A guide for parents about the different types of eating disorders
There are technically five eating disorder diagnoses, but few eating disorders fit neatly into a single diagnostic code. And in fact the different types of eating disorders have a lot in common behaviorally and psychologically.
Your child may have a relatively straight-forward diagnosis like anorexia or bulimia. Or they may have one of the many variations that show up in OSFED, a category that covers multiple subtypes like over-exercise disorders, anorexia at higher weight, and orthorexia.
Whatever your child’s diagnosis, treatment can help! Your child will need to learn to live without their eating disorder, and parents and family can make a huge difference.
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Types Of Eating Disorders By The Numbers
47% Other Specified Feeding and Eating Disorder (OSFED). The most common eating disorder is for when eating disorder behaviors don’t fit the criteria for other types. Though this may make it sound less serious, it is equally severe and dangerous.
22% Binge Eating Disorder (BED). The second most common eating disorder is binge eating disorder. This often involves a restrict-binge cycle in which a person restricts food and then binge eats.
19% Bulimia (BN). This involves a restrict-binge-purge cycle. Purging may include vomiting, laxative use, and/or over-exercise. Bulimia is strongly associated with trauma.
8% Anorexia (AN). This eating disorder is characterized by restriction, significant weight loss, and a low BMI. If a person has all the symptoms including significant weight loss but is not in a low BMI category they will be diagnosed with OSFED.
5% Avoidant Restrictive Food Intake Disorder (ARFID). The only eating disorder that is not technically associated with body image and a desire to lose weight. ARFID involves food avoidance and restriction often due to sensory issues.
Other Specified Feeding and Eating Disorders (OSFED)
Though few have heard of it, OSFED is the most common eating disorder. Unfortunately, it is often misinterpreted as being less serious. But studies have shown that people with OSFED suffer consequences that are just as severe, often even more severe than those who are diagnosed with anorexia or bulimia. This is partly due to the fact that OSFED is less likely to be diagnosed early and may be under-treated.
OSFED has many subtypes, including purging disorder, orthorexia, bigorexia, night eating syndrome, and exercise disorder. It is also used to categorize “atypical anorexia.” These are people who meet all the criteria for anorexia except low body weight according to BMI. This is controversial since people with the symptoms of anorexia at higher BMI percentiles face the same health risks.
Binge Eating Disorder
Most people think of binge eating disorder as the opposite end of the spectrum from anorexia. They assume that people who have binge eating disorder love eating “too much,” lack self-control and have high body weight. However, these assumptions over-simplify a complex physical and emotional system that drives binge eating. They can interfere with our ability to recognize and treat binge eating disorder.
Binge eating disorder is defined by binge eating episodes. These are specific episodes during which the person consumes more than is typical, faster than usual, and gets uncomfortably full. Binge eating disorder involves tremendous shame and embarrassment.
Restriction and physical and emotional dysregulation are the most common triggers for binge eating episodes. Restricting food, and even just thinking about restricting food and wanting to lose weight can create a physiological urge to binge eat.
This disorder involves all of the main eating disorder behavior symptoms: restricting, binge eating, and purging. It has the added element of a possible dependence because the act of vomiting may release chemicals that positively reinforce the behavior.
Research has revealed that genetic effects and environmental factors contribute to the risk of developing bulimia. Bulimia is associated with depression, anxiety, substance use, and self-harm behaviors such as cutting.
There is also a high degree of overlap between bulimia and childhood adversity, trauma, insecure parental attachment. PTSD and other symptoms of trauma are more common in people with bulimia compared to other eating disorders.
This is the best-known and the most widely studied eating disorder. Nonetheless, there is still a tremendous mystery about it and like all eating disorders it is difficult to treat. Anorexia is an endless cycle of food restriction. The restriction may be due to biological factors ranging from genes to highly sensitive nervous systems and different brain mechanisms and hunger cues. There is significant heritability of anorexia.
For far too long, anorexia was presented as a disorder of vanity. But while negative body image is an important symptom of the disorder, anorexia has very little to do with vanity. In fact, it is becoming increasingly clear that the root causes are likely biological.
Anorexia is associated with anxiety disorders, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD). An essential part of treating anorexia is weight restoration. As long as the person remains weight-suppressed, they are unlikely to respond to psychological interventions.
Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID symptoms include strong food aversions and food avoidance. For example, someone with ARFID may avoid eating specific foods, especially meats, vegetables, and fruit. This may take place due to an aversion to sensory input from taste, texture, smell, appearance, and even sound.
Others may restrict what they eat because they have a low interest in eating or have lower hunger cues and appetite than normal. Also, some people avoid food or even stop eating altogether after a traumatic experience with eating like vomiting, choking, being constipated, nauseated, etc.
ARFID is associated with anxiety disorders, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD). ARFID is very similar to anorexia but it differs in that there is no desire to lose weight or change the body size or shape. Many times it is first observed when the child is very young.
Use these scripts:
- At the dinner table when behavior is getting out of control
- When you need to set boundaries – fast!
- After something happened so you can calmly review the triggers and events
Key Articles About Types of Eating Disorders
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