Christmas just ended, and people all over the nation are still loosening their belts a little bit from their most recent night of feasting and conviviality. Those who managed to stay sober over the holidays are hopefully showing a bit of gratitude for the feat they have just accomplished, but there are many out there who are still suffering. And while we usually confine our focus to addicts and alcoholics, they are not the only ones who found their addictive tendencies challenged this holiday season. Those who suffer from many various eating disorders have encountered their own struggles as well.
Many do not think of eating disorders as addictions, but we are here to tell you that they most certainly are. The overeater or the anorexic may not be at risk of overdose or alcohol poisoning, but their extreme urges still put them at great health risk. In some cases, these risks may even prove fatal. But before we get to that, let’s discuss the nature of eating disorders as a form of addiction.
Eating Disorders ARE Addictions
This is a matter we’ve talked about before, although our discussion at the time was focused on the particular struggles of MMA fighter Ronda Rousey. She managed to overcome her struggles with drugs and eating disorders, but there are many who do not. As is the case with drugs and alcohol, however, there are some who would attribute the choices made by her or any other person to simple bad decision-making. With a limited understanding regarding the disease model of addiction, such persons fail to see the complex mentality behind the actions of the addict.
Addiction Blog documents this mentality and its relation to eating disorders quite well. They note the definition of addiction provided by Dr. Gerald May in his book, Addiction and Grace, in which addiction is described as “any compulsive, habitual behavior that limits the freedom of human action.” Furthermore, alcoholics and drug addicts are taught through programs such as AA and NA that alcoholism and addiction are conditions over which we are powerless, and under which our lives become unmanageable. Not only do these definitions match the one provided by Addiction Blog and Dr. May, but they also greatly describe the nature of most eating disorders.
When you consider the nature of most eating disorders, the addictive tendencies are quite apparent. Those who are prone to compulsive overeating may feel as if they are hardly in control of themselves. Their capacity for rational thought becomes compromised, and it is as if another entity altogether has taken the reins in controlling their actions. The same applies to those who suffer from bulimia, and must compulsively purge after binge eating. Even anorexia could be said to constitute a form of addiction, as the sufferer is powerless over their compulsion to abstain from nourishment.
When you look at things from this perspective, you’ll find that the nature of addiction as seen in eating disorders is not all that different from the nature of alcoholism and drug addiction. The only difference is the “drug” of choice. Eating disorders are still focused on filling a void within ourselves, and we sometimes attempt to do this in the most literal way possible. Anorexia may not be concerned with filling a literal internal void, but it is still largely centered on our fear of the world around us. This fear manifests in many different ways. In fact, even eating disorders are somewhat varied among themselves.
Types of Major Eating Disorders
We have already mentioned each of the three main types of eating disorders (anorexia nervosa, bulimia nervosa, and binge eating disorder) above. Each of these disorders has its own signs and symptoms, manifesting themselves within people in very different ways. If we are to talk about the causes and effects of these disorders, we must first examine said signs and symptoms in order to increase your understanding of what these conditions really entail. This will also help you to better ascertain whether or not you or a person you know may be suffering from one of these conditions.
The first we would like to discuss is binge eating disorder, which stands apart from the other two. Out of all three major eating disorders, this is the only one in which the sufferer is not overly concerned with losing weight. That does not mean that the person is not worried about weight gain; in fact, the weight they gain from overeating may lead to severe depression. Still, they will continue to eat with very little in the way of inhibitions. This disorder is common under the age of 40, usually beginning around the age of 25. As common in men as it is in women, the major signs to look for are people who hoard food, and who seem to rack up a large number of empty containers in a short amount of time. Conscious about their weight, they will often wear baggy clothes and attempt to go on diets. They will also generally eat in secret, knowledgeable of the fact that they are eating more than the average person. As they grow to feel worse about their rate of consumption, the overeater will often eat more. As noted by WebMD, those who suffer from this disorder will rarely engage in physical exercise.
