What are some common eating disorders?
Eating disorders are serious and complex mental health problems that can impact a person’s long-term physical health and mortality. Over time, we have come to recognize eating disorders as a diverse group of conditions, which are described in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) (DSM-5). These mental health concerns all share a common feature: disturbances in a person’s feelings, thoughts and behaviours related to their body and food.
Anorexia Nervosa
Anorexia nervosa is where a child or young person overestimates their body size and places a significant amount of emphasis on the importance of their physical appearance. They are motivated by a powerful and persistent fear of gaining weight or “becoming fat.” Here, a child or young person will engage in behaviours that interfere with maintaining adequate weight (like restricting food, exercising intensely, using medications to lose weight or keep it low) and use “body checking” strategies (like habitual weighing, using mirrors to check for fat, obsessively measuring body parts) to evaluate body size and weight frequently.
Bulimia Nervosa
Bulimia nervosa is when a young person negatively evaluates their weight and body shape and believes that the way they look matters more than anything else about them. These thoughts and feelings lead them to engage in a cycle of restricting food, followed by binging food, and then either purging (throwing up) or using laxatives as a way of attempting to rid the body of the calories consumed. A person is diagnosed with bulimia when this cycle typically happens weekly for at least three months.
Binge Eating Disorder
In binge eating disorder, a young person tends to eat very quickly and continues to eat despite being full. They often eat alone because they’re embarrassed by the quantity of food they are consuming and feel a mix of emotions (like disgust, guilt, or depression) while doing so. We all overeat from time to time, but binge eating disorder involves regularly consuming more food than your body needs. This behaviour is psychologically distressing for the individual and uncontrollable.
Avoidant Restrictive Food Intake Disorder (ARFID)
Avoidant Restrictive Food Intake Disorder (ARFID) is where a child or young person limits the volume and/or variety of food they eat. Unlike other eating disorders, ARFID isn’t due to a person’s distress about weight or body shape. Instead, it’s selective eating that is motivated by a lack of interest in food, a sensitivity or strong reaction to the taste, texture or smell of food, and/or a fear of choking or vomiting while eating. ARFID typically starts in infancy or early childhood and can persist into adulthood (it’s present in about 0.5-5% of children and adults in the general population). This condition isn’t related to a lack of access to food (food insecurity) or cultural practices (like fasting during Eid or keeping kosher), and it can’t be explained by another medical issue or disorder. Children or young people diagnosed with ARFID aren’t just “picky eaters.” The impacts of this condition include weight loss, stalled growth, nutritional deficiencies, and behavioural consequences (like troubled relationships, poor engagement in work or school, etc.).
Orthorexia
Orthorexia is a pattern of behaviour that involves an obsession or preoccupation with “healthy eating.” Here, a child or young person tends to focus on eating correctly or properly rather than enjoying a range of foods. Although many of us prioritize healthful eating, people struggling with orthorexia focus obsessively on food and use weight as a measure of their success in controlling their nutrition. Social isolation and health problems can occur in orthorexia. While this isn’t a diagnosable eating disorder in the DSM-5 (instead, it’s an “informal definition”), this condition can evolve into anorexia nervosa if weight loss becomes extreme.
There are other eating disorders that don’t necessarily match the criteria for any of the conditions described above but impact a child or young person’s health negatively, nonetheless.
Pica
Pica is the consumption of non-food items (like paper, hair, string, soil, paint, rocks, etc.) that lasts for at least a month. While children between a year and a half to two years of age often put things in their mouths, this is a deliberate, persistent act of eating objects (some of which can be toxic) that can interfere with digestion and weight gain and cause illness.
Rumination Disorder
Rumination disorder (which is sometimes linked to anorexia or bulimia nervosa) is where a child or young person swallows food and brings up the chewed or partially digested contents back into the mouth without any signs of gagging or nausea. For a medical professional to diagnose this eating disorder, the act of regurgitation must take place regularly over the course of a month.
In some cases, there may be some qualities or characteristics of an eating disorder present that don’t fit neatly into any one of the above DSM-5 categories. In these situations, a diagnosis of Other Specified Feeding or Eating Disorders (OSFED, formerly known as “eating disorder not otherwise specified”) may be used. This is an umbrella term that encompasses a mix of symptoms, so it’s a good idea to ask your primary care doctor or eating disorder specialist for specific details about how this term applies to your child or young person.