variety of effective treatments available for the eating disorders. Levels of care include inpatient, residential, partial hospitalization (PHP), intensive outpatient (IOP), and outpatient. As with any emotional/mental disorder, treatments are based upon individual need and the results vary on a per case basis.

Of note, common psychotherapies include acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), enhanced cognitive behavioral therapy (CBT-E), cognitive remediation therapy (CRT), dialectical behavior therapy (DBT), family-based treatment (FBT), interpersonal therapy (IPT), and psychodynamic therapy.

Let’s Close

It’s so easy for any of us to cruise through life, all the while ignoring maladaptive thoughts, feelings, and behaviors – as though that’s just the way it is.

If an eating disorder is at the foundation of all the hubbub, I’m hoping this piece will get your attention and serve as a call to action. And, again, perhaps you’re being called to alert someone in need.

Eating disorders destroy lives, but help is available. And that’s important information for any mood or anxiety disorder sufferer. I mean, we can’t ignore the comorbid potentialities.

Hey, be sure to check-out the wonderfully helpful info and resources on the NEDA website.

And when you get time, scan those Chipur mood and anxiety disorder-related titles.

A Carb-Pounding Frenzy: “Yikes, What’s Goin’ on Here?”

A Carb-Pounding Frenzy: “Yikes, What’s Goin’ on Here?”

Your day has been JPN and you’re wired to the max. Long about 2:00 p.m. it hits – that longing for the brownies prominently sitting on your kitchen counter. And the very moment you get home you attack, in a carb-pounding frenzy. “Yikes, what’s goin’ on here?”

So what does she do in response? You guessed it. She pounds even more carbs to make her feel better. And she now finds herself in the midst of a very nasty cycle…

Come on, you know the drill. Call it what you’d like: carb-pounding, emotional eating, stress eating, carb-craving. It’s all about calming, and hoping for some measure of mood elevation.

Trouble is, it can be a major problem, with far-reaching consequences, for anyone dealing with a mood or anxiety disorder.

Well, the only way I know to solve a problem is to learn all we can about it. So let’s get busy.

Oh, want to let you know this is rather a dust-up of a couple of pieces I ran years back. Thing is, the issue has popped-up frequently with some folk I know, so I wanted to get a fresh word out and about.

What Are Carbohydrates?

Carbohydrates are our primary source of energy, categorized as simple or complex. Both are digested into glucose (blood sugar).

Simple carbs contain refined sugars, provide few essential nutrients, and are digested quickly. We’re talking those brownies, pop, cookies, breakfast cereal, fruit juice concentrate, etc. Complex carbs are loaded with goodies such as fiber, vitamins, and minerals, and take longer to digest. Included are breads, legumes, rice, pasta, and starchy vegetables.

Still, simple or complex, carbs = sugar.

What Is Carb-Craving?

Blood sugar and depressionOkay, carb-craving is a sudden and overwhelming drive to consume carb-rich foods, primarily simple. Certainly, depressed mood, anxiety, and stress can be triggers. But when it’s all said and done, carb-craving is most often generated by a rebound biochemical reaction to low blood sugar levels – hypoglycemia.

Let’s take a look…

For the following, we’re going to assume the individual is feeling depressed and anxious. We’ll also assume, in the moment, her blood sugar level is low.

So, bam, her carb-pounding begins. As a result, her blood sugar level, and likely her mood, significantly increase. The surge in blood sugar triggers an increase in the production of insulin. Produced in the pancreas, insulin (the hunger hormone) now becomes a player in that it manages the metabolism of carbs, most notably glucose.

The insulin onslaught causes a pronto drop in blood sugar (functional or reactive hypoglycemia), and on come the physical, mental, and emotional manifestations of hypoglycemia: ramped-up cravings, irritability, fatigue, trembling, headache, feeling of overall weakness, confusion, feeling faint, and more.

Of course, we all know what happens next. Given she struggles with depression and anxiety, she comes up with the usual array of cognitive distortions, misinterpretations, and overreactions. And it all totally gums her up. And it sure doesn’t help that in an emergency reaction, epinephrine (adrenaline) has gotten in on the act – because her body has generated a low blood sugar alarm.

So what does she do in response? You guessed it. She pounds even more carbs to make her feel better. And she now finds herself in the midst of a very nasty cycle.

By the way, since blood sugar can’t get to its targeted cells, it’s railroaded into fat cells. Even worse, as the insulin ride continues, even the fat cells will ultimately close their doors. That leaves the bloodstream as the final glucose resting place.

And now, she may one day soon be dealing with type 2 diabetes.

Ah, but There’s More

As though things aren’t bad enough, we need to add a couple more pieces here. A player in all of this is serotonin, as in insufficient supply. That not only impacts our levels of mood and anxiety, it inhibits thought processing. When that’s compromised, impulsivity and other goodies may hit the scene. And that makes it all the more difficult to turn away from the carbs.

Finally, sugar causes a release of beta-endorphin, which can make anyone feel awfully good. But the thing is, sugarheads respond more intensely, often feeling intoxicated. And if it continues to happen, a permanent drop in beta-endorphin levels may occur.

Let’s Wrap It Up

Dang, right? Perhaps information overload with this baby, but we gotta’ do what we gotta’ do.

Throughout my decades long relationship with my emotional and mental circumstances, I found seeking and learning to be just huge. I mean, it fills so many gaps and prevents so much misinterpretation and overreaction.

Carb-pounding happens for a reason, people. And now you know why. That means you can plan strategy to flat knock it out.


Hey, that JPN in the opening? Can you guess? Yep, Just Plain Nuts.

Blood glucose chart credit

If you’d like to read more Chipur mood and anxiety disorder articles, I know where you can find hundreds of them. Feel free, dig right-in.