Anorexia nervosa lies on the other end of the spectrum. Rather than overeating, the anorexic will refrain from consumption due to a belief that they are overweight. This belief, however, is often inaccurate, a potential result of body dysmorphic disorder. The Mayo Clinic defines body dysmorphia as “a type of chronic mental illness in which you can’t stop thinking about a flaw in your appearance—a flaw that is either minor or imagined.” The anorexic’s addictive tendencies arise from an obsession with ironing out this flaw, even long after doing so has caused them to become grossly underweight. People who suffer from anorexia may wear bulky clothes, either to conceal their weight loss or to hide their imagined weight gain. It is most common among younger females, and many may stop menstruating when the issue grows out of hand. If an underweight person is frequently speaking negatively about their weight and using words like “fat” while engaging in excessive exercise and/or never eating in front of another person, then it is likely that they are struggling with this condition. Some will also abuse diuretics to further induce weight loss, and may even have bouts of bulimia.
Bulimia nervosa is similar to anorexia in that it largely occurs in women, usually onset within the sufferer’s teenage years. They will also exercise frequently, and may experience bouts of borderline anorexia in which they go on long dietary fasts. The primary symptom of bulimia nervosa is that the bulimic will usually binge on food, overeating until they decide to purge themselves by vomiting or taking laxatives. Those who suffer from bulimia are not as likely to be underweight, but they will still have a fear of weight gain and may still exhibit some body dysmorphic tendencies. It is a little easier to tell when a person is suffering from bulimia, as they will often disappear to the bathroom after a meal and may occasionally smell of vomit. Some might do better at hiding their condition by using excessive amounts of mouthwash, mints, or gum. Still, those who live with them may notice food disappearing at an alarming rate. As with the other disorders, many bulimics will wear baggy clothing out of concern for their appearance, and may frequently complain about their size. They are also likely to have scars on their knuckles as a result of their purging.
How Eating Disorders Are Caused
As noted by Addiction Blog in a previously linked article, eating disorders are similar to other addictions in that they usually appear to offer the sufferer some means of freedom or escape. Much as the alcoholic may enjoy drinking because it allows them to alter their state of mind, those who suffer from eating disorders may feel that their actions are helping them to handle their fears of weight gain and their concerns over their physical appearance. This is sheer deception, but it appears comforting to those who are gripped by fear and searching for a way to remove it.
While body dysmorphia is still one major potential cause of anorexia and bulimia, mood disorders such as depression and anxiety may also be at the root of these eating disorders in addition to overeating. Note that depression and anxiety are also major co-occurring disorders of drug addiction and alcoholism. When a person chooses to use food (or abstention from it) as a coping mechanism for their internal pain, they are able to feel as if they have taken control of a situation over which they previously had no power. Again, this person is generally deceiving themselves with this belief. Nonetheless, addiction is a disease that offers a level of synthetic comfort, and many who suffer from it are prone to feeling as if their addictive tendencies have offered them something closer to true happiness than they have ever felt in the past. As such, it will be very difficult for many people to change their ways once they have begun their downward spiral.
A previously linked WebMD article also notes that many eating disorders share comorbidity with substance abuse. According to the National Eating Disorders Association (NEDA), this correlation may be just as influenced by genetic factors as it is by psychological factors. In fact, they believe genetics to account for about 40-60% of people in whom eating disorders and substance addiction are comorbid. Some will use illicit drugs that suppress their appetites, while others will become addicted to steroids and other drugs that promote fitness. There are also many who drink, despite the fact that alcohol is generally quite high in calories. The primary theory is that those who abuse alcohol may be doing so to elicit vomiting without leaving telltale scars on their knuckles. In the case of the overeater, alcohol is simply another form of consumption.
Dangers and Notable Side Effects
Each of the above disorders is dangerous in its own way, and even body dysmorphia carries with it some potentially dangerous side effects. Reid Ewing, the actor who plays Dylan on Modern Family, wrote in a November 2015 op-ed piece for the Huffington Post that he has been struggling with body dysmorphic disorder since he was a teenager. When he was 19, he began undergoing cosmetic surgery. But it didn’t allay his concerns. He became more worried than ever, and proceeded to undergo further surgeries. He now regrets these choices, wishing he had appreciated his prior appearance. Other celebrities, such as Robert Pattinson, Hayden Panettiere, and Sarah Michelle Gellar have all professed to struggle with body image in the past. Note that all of these celebrities are generally highly lauded for their looks.
