Disordered eating

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Disordered eating describes a variety of abnormal eating behaviors that, by themselves, do not warrant diagnosis of an eating disorder.

Contents

Disordered eating includes behaviors that are common features of eating disorders, such as:

Disordered eating also includes behaviors that are not characteristic of a specific eating disorder, such as:

Potential causes of disordered eating

Disordered eating can represent a change in eating patterns caused by other mental disorders (e.g. clinical depression), or by factors that are generally considered to be unrelated to mental disorders (e.g. extreme homesickness). [7]

Certain factors among adolescents tend to be associated with disordered eating, including perceived pressure from parents and peers, nuclear family dynamic, body mass index, negative affect (mood), self-esteem, perfectionism, drug use, and participation in sports that focus on leanness. These factors are similar among boys and girls alike. [3] However, the reported incidence rates of disordered eating are consistently and significantly higher in female than male participants. 61% of females and 28% of males reported disordered eating behaviors in a study of over 1600 adolescents. [8]

Nuclear family environment

The nuclear family dynamic of an adolescent plays a large part in the formation of their psychological, and thus behavioral, development. A research article published in the Journal of Adolescence concluded that, “…while families do not appear to play a primary casual role in eating pathology, dysfunctional family environments and unhealthy parenting can affect the genesis and maintenance of disordered eating.” [8]

One study explored the connection between the disordered eating patterns of adolescents and the poor socioemotional coping mechanisms of guardians with mental disorders. It was found that in homes of parents with mental health issues (such as depression or anxiety), the children living in these environments self-reported experiencing stressful home environments, parental withdrawal, rejection, unfulfilled emotional needs, or over-involvement from their guardians. [8] It was hypothesized that this was directly related to adolescent study participants also reporting poor emotional awareness, expression, and regulation in relation to internalized/externalized eating disordered habits. Parental anxiety/depression could not be directly linked to disordered eating, but could be linked to the development of poor coping skills that can lead to disordered eating behaviors. [8]

Another study specifically investigated whether a parental's eating disorder could predict disordered eating in their children. It was found that rates of eating disorder appearances in children with either parent having a history of an eating disorder were much higher than those with parents without an eating disorder. [9] Reported disordered eating peaked between ages 15 and 17 with the risk of eating disorder occurrences in females 12.7 times greater than of that in males. This is, "of particular interest as it has been shown that maternal ED [eating disorders] predict disordered eating behaviour in their daughters." [9] This suggests that poor eating habits result as a coping mechanism for other direct issues presented by an unstable home environment.

Social stresses

Additional stress from outside the home environment influence disordered eating characteristics. Social stresses from peer environments, such as feeling out of place or discriminated against, has been shown to increase feelings of body shame and social anxiety in studies of minority groups that lead to a prevalence of disordered eating. [10]

A study published in the International Journal of Eating Disorders used data from the Massachusetts Youth Risk Behavior Surveys from 1999 to 2013 to examine how disordered eating has trended in heterosexual versus LGB (lesbian, gay, bisexual) youth. [11] The data from over 26,000 surveys investigated the practices of purging, fasting, and using diet pills. It was found that, "sexual minority youth report disproportionately higher prevalence of disordered eating compared to heterosexual peers: up to 1 in 4 sexual minority youth report…patterns of disordered eating…" [11] In addition, the gap between the number of LGBT females and heterosexual females controlling weight in unhealthy ways has continued to widen. [11]

The concept this study proposed to explain this disparity comes from the minority stress theory. This states that unhealthy behaviors are directly related to the distal stress, or social stress, that minorities experience. [11] These stressors could include rejection or pressure by peers, and physical, mental, and emotional harassment.

A study published in Psychology of Women Quarterly explored the connection between social anxiety stresses and eating disordered habits more in depth in women in the LGBTQ community who were also racial minorities. [10] Over 450 women ranked their interactions with everyday discrimination, their LGBTQ identity, social anxiety, their objectified body consciousness, and an eating disorder inventory diagnostic scale. The findings of the compilation of survey responses indicated that increased discrimination led to proximal minority stress, leading to feelings of social anxiety and body shame, which could be directly associated with binge eating, bulimia, and other signs of disordered eating. [10] It has also been suggested that being a “double” or “triple” minority who experiences discrimination towards multiple characteristics contributes to more intense psychological distress and maladaptive coping mechanisms. [10]

Athletic influences

Disordered eating among athletes, particularly female athletes, has been the subject of much research. In one study, women with disordered eating were 3.6 times as likely to have an eating disorder if they were athletes. In addition, female collegiate athletes who compete in heavily body conscious sports like gymnastics, swimming, or diving are shown to be more at risk for developing an eating disorder. This is a result of the engagement in sports where weekly repeated weigh-ins are standard, and usually required by coaches. [6]

