Eating disorders - anorexia, bulimia, and binge eating disorder

Eating disorders - anorexia, bulimia, and binge eating disorder

Patrycja is seventeen years old. Her mom says she "just doesn't eat much." That she's picky. That it'll pass. Patrycja weighs 42 kilograms at a height of 168 centimeters. She counts every calorie. She exercises for two hours a day. She wears oversized clothes so no one can see how much weight she's lost. Her friends tell her she looks great - and this reinforces her belief that she's on the right track. In the mirror, she sees fat that isn't there.

Patrycja has anorexia. But neither she nor her parents know it yet. Because eating disorders are illnesses that disguise themselves perfectly - under the guise of a healthy lifestyle, discipline, control.

What are eating disorders?

Eating disorders are serious mental illnesses that manifest through disordered eating behaviors. They're not a matter of "willpower," "whims," or a "phase." They have biological (genetic, neurochemical), psychological (self-esteem, control, trauma), and social (cultural pressure, beauty ideals) underpinnings. And they can be fatal - anorexia has the highest mortality rate of all mental illnesses.

The three most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder (BED). The boundaries between them can be fluid - a person may transition from one form to another over the course of their life.

Anorexia - when control over food becomes an illness

Anorexia is not "wanting to be thin." It's a complex mental illness in which fear of gaining weight and distorted body perception lead to drastic restriction of food intake. A person with anorexia may weigh significantly less than they should, yet still see themselves as "too fat." This is not a lie or an act - it's a perceptual disturbance called body dysmorphia.

Anorexia may involve drastic calorie restriction, excessive exercise, use of laxatives or diuretics, avoidance of eating with others, ritualistic behaviors around food (cutting into tiny pieces, eating in a specific order, hiding food).

The physical consequences of anorexia are severe: electrolyte imbalances (which can lead to cardiac arrhythmias), osteoporosis, muscle wasting, hair loss, hormonal disruption (loss of menstruation), kidney and liver damage, weakened immune system. In extreme cases - death.

But anorexia is above all psychological suffering. Behind the control over food lies an attempt to control a life that feels chaotic. Behind the desire to be thin - a deep sense of personal inadequacy. Behind the refusal to eat - punishing oneself for an imperfection that cannot be fixed.

Bulimia - the binge-purge cycle

Bulimia is characterized by binge eating episodes (consuming large amounts of food in a short time, with a feeling of loss of control), followed by attempts to "undo" it - through induced vomiting, use of laxatives, excessive exercise, or fasting.

A person with bulimia may have a normal weight - which makes the illness harder to spot from the outside than anorexia. But internally, they experience tremendous suffering: shame after a binge episode, fear of gaining weight, a sense of loss of control, loneliness (because bulimia is an illness carried in secret - episodes most often happen in hiding).

Physical consequences of bulimia include dental enamel erosion (from stomach acid), chronic sore throat, esophageal problems, electrolyte imbalances, swollen salivary glands, gastrointestinal problems. Psychological consequences - depression, anxiety, social isolation, suicidal thoughts.

Binge eating disorder - illness without purging

Binge eating disorder (BED) is the most common eating disorder, and at the same time the least recognized. It involves regular binge episodes - consuming large amounts of food in a short time, with a feeling of loss of control - without compensatory behaviors (no vomiting, no fasting).

A person with BED eats even when they're not hungry. They eat quickly, in secret, until they feel physical discomfort. After the episode, they feel shame, self-disgust, guilt. Episodes are often triggered by emotions - stress, sadness, loneliness, boredom.

BED is often mistaken for "lack of discipline" or "indulgence." This is hurtful and false. BED is a mental illness that requires treatment - just like anorexia or bulimia. It frequently co-occurs with depression and anxiety disorders.

Who is at risk?

Eating disorders can affect anyone - regardless of gender, age, body weight, or social status. Although stereotypically associated with teenage girls, boys, adult men and women, middle-aged people, people who are overweight, and people of normal weight are also affected.

Risk factors include low self-esteem, perfectionism, difficult childhood experiences (abuse, neglect, bullying), trauma, environmental pressure regarding appearance (athletes, models, dancers), family history of mood disorders, and genetic predisposition.

How to recognize eating disorders in a loved one

Eating disorders develop gradually and often in secret. Warning signs to watch for:

• Sudden change in eating habits - eliminating entire food groups, eating only "healthy" products, avoiding shared meals
• Obsessive calorie counting, weighing food, reading labels
• Sudden weight loss or gain
• Excessive exercise - exercising despite illness, injury, bad weather
• Going to the bathroom immediately after meals (may indicate induced vomiting)
• Hoarding and hiding food
• Social withdrawal, irritability, mood changes
• Obsessive mirror-checking or avoidance of mirrors
• Wearing loose clothing to hide the body

Treatment of eating disorders

Eating disorders require comprehensive treatment that combines psychological, dietary, and - in many cases - psychiatric help. Treatment is not about "learning to eat normally." It's work on the deep psychological problems that underlie the disorder.

Psychotherapy - particularly cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) - is the foundation of eating disorder treatment. Working with a psychodietitian helps rebuild healthy eating habits. Psychiatric treatment (pharmacotherapy) may be necessary when the eating disorder is accompanied by depression, anxiety, or obsessive-compulsive disorder.

Support at Sztuka Harmonii

At the Sztuka Harmonii Psychological Center in Gdansk, we offer support for people with eating disorders and a disordered relationship with food. Psychodietetic consultations help understand the psychological mechanisms behind food-related problems. Individual psychotherapy addresses deeper issues - self-esteem, control, trauma, relationships. For adolescents with eating problems, Milena Komorowska, MA and Sandra Malkowska, MA offer psychological support tailored to the needs of teenagers.

If you suspect that you or someone close to you is struggling with an eating disorder - don't wait. The sooner you begin treatment, the better the prognosis. Call 732 059 980 and schedule a consultation. Eating disorders are illnesses from which recovery is possible - but professional help is needed.