Binge eating disorder also leads to regret, albeit in a much different way. As the overeater regrets their weight gain and winds up in the vicious cycle of eating their feelings, they are often subjected to many more physical consequences. This is especially true when overeating results in obesity. These can lead to the onset of diabetes, as well as high blood pressure and numerous cardiovascular problems. Obesity can also lead to gallstones, gallbladder disease, stroke, osteoarthritis, respiratory problems such as sleep apnea, and gout. Those who gain too much weight from overeating may even find themselves at increased risk for several cancers, including colon cancer and breast cancer.
Anorexia nervosa can also lead to a number of health complications. Since the anorexic often becomes the precise opposite of what they fear, they run the risk of becoming so grossly underweight as to risk malnutrition. They will be less able to function properly, and they will be at potentially great risk when exercising if they attempt to do more than their body can handle. If the problem gets too bad, they may even be at risk of organ failure. In other words, while overeating and anorexia may appear to be on opposite poles, both of these eating disorders are potentially fatal.
Bulimia nervosa is known for causing a slew of dental problems, as the teeth are exposed to an excessive amount of stomach acid. This reflux, however, can often be so severe as to cause numerous problems that are anything but cosmetic. As the stomach acid travels up the throat during a purge, it wears on the membranes over time. This may eventually lead to bleeding from the esophagus. Those who suffer from bulimia may also suffer from abnormal heart rhythms. Furthermore, remember that many who suffer from both anorexia and bulimia are prone to abusing diuretics. Depending upon the specific pill they are taking, they may be putting themselves in the crosshairs of any number of potentially fatal side effects.
Getting the Help You Need
Overeaters Anonymous (OA) is a group quite similar to AA or NA. It is a 12-step program offering fellowship for those who must deal with the emotional and spiritual aspects of binge eating disorder in addition to the physical components. In addition to joining OA, those who suffer from binge eating disorder should consult a licensed professional about receiving antidepressants and/or psychotherapy. It would also be worth their time to seek out behavioral weight reduction programs, which focus on losing weight while also teaching those with this disorder to better control their eating habits. Vyvanse, an FDA-approved stimulant containing lisdexamfetamine dimesylate and often used in the treatment of ADHD, has also been shown to reduce binge eating habits through an increased balance of certain neurotransmitters.
Patients struggling with anorexia will often need a great deal of therapy in order to overcome their body dysmorphia. In fact, really anybody who suffers from the primary three eating disorders would do well to be treated in this fashion. Anorexic patients may also require antidepressants, and will need to focus on proper nutrition (which will also serve to benefit their mental health). Along with bulimia, anorexia is one of the easier eating disorders to treat from a physical standpoint, as any extreme weight loss can be regained as the patient learns to eat properly. Treating anorexia on a psychological and emotional level may take a bit more time.
Those who suffer from bulimia are often treated through cognitive behavioral therapy and/or antidepressants. Anticonvulsant medications such as carbamazepine and valproate have also been shown to yield some success in previous trials. The anticonvulsant topiramate has also shown some success in reducing bulimic symptoms, although trials have been more limited. As with anorexia, it will take much longer to treat the psychological and emotional symptoms than the physical ones.
If you or anyone you know is suffering from one of the above eating disorders, measures should be taken to seek treatment immediately. Many of these disorders may already be quite severe by the time they are discovered, and it is vital to reduce the likelihood of suffering various health defects that may be caused by any one of these conditions. One may not risk dying overnight, as is possible with drinking and drug abuse. But killing oneself slowly over time is no more desirable.
So do the right thing, and seek help for yourself or for anyone you know who may be struggling with an eating disorder of their own. Above all, learn to appreciate yourself. It is far better to love who we are than to be lost forever to the world.