A study published in Eating Behaviors examined the pressure of mandated weigh-ins on female collegiate athletes and how that pressure was dealt with in terms of weight management. [12] After analyzing over 400 survey responses, it was found that athletes reported increased uses of diet pills/laxatives, consuming less calories than needed for their sport, and following nutrition information from unqualified sources. 75% of the weighed athletes reported using a weight-management method such as restricting food intake, increasing exercise, eating low fat foods, taking laxatives, vomiting, and other. [12]

These habits were found to be worse in athletes that were weighed in front of their peers than those weighed in private. [12] In addition, especially in gymnasts, preoccupation and anxiety about gaining weight and being weighed, and viewing food as the enemy were prevalent mindsets. This harmful mindset continued even after the gymnasts were retired from their sport: "Although retired, these gymnasts were still afraid to step onto a scale, were anxious about gaining weight…suggesting that the negative effects of being weighed can linger…[and] suggest[ing] that the weight/ fitness requirements acted as a socio-cultural pressure that would substantially increase the women’s risk of developing an eating disorder in the future." [12]

Disordered eating, along with amenorrhea and bone demineralization, form what clinicians refer to as the female athletic triad, or FAT. [13] In contribution to these eating disorders that these female athletes develop, Results in the lack of nutrition. This can lead to the loss of several or more consecutive periods which then leads to calcium and bone loss, putting the athlete at great risk of fracturing bones and damaging tissues. Each of these conditions is a medical concern as they create serious health risks that may be life-threatening to the individual. While any female athlete can develop the triad, adolescent girls are considered most at risk because of the active biological changes and growth spurts that they experience, rapidly changing life circumstances that are observed within the teenage years, and peer and social pressures. [14]

Social media

Researchers have said the most pervasive and influential factor controlling body image perception is the mass media. [15] One study examined the impact of celebrity and peer Instagram images on women's body image as, “comparisons will be most readily made with individuals who are perceived as being similar” to the target as there is more of a relationship between the two parties. [15] The participants in this study, 138 female undergraduate students ages 18–30, were shown 15 images each of attractive celebrities, attractive unknown peers, and travel destinations. The participant's reactions were observed and visual scales were used to measure mood and dissatisfaction before and after viewing the images. The findings of this experiment determined that negative mood and body dissatisfaction rankings were greater after being exposed to the celebrity and peer images, with no difference between celebrity versus peer images. [15] The media is especially dangerous for females at risk for developing body image issues, and disordered eating, because the sheer number of possible comparisons become larger.

See also

Related Research Articles

An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health. These behaviors include eating either too much or too little. Types of eating disorders include binge eating disorder, where the patient keeps eating large amounts in a short period of time typically while not being hungry; anorexia nervosa, where the person has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD. It is estimated 20–60% of patients with an ED have a history of OCD.

<span class="mw-page-title-main">Bulimia nervosa</span> Type of eating disorder

Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating, followed by purging or fasting, as well as excessive concern with body shape and weight. This activity aims to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives.

<span class="mw-page-title-main">Homosexuality and psychology</span> Homosexuality as studied by the field of psychology

The field of psychology has extensively studied homosexuality as a human sexual orientation. The American Psychiatric Association listed homosexuality in the DSM-I in 1952 as a "sociopathic personality disturbance," but that classification came under scrutiny in research funded by the National Institute of Mental Health. That research and subsequent studies consistently failed to produce any empirical or scientific basis for regarding homosexuality as anything other than a natural and normal sexual orientation that is a healthy and positive expression of human sexuality. As a result of this scientific research, the American Psychiatric Association removed homosexuality from the DSM-II in 1973. Upon a thorough review of the scientific data, the American Psychological Association followed in 1975 and also called on all mental health professionals to take the lead in "removing the stigma of mental illness that has long been associated" with homosexuality. In 1993, the National Association of Social Workers adopted the same position as the American Psychiatric Association and the American Psychological Association, in recognition of scientific evidence. The World Health Organization, which listed homosexuality in the ICD-9 in 1977, removed homosexuality from the ICD-10 which was endorsed by the 43rd World Health Assembly on 17 May 1990.

Binge eating disorder (BED) is an eating disorder characterized by frequent and recurrent binge eating episodes with associated negative psychological and social problems, but without the compensatory behaviors common to bulimia nervosa, OSFED, or the binge-purge subtype of anorexia nervosa.

Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable eating. It is a common symptom of eating disorders such as binge eating disorder and bulimia nervosa. During such binges, a person rapidly consumes an excessive quantity of food. A diagnosis of binge eating is associated with feelings of loss of control. Binge eating disorder is also linked with being overweight and obesity.

