Eating

Disorder
s
By Maryam Mir
59675
 Table of
Contents
01 What are eating Treatment 04
disorders?
02 Types and Myths vs Truths 05
diagnosis
03 Causes
 What are eating
disorders?
Eating disorders are defined as persistent disturbances in eating behavior or
related behaviors that significantly impair physical health or psychosocial
functioning. They are characterized by an intense preoccupation with food,
body weight, and shape, often accompanied by distorted perceptions of body
image and maladaptive behaviors related to eating, such as severe
restriction, bingeing, or purging.
The categories include:
● Anorexia Nervosa
● Bulimia Nervosa
● Binge-Eating Disorder
● Avoidant/Restrictive Food Intake Disorder (ARFID)
● Other Specified Feeding or Eating Disorder (OSFED)
 Anorexia Key ICD-11 Criteria:

Nervosa
Anorexia Nervosa is a disorder characterized by a
refusal to maintain a minimally normal body weight,
● Low body weight: significantly below expected
range.
● Fear of weight gain: not relieved by weight loss.
intense fear of gaining weight, and a significant ● Body image disturbance: distorted self-perception,
disturbance in the perception of the shape or size of overvaluation of weight/shape.
one’s body." ● May or may not involve purging behaviors.

Subtypes:
● Restricting type – weight loss achieved through Note: In ICD-11, amenorrhea is no longer
required as a diagnostic criterion (it was in
dieting, fasting, or excessive exercise.
DSM-IV).
● Binge-eating/purging type – includes recurrent
episodes of binge eating or purging (e.g.,
vomiting, laxatives).

Psychological Features:
Obsessive thoughts about food, calories, body
image.
Anorexia Nervosa -
Treatment Anorexia Nervosa
● Nutritional rehabilitation: gradual weight
restoration is the top priority
● Medical monitoring: electrolytes, ECG, vital
signs, bone health
Psychotherapy:
Family-Based Therapy (FBT) – first-line for
adolescents
Cognitive Behavioral Therapy (CBT) – for adults
Pharmacotherapy:
Limited benefit; may use SSRIs after weight
restoration to treat comorbid depression/OCD
Atypical antipsychotics (e.g., olanzapine) may help
with weight gain/anxiety
 Bulimia
Diagnostic Criteria (ICD-11):

Nervosa
Bulimia Nervosa is characterized by recurrent episodes of
binge eating followed by inappropriate compensatory
Frequent binge eating episodes (at least
once a week).
behaviors to prevent weight gain, such as self-induced Inappropriate compensatory behaviors.
vomiting, misuse of laxatives, or excessive exercise. Overvaluation of body image.
Behavior is not exclusive to episodes of
Key Features: anorexia nervosa.
Repeated episodes of binge eating (eating a large Complications of Bulimia Nervosa:
amount of food in a short time, with a sense of loss of Medical:
control). Electrolyte imbalances (hypokalemia →
Followed by compensatory behaviors (vomiting, fasting, arrhythmias)
over-exercising, or misuse of diuretics/laxatives). Esophagitis, dental erosion (from vomiting)
Self-evaluation is overly influenced by body shape and Parotid gland swelling, gastric rupture (rare)
weight. Psychiatric:
Unlike anorexia, individuals are typically of normal Depression, anxiety, substance use
weight or overweight. Often comorbid with personality disorders
(especially borderline)
 Bulimia
Nervosa
Psychotherapy:
CBT is the gold standard

Pharmacotherapy:
Fluoxetine (Prozac) – only FDA-
approved drug for bulimia; reduces
binge/purge behaviors
Nutritional counseling: normalize
eating patterns and prevent
restriction
Binge eating
Binge Eating Disorder is characterized by recurrent episodes of binge eating without the regular use
disorder
of inappropriate compensatory behaviors that are seen in bulimia nervosa.
Most common eating disorder in the general population. Often associated with obesity, but not all
individuals with BED are obese. Patients report a loss of control during binge episodes and significant
distress afterward.

Core ICD-11 Diagnostic Features:

