International No Diet Day 2020: What Are Eating Disorders?

Every year, International No Diet Day (INDD) is observed on 6 May. The day celebrates body acceptance, raising awareness on the importance of body positivity and body shape diversity. INDD also aims to promote a healthy lifestyle with a focus on health at any size.

The goals of INDD is to "question the idea of one 'right' body shape, raise awareness of weight discrimination, size bias and fatphobia, declare a day free from diets and obsessions about body weight, present the facts about the diet industry, emphasizing the inefficacy of commercial diets, honour the victims of eating disorders and weight-loss surgery and help end weight discrimination, sizism and fatphobia" [1].

INDD has faced criticisms for its approach, where health experts assert that although the day is celebrated with the right intentions, it ignores the importance of staying fit and healthy.

On this International No Diet Day, we will focus on one of the key aspects of the day, eating disorders, as INDD honours the victims of eating disorders and weight-loss surgery [2].

What Are Eating Disorders?

Eating disorders are serious conditions that are characterized by irregular eating habits and severe distress about one's body weight or shape [3]. Eating disorders not only affect your physical health but also your mental health.

Eating disorders are complex and are complex mental health conditions that often require the help of psychological experts. Most eating disorders involve focusing too much on your weight and body shape, resulting in the development of dangerous eating behaviours [4].

Eating disorders often develop in the teen and young adult years, although they can develop at other ages as well. One can develop an eating disorder with an obsession with body shape and food, which in severe cases can result in health consequences and even death if left untreated.

Reports state that eating disorders are most prevalent among young women [5]. Eating problems may include inadequate or excessive food intake which can ultimately damage an individual's well-being.

What Are The Types Of Eating Disorders?

The most common forms of eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder [6].

Anorexia nervosa: It is one of the most common types of eating disorders. It generally develops during adolescence and tends to affect more women than men. People with anorexia generally view themselves as overweight, even when they are dangerously underweight [7]. Anorexia is officially categorized into two subtypes - the restricting type and the binge eating and purging type [8]. Individuals with anorexia nervosa may limit their food intake, as they have an intense fear of gaining weight.

Bulimia nervosa: Like anorexia, bulimia normally develops during adolescence, and is common among women [9]. People with bulimia frequently eat unusually large amounts of food in a specific period of time and they tend to continue eating till they are painfully full. People with this eating disorder compensate for the calories consumed by vomiting, fasting, taking laxatives, and through excessive exercise [10].

Also, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight.

Binge eating disorder: One of the most common eating disorders binge eating disorder typically begins during adolescence and early adulthood. In some people, it has been reported in later stages as well [11]. People with binge eating disorder do not restrict calories or try to get rid of the calories by vomiting or through excessive exercise [12]. People with binge eating disorder often have overweight or obesity.

What Are The Types Of Eating Disorders?

Pica: A lesser-known type of eating disorder, pica involves eating things that are not considered food [13]. Pica can occur in adults, as well as children and adolescents and the ones suffering from this form of the eating disorder tend to crave for ice, dirt, soil, chalk, soap, paper, hair, cloth, wool, pebbles, laundry detergent etc. Pica is mostly reported in children, pregnant women, and individuals with mental disabilities [14].

Individuals with pica may be at an increased risk of poisoning, infections, gut injuries, and nutritional deficiencies and can even cause death - depending on the types of substances consumed.

Rumination disorder: People with this condition tend to bring swallowed food up again to the mouth, re-chews it, and then either re-swallows it or spits it out [15]. This rumination typically occurs within the first 30 minutes after a meal and is voluntary.

This disorder can develop during infancy, childhood, or adulthood [16]. Adults with this disorder may restrict the amount of food they eat, resulting in unhealthy weight loss.

Avoidant/restrictive food intake disorder (ARFID): Individuals with this disorder experience disturbed eating either due to a lack of interest in eating or due to specific smells, tastes, colour, texture and temperature of foods [17]. ARFID is an eating disorder that causes people to undereat.

Some of the other types of eating disorders are night eating syndrome, purging disorder and other specified feeding or eating disorder (OSFED).

What Causes Eating Disorders?

The exact cause of eating disorders is unknown. Health experts link it to genetics and biology, as well as psychological and emotional health, such as low self-esteem, perfectionism, impulsive behaviour and troubled relationships [18].

What Are The Symptoms Of Eating Disorders?

Symptoms of anorexia nervosa: Being underweight, extremely restrictive eating patterns, an intense fear of gaining weight, unwillingness to maintain a healthy weight, a distorted body image and denial of being underweight [19].

Symptoms of bulimia nervosa: Constant binge eating with no control, inappropriate purging behaviours such as forceful vomiting and a fear of gaining weight [20].

Symptoms of binger eating disorder: Eating large amounts of foods rapidly, lack of control and shame, disgust, or guilt, when thinking about binge-eating behaviour.

Symptoms of pica: An appetite for non-food substances, such as ice, dirt, soil, chalk, soap, paper, hair etc.

Symptoms of rumination disorder: Restriction of the amount of food in public.

Symptoms of avoidant/restrictive food intake disorder: Avoidance of healthy foods, weight loss or poor development for age and nutrient deficiencies [21].

What Are The Risk Factors For Eating Disorders?

Certain factors may increase the risk of developing an eating disorder such as [22]:

• family history,
• mental health disorders such as anxiety disorder, depression or obsessive-compulsive disorder,
• dieting and starvation, and
• stress.

What Are The Complications Of Eating Disorders?

Eating disorders cause a wide variety of complications, where some of them can be life-threatening. The complications caused by eating disorders are as follows [23]:

• Growth and development problems
• Depression
• Anxiety
• Suicidal thoughts or behaviour
• Social and relationship problems
• Substance abuse
• Work and school issues
• Death

How Are Eating Disorders Diagnosed?

Eating disorders are diagnosed based on signs, symptoms and eating habits. If an individual is suspected of having an eating disorder, the doctor will prescribe the psychological evaluation and a physical exam [24].

How Are Eating Disorders Treated?

The treatment for eating disorders depends on the specific type of eating disorder. In general, the treatment measures include the following [25]:

• Psychotherapy (cognitive behavioural therapy and family-based therapy)
• Healthy eating
• Medications to help control urges to binge or purge

Can Eating Disorders Be Prevented?

Although there is no specific way to prevent eating disorders, a parent can take certain steps such as avoiding dieting around the child, cultivating and reinforcing healthy eating habits and body image and talking to your child about misperceptions and unhealthy eating choices.

On A Final Note…

If you notice a family member or friend who seems to show signs of an eating disorder, consider talking to that person with compassion and guide them to get the right kind of help to overcome the eating disorders.