<span class="mw-page-title-main">Body image</span> Aesthetic perception of ones own body

Body image is a person's thoughts, feelings and perception of the aesthetics or sexual attractiveness of their own body. The concept of body image is used in several disciplines, including neuroscience, psychology, medicine, psychiatry, psychoanalysis, philosophy, cultural and feminist studies; the media also often uses the term. Across these disciplines, there is no single consensus definition, but broadly speaking, body image consists of the ways people view themselves; their memories, experiences, assumptions, and comparisons about their appearances; and their overall attitudes towards their respective heights, shapes, and weights—all of which are shaped by prevalent social and cultural ideals.

Child psychopathology refers to the scientific study of mental disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and autism spectrum disorder are examples of psychopathology that are typically first diagnosed during childhood. Mental health providers who work with children and adolescents are informed by research in developmental psychology, clinical child psychology, and family systems. Lists of child and adult mental disorders can be found in the International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10), published by the World Health Organization (WHO) and in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association (APA). In addition, the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood is used in assessing mental health and developmental disorders in children up to age five.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

<span class="mw-page-title-main">Relative energy deficiency in sport</span> Syndrome of disordered eating, oligomenorrhoea and osteopenia

Relative energy deficiency in sport (RED-S) is a syndrome in which disordered eating, amenorrhoea/oligomenorrhoea, and decreased bone mineral density are present. It is caused by eating too little food to support the amount of energy being expended by an athlete, often at the urging of a coach or other authority figure who believes that athletes are more likely to win competitions when they have an extremely lean body type. RED-S is a serious illness with lifelong health consequences and can potentially be fatal.

<span class="mw-page-title-main">College health</span> Health of individuals enrolled in college

College health is a desired outcome created by a constellation of services, programs and policies directed at advancing the health and wellbeing of individuals enrolled in an institution of higher education, while also addressing and improving both population health and community health. Many colleges and universities worldwide apply both health promotion and health care as processes to achieve key performance indicators in college health. The variety of healthcare services provided by any one institution range from first aid stations employing a single nurse to large, accredited, multi-specialty ambulatory healthcare clinics with hundreds of employees. These services, programs and policies require a multidisciplinary team, the healthcare services alone include physicians, physician assistants, administrators, nurses, nurse practitioners, mental health professionals, health educators, athletic trainers, dietitians and nutritionists, and pharmacists. Some of the healthcare services extend to include massage therapists and other holistic health care professionals. While currently changing, the vast majority of college health services are set up as cost centers or service units rather than as parts of academic departments or health care delivery enterprises.

<span class="mw-page-title-main">Questioning (sexuality and gender)</span> Process of self-exploration

The questioning of one's sexual orientation, sexual identity, gender, or all three is a process of exploration by people who may be unsure, still exploring, or concerned about applying a social label to themselves for various reasons. The letter "Q" is sometimes added to the end of the acronym LGBT ; the "Q" can refer to either queer or questioning.

As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.

Various issues in medicine relate to lesbian, gay, bisexual, and transgender people. According to the US Gay and Lesbian Medical Association (GLMA), besides HIV/AIDS, issues related to LGBT health include breast and cervical cancer, hepatitis, mental health, substance use disorders, alcohol use, tobacco use, depression, access to care for transgender persons, issues surrounding marriage and family recognition, conversion therapy, refusal clause legislation, and laws that are intended to "immunize health care professionals from liability for discriminating against persons of whom they disapprove."

<span class="mw-page-title-main">Anorexia nervosa</span> Type of eating disorder

Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin.

Social stigma of obesity is bias or discriminatory behaviors targeted at overweight and obese individuals because of their weight and a high body fat percentage. Such social stigmas can span one's entire life, as long as excess weight is present, starting from a young age and lasting into adulthood. Studies also indicate overweight and obese individuals experience higher levels of stigma compared to other people. Stigmatization of obesity is associated with increased risk of obesity and increased mortality and morbidity.

Minority stress describes high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status; well understood causes of minority stress are interpersonal prejudice and discrimination. Indeed, numerous scientific studies have shown that when minority individuals experience a high degree of prejudice, this can cause stress responses that accrue over time, eventually leading to poor mental and physical health. Minority stress theory summarizes these scientific studies to explain how difficult social situations lead to chronic stress and poor health among minority individuals.

Drunkorexia is a colloquialism for anorexia or bulimia combined with an alcohol use disorder. The term is generally used to denote the utilization of extreme weight control methods to compensate for planned binge drinking. Research on the combination of an eating disorder and binge drinking has primarily focused on college-aged women, though the phenomenon has also been noted among young men. Studies suggest that individuals engage in this combination of self-imposed malnutrition and binge drinking to avoid weight gain from alcohol, to save money for purchasing alcohol, and to facilitate alcohol intoxication.

Emotional eating, also known as stress eating and emotional overeating, is defined as the "propensity to eat in response to positive and negative emotions". While the term commonly refers to eating as a means of coping with negative emotions, it sometimes include eating for positive emotions, such as overeating when celebrating an event or to enhance an already good mood.