Recurrent binge eating episodes (at least once a week for several months).
Episodes involve eating more rapidly than normal, eating until uncomfortably full, eating large
amounts when not hungry, eating alone due to embarrassment, and feeling disgusted, depressed, or
guilty afterward.
Marked distress about binge eating.
No use of purging, fasting, or over-exercising to counteract binges.
Complications of Binge Eating Disorder:
- Medical:
Obesity, type 2 diabetes, hypertension, dyslipidemia
Gastrointestinal issues (e.g., gastric dilation)
Binge eating
disorder
Psychotherapy:
CBT – most effective
Interpersonal therapy (IPT) – also effective
Pharmacotherapy:
SSRIs (e.g., fluoxetine, sertraline)
Lisdexamfetamine (Vyvanse) – approved for
moderate-to-severe BED
Topiramate – may reduce binge frequency
but has cognitive side effects
Behavioral weight loss therapy (only after binge
control)
 Avoidant/Restrictive Food Intake
Definition Disorder (ARFID)Complications of
Key ICD-11
• ARFID is characterized by an eating • Key ICD-11 Criteria:
or feeding disturbance (e.g., • Criteria
Eating disturbance not AFRID
apparent lack of interest in eating explained by cultural norms, • Medical:
or food; avoidance based on the medical conditions, or lack of • Nutritional deficiencies (iron,
sensory characteristics of food; food. vitamin C, etc.)
concern about aversive • Can involve: • Growth delay in children
consequences of eating) that leads • Sensory-based avoidance • Need for enteral feeding in
to persistent failure to meet (e.g., texture, smell) severe cases
nutritional and/or energy needs • Fear of aversive • Psychiatric:
consequences (e.g., choking, • Anxiety disorders,
Not driven by body image concerns, vomiting) neurodevelopmental conditions
unlike anorexia or bulimia. • Apparent lack of interest in (esp. autism spectrum disorder)
eating
Often starts in childhood or
adolescence, but can persist into
adulthood.
 Other Specified Feeding or Eating
Disorder (OSFED)
OSFED includes eating disorders that cause clinically significant distress or
impairment but do not meet the full criteria for anorexia nervosa, bulimia
nervosa, or binge eating disorder.
Most common eating disorder diagnosis in clinical settings.

Symptoms are real and dangerous but may fall short in frequency, duration, or
intensity of full diagnostic categories.
Common Examples of OSFED:
● Atypical Anorexia Nervosa – all features of anorexia are present, but weight
is within or above the normal range.
● Bulimia Nervosa (Low Frequency/Duration) – same symptoms, but occur
less than once per week or for less than 3 months.
● Binge Eating Disorder (Low Frequency/Duration) – same as above.
● Purging Disorder – purging without binge eating.
● Night Eating Syndrome – excessive nighttime eating causing distress.
Complications:
Medical and psychiatric risks similar to full-syndrome disorders.
 Treatment
ARFID:
CBT-AR (ARFID-specific)
Exposure therapy for food fears
Nutritional support and, if needed,
supplemental feeding
OSFED:
Treat based on closest matching full-
syndrome disorder
Focus on individualized psychotherapy +
nutritional guidance
 Causes
Eating disorders are multifactorial — caused by an interplay of biological, psychological, and sociocultural factors.
1. Biological Factors
• Genetics: Increased risk among first-degree relatives; twin studies show high heritability.
• Neurochemical factors: Dysregulation in serotonin, dopamine, and norepinephrine systems (linked to mood,
appetite, and impulse control).
• Hypothalamic dysfunction: May influence appetite and satiety signals.
• Puberty: Hormonal changes during adolescence may trigger or worsen symptoms.
2. Psychological Factors
• Personality traits: Perfectionism, rigidity, obsessionality, low self-esteem, harm avoidance.
• Cognitive distortions: Overvaluation of weight/shape, black-and-white thinking about food.
• History of trauma: Especially sexual or emotional abuse.
• Comorbid psychiatric disorders: Depression, anxiety disorders, OCD, borderline personality disorder.
3. Sociocultural Factors
• Cultural ideals: Thinness is often equated with beauty, success, and control (especially in Western societies).
• Media exposure: Unrealistic body standards in advertising, social media, and entertainment.
• Peer pressure: Especially among adolescents and athletes (e.g., dancers, wrestlers).
• Family dynamics: Enmeshment, high parental expectations, critical comments about weight or appearance.
 Myths vs. Truths
Myth Truth
🧁 Eating disorders are 🧠 They are serious mental illnesses rooted in psychological, biological, and
just about food or vanity. social factors — not just appearance or eating habits.
K Only teenage girls get 👥 Eating disorders affect all genders, ages, ethnicities, and body types. Men,
eating disorders. children, and older adults are also affected.
⚖️You can tell who has ❌ People with eating disorders can be underweight, normal weight, or
an eating disorder by overweight. You can’t diagnose based on appearance.
looking at them.
🍽 Just eat more (or M It’s not about willpower. Recovery needs professional treatment, not just
less) and it’ll go away. diet advice.
📉 Anorexia is the only 🚨 All eating disorders are serious and potentially life-threatening, including
serious eating disorder. bulimia, BED, and ARFID.
💊 Medication alone can 💡 Best outcomes come from a multidisciplinary approach: therapy,
cure eating disorders. nutritional support, medical care, and sometimes meds.