
Eating disorders are on the rise, affecting about 30 million people worldwide today. And they can be life-threatening.
Amy Ethridge, an occupational therapist and clinical psychiatric specialist in the Adolescent Medicine and Eating Disorders Program at the Milton S. Hershey Medical Center, describes the causes as pieces of a puzzle. “It is usually a stress response, too,” she said.
Patients do not choose eating disorders, and parents do not cause them. Television programs and advertisements that promote unattainable body types do not help. Heredity and anxiety can also play a role.

Ethridge and Jamal Essayli, director of the medical center’s Young Adult Eating Disorders Program, shared some information about eating disorders and how to get treatment [1]. Acquiring an eating disorder does not happen overnight. It’s not a choice – people of all ages, genders, cultures and backgrounds can be affected.
The most common eating disorder is anorexia nervosa. Fear of weight gain motivates anorexia sufferers to restrict their calorie intake drastically. Often, patients also have distorted perceptions of their bodies. Weight loss, an excessive focus on body image, weight anxiety and avoidance of calorie-rich or non-diet foods are warning signs to be aware of.
Symptoms of atypical anorexia nervosa are similar, but the person is not underweight. There is no limit to the size and shape of people who suffer from eating disorders.
Essayli explained that higher-weight individuals are more likely to be affected by eating disorders. “It is critical that providers screen for warning signs of eating disorders like anxiety about eating in individuals who are not underweight, as these individuals often go undetected due to their weight status.”
Another eating disorder, bulimia nervosa, involves restricting food intake to lose or reduce weight gain. In addition, they often binge eat, eating excessive quantities of food in a short period.

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They may vomit, take laxatives or exercise excessively to compensate for the calories eaten during binges. A poor body image is familiar among those suffering from bulimia nervosa. Symptoms can include chronic sore throats, swollen salivary glands, digestive issues and worn tooth enamel due to stomach acid.
Dieting can also cause out-of-control food consumption in binge-eating disorders. It is usual for people with this disorder to eat when they are not hungry, often in secret. To compensate, they engage in behaviors like vomiting.
Another type of eating disorder is avoidant/restrictive food intake disorder. The reason for restricting and avoiding food, in this case, is unrelated to body image.
There may be a severe picky eating problem, a fear of choking or vomiting, or a lack of appetite. Children with this condition may not be able to develop properly.
Although eating disorders can only be diagnosed by a medical professional, there are warning signs to look out for. Someone might overtrain, be obsessed with food and dieting, or worry about what they’ll eat at a restaurant.

Refusing to eat certain foods without having an allergy may be an indication. For example, restricting all carbohydrates in order to lose weight.

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Food rituals, excessive chewing, or being careful not to let two foods touch can indicate an avoidant/restrictive food intake disorder. Additionally, eating alone, skipping meals or taking small portions are common signs.
The size and shape of one’s body is a common concern, but distorted perception can make it an obsession. Dental erosion and frequent bathroom trips can also be indicators.
If you’re concerned about a loved one, Ethridge offers advice on discussing them with them. “Expressing concern about the behavior is the best course of action,” she said.
Talk about what you have noticed has happened or has become challenging for them. Beware of minimizing the matter by resorting to telling them to “just eat.”
Be ready for negative responses and even dismissal of the topic. The goal is not to diagnose it but to help them get treatment by starting with a medical evaluation [2].
[1] https://www.pennstatehealth.org/doctors/jamal-h-essayli-phd
[2] https://www.usnews.com/news/health-news/articles/2023-03-13/what-are-eating-disorders-and-what-are-the-signs