Body image disturbance (BID) is a common symptom in patients with eating disorders and is characterized by an altered perception of one's own body.

People who are LGBT are significantly more likely than those who are not to experience depression, PTSD, and generalized anxiety disorder.

References

  1. 1 2 3 "Definitions". nedic.ca. Retrieved 31 August 2014.
  2. ↑ "Binge eating disorder". www.nedc.com.au. 17 August 2017. Retrieved 2019-02-03.
  3. 1 2 Ricciardelli, Lina A.; McCabe, Marita P. (March 2004). "A Biopsychosocial Model of Disordered Eating and the Pursuit of Muscularity in Adolescent Boys". Psychological Bulletin. 130 (2): 179–205. doi:10.1037/0033-2909.130.2.179. PMID   14979769.
  4. ↑ Jones, Jennifer M.; Susan, Bennett; Olmsted, Marion P.; Lawson, Margaret L.; Rodin, Gary (September 4, 2001). "Disordered eating attitudes and behaviours in teenaged girls: a school-based study". CMAJ. 165 (5): 547–552. PMC   81412 . PMID   11563206 . Retrieved 31 August 2014.
  5. 1 2 Quick, Virginia M.; Byrd-Bredbenner, Carol; Neumark-Sztainer, Dianne (May 2013). "Chronic Illness and Disordered Eating: A Discussion of the Literature". Advances in Nutrition. 4 (3): 277–286. doi:10.3945/an.112.003608. PMC   3650496 . PMID   23674793 . Retrieved 31 August 2014.
  6. 1 2 Voelker, Dana K.; Petrie, Trent A.; Neumann, Craig S.; Anderson, Carlin M. (2016). "Psychosocial Factors as Longitudinal Predictors of Bulimic Symptomatology Among Female Collegiate Athletes". Psychology of Sport and Exercise. 26: 123–129. doi:10.1016/j.psychsport.2016.06.009.
  7. ↑ "Understanding the causes of eating disorders | The Butterfly Foundation". thebutterflyfoundation.org.au. Retrieved 2019-02-03.
  8. 1 2 3 4 Martinson, Laura E.; Esposito-Smythers, Christianne; Blalock, Dan V. (2016). "The Effects of Parental Mental Health and Social-emotional Coping on Adolescent Eating Disorder Attitudes and Behaviors". Journal of Adolescence. 52: 154–161. doi:10.1016/j.adolescence.2016.08.007. PMC   5028292 . PMID   27567519.
  9. 1 2 Bould, H.; Sovio, U.; Koupil, I.; Dalman, C.; Micali, N.; Lewis, G.; Magnusson, C. (2015). "Do Eating Disorders in Parents Predict Eating Disorders in Children? Evidence from a Swedish Cohort". Acta Psychiatrica Scandinavica. 132 (1): 51–59. doi:10.1111/acps.12389. PMID   25572654. S2CID   5498797.
  10. 1 2 3 4 Mason, Tyler B.; Lewis, Robin J. (2016). "Minority Stress, Body Shame, and Binge Eating Among Lesbian Women: Social Anxiety as a Linking Mechanism". Psychology of Women Quarterly. 40 (3): 428–440. doi:10.1177/0361684316635529. S2CID   147427507.
  11. 1 2 3 4 Watson, Ryan J.; Adjei, Jones; Saewyc, Elizabeth; Homma, Yuko; Goodenow, Carol (2017). "Trends and Disparities in Disordered Eating Among Heterosexual and Sexual Minority Adolescents". International Journal of Eating Disorders. 50 (1): 22–31. doi:10.1002/eat.22576. PMC   5768430 . PMID   27425253.
  12. 1 2 3 4 Tackett, Bailey P.; Petrie, Trent A.; Anderson, Carlin M. (2016). "The Frequency of Weigh-ins, Weight Intentionality and Management, and Eating Among Female Collegiate Athletes". Eating Behaviors. 23: 82–85. doi:10.1016/j.eatbeh.2016.08.007. PMID   27579968.
  13. ↑ Morgado de Oliveira Coelho, Gabriela; Innocencio da Silva Gomes, Ainá; Gonçalves Ribeiro, Beatriz; de Abreu Soares, Eliane (May 12, 2014). "Prevention of eating disorders in female athletes". Open Access Journal of Sports Medicine. 5: 105–113. doi: 10.2147/OAJSM.S36528 . PMC   4026548 . PMID   24891817.
  14. ↑ "Athletes and Eating Disorders". National Eating Disorders Association. Retrieved 2016-11-24.
  15. 1 2 3 Brown, Zoe; Tiggemann, Marika (2016). "Attractive Celebrity and Peer Images on Instagram: Effect on Women's Mood and Body Image". Body Image. 19: 37–43. doi:10.1016/j.bodyim.2016.08.007. PMID   27598763. S2CID   1838871.
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