Anorexia Nervosa

If you have this disorder, you see yourself as overweight even though you are dangerously thin. The process of eating becomes an obsession. You develop unusual eating habits, such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. You may repeatedly check your body weight and engage in other techniques to control your weight, such as intense and compulsive exercise or purging. Purging can be done by vomiting or by abusing laxatives, enemas, and diuretics. Girls with anorexia often experience a delayed onset of their first menstrual period.

Symptoms of anorexia nervosa may include:

• Excessive weight loss
• Obsession with food calories and fat content
• Dieting even when thin
• Intense fear of gaining weight, even when underweight
• Distorted self-image of excess weight despite evidence to the contrary
• Undue influence of body weight or shape on self-evaluation
• Loss of menstrual periods (secondary amenorrhea) or delay in onset of period (menarche)
• Excessive exercising
• Feeling cold, especially in the hands and feet
• Being secretive about food
• Hair loss and/or growth of fine hair on the body
• Fainting or severe lightheadedness
• Constipation
• Depression and/or anxiety
• Heart palpitations

The course and outcome of anorexia nervosa varies among people. Some recover fully 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.

Bulimia Nervosa

In bulimia, binge eating episodes are followed by purging or exercise. Therefore, you may weigh within the normal range for your age and height. However, like individuals with anorexia, you may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with your body. You may binge and purge in secrecy, feeling disgusted and ashamed when you binge, yet relieved once you purge.

Behavioral symptoms include:

• Eating huge amounts of food at one time and, as a result, often spending a great deal of money on food
• Feeling like your eating is out of control
• Making yourself throw up
• Taking laxatives, enemas, water pills, or diet pills
• Excessive exercising
• Spending a lot of time alone
• Mood swings
• Depression
• Trouble controlling impulses
• Alcohol or drug misuse

Physical symptoms include:

• Abdominal pain
• Menstrual problems
• Swelling of cheeks and jaw
• Sore throat
• Swollen salivary glands
• Bloating
• Stained or chipped teeth due to contact with stomach acid
• Cuts or scars on back of hands from scraping skin on teeth during forced vomiting

Bulimia can lead to other problems including:

• Dental and throat problems from stomach acid that rises during vomiting
• Changes in body chemistry and fluids due to vomiting and abuse of laxatives or water pills

Symptoms of these complications include:

• Dizziness
• Feeling faint
• Extreme thirst
• Muscle cramps
• Weakness
• Constipation
• Irregular heartbeat
• Heart problems

Binge Eating Disorder

If you have binge eating disorder, you experience frequent episodes of out-of-control eating, with the same binge eating symptoms as those with bulimia. The main difference is that you do not purge. Therefore, you may be overweight for your age and height. Feelings of self-disgust and shame associated with this illness can lead to recurrent binging.

Symptoms include:

• Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
• The binge-eating episodes are associated with at least three of the following:
  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of embarrassment about how much you are eating
• Feeling disgusted with yourself, depressed, or very guilty after overeating
• Marked distress about the binge eating behavior
• The binge eating occurs, on average, at least two days a week for six months
• The binge eating is not associated with the regular use of inappropriate compensatory behaviors (ie, purging, fasting, or excessive exercise)