Hello everyone and happy Tuesday. This week is National Eating Disorder Awareness. As a future RD, eating disorders are something I’ve wanted to learn more about for a while. They’re a complex issue and should be managed with a healthcare team, including a dietitian. If you or a loved one have symptoms similar to any of these, I would encourage you not to self-diagnose, but talk to a healthcare professional. Whether you personally know anyone who might be dealing with this or not, you can still help! I’ll share some links at the end of this article with more information.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines psychiatric disorders, including eating disorders. According to the DSM-5, published in 2013, there are seven different EDs. I’ll describe them below.

Anorexia Nervosa

Anorexia nervosa is what commonly comes to mind at the mention of an eating disorder. People with this ED focus on extreme weight loss, usually through low calorie intake and/or high amounts of exercise. People with anorexia nervosa can also exhibit binging and/or purging, extreme weight loss, and dressing in layers to hide weight loss and stay warm.

Bulimia Nervosa

Bulimia nervosa is characterized by episodes of binge eating followed by inappropriate compensatory behaviors. These behaviors include fasting, high amounts of exercise, or purging with laxatives or self-induced vomiting. Other signs may include the disappearance of large amounts of food from the house, and calluses on the back of the hand from self-induced vomiting.

Binge Eating Disorder (BED)

Symptoms of binge eating disorder include frequent binge periods where the person feels out of control, eats excessively, and to the point of discomfort. Afterwards the person feels intense guilt and shame over the episode.

Avoidant Restrictive Food Intake Disorder (ARFID)

Avoidant Restrictive Food Intake Disorder was new to me. I think that’s because, unlike many of the more well-known eating disorders, ARFID has no tie to body image. Instead, this disorder describes when a person avoids a high number of foods. Now, many of us had a “picky eater” phase at some point, but ARFID is more than that. It’s problematic because the person’s range of preferred foods narrows to the point of stalled weight in children and weight loss in adults. Because their caloric intake is low, it may also lead to micronutrient deficiencies.

Rumination Disorder

Here’s another one I hadn’t heard of. Rumination disorder involves regurgitating food almost effortlessly. The person isn’t disgusted or distressed when regurgitating their food. Healthcare professionals sometimes misdiagnose this disorder as some kind of vomiting problem like GERD (gastroesophageal reflux disease) or gastroparesis (delayed digestion).

Other Specified Feeding and Eating Disorders (OSFED)

If you’ve read older information on eating disorders, you may be more familiar with the acronym EDNOS (Eating Disorder Not Otherwise Specified). Patients are diagnosed with OSFED when they don’t meet the requirements of something like anorexia or bulimia nervosa, but still have a very serious eating disorder. Therefore, a person with OSFED may have any of the following symptoms in any combination, including binging and/or purging, evidence of high use of laxatives, diuretics, and/or vomiting, or dieting behaviors.

Unspecified Feeding or Eating Disorder (UFED)

UFED is different from OSFED. A person diagnosed with UFED may show symptoms of an eating disorder, but the clinician chooses not to offer a more specific diagnosis. Often this is because there isn’t enough information on the patient, such as in an emergency room setting, so the clinician can’t be more specific.

How Can You Help?

Eating disorders can affect anyone. If you want to learn more or take action, here are some resources that are great places to start.

• Educate yourself! Here are some good websites and brochures if this article has inspired you to do some digging on your own.
  • A brochure from the National Eating Disorders Association
  • A great overview from the American Depression and Anxiety Association with links to other resources
  • Eating disorders affect more types of people than you realized. Go to this page and scroll down to “Infographics” to learn more.
• Get involved! Go to NEDA’s “Take Action” page to find out what you can do to raise awareness and advocate for eating disorders.
• Finally, if you or someone you know might need help with an eating disorder, text “NEDA” to 741741, or call (800) 931-2237. Or click here to get connected with a trained helpline volunteer.

Until next time,
Emmalee