Types of Eating and Body Image Disorders

Anorexia Nervosa

Symptoms/Warning Signs

  • Significant or extreme weight loss with no known medical illness
  • Reduced food intake
  • Eating rituals (eating very slowly, cutting food into tiny pieces, etc.)
  • Denial of hunger
  • Irritability and mood swings
  • Social isolation
  • Avoiding joining friends for meals, or avoiding friends during normal meal times
  • Depression, flattened emotion
  • Excessive exercise
  • Hyper-vigilant monitoring of caloric or fat intake
  • Feels/describes self as fat, even when it is not true
  • Has a resistance to gaining healthy weight
  • Rigid behaviors
  • Intense drive for thinness

Medical Consequences

  • Heart problems (esp. cardiac arrhythmia)
  • Cessation of menstruation
  • Kidney stones, kidney failure, and dehydration
  • Growth of fine body hair all over the body
  • Muscle atrophy
  • Digestive problems (bowel irritation and constipation)
  • Osteoporosis

Bulimia Nervosa

Symptoms/Warning Signs

  • Recurrent episodes of binge eating (eating an excessive amount of food within a specific time period) while feeling a lack of control over eating
  • Engages in compensatory behavior in order to avoid weight gain, like self-induced vomiting, misuse of laxatives or other medications, fasting, or excessive exercise
  • Weight fluctuations within 15 pounds of customary weight
  • Regularly goes to the bathroom after eating to vomit
  • May buy large quantities of food which disappear quickly
  • Eats in secret
  • Regular appearance of facial swelling, broken vessels in the eyes, rawness at corners of the mouth, scarring on top of hand
  • Laxatives, diet pills, or diuretics, or wrappers from these products, found around the home
  • Restriction of food with no apparent weight loss

Medical Consequences

  • Sodium and potassium depletion leading to potentially fatal heart problems
  • Dental problems (stomach acids in vomit erode tooth enamel)
  • Throat/esophagus/stomach problems (irritation and tears in lining)
  • Laxative dependence, leading to inability to have normal bowel movements

Binge Eating Disorder

Symptoms/Warning Signs

  • Frequent repeated binge eating
  • Eating much faster than normal
  • Eating large amounts of food when you’re not hungry (perhaps to cope with emotions)
  • Eating alone so others don’t see how much you eat
  • Feeling bad about your behavior (irritation, self-disgust, guilt) and about your body size and/or weight
  • Frequent feelings of being “out of control” during binges

Medical Consequences

  • High blood pressure
  • High cholesterol levels
  • Heart disease

Diabulimia — A Newly Recognized
Danger in Eating Disorders

Diabulimia is the term used when eating disorders present themselves through harmful habits in Type I Diabetes management. Individuals with Type I Diabetes (also referred to as juvenile diabetes or IDDM) are charged with the arduous task of taking daily injections of a hormone called insulin, which their body can no longer make.

Insulin is the hormone that allows the body to take the energy from the food we eat, from the blood vessels into the cells. Not having or not taking insulin causes severe and dangerous complications almost immediately. Unfortunately, some people use this as a tactic to lose weight. Weight is temporarily lost quickly, but short term and long term consequences remain.

The term “Diabulimia” has been developed only in the past few years, and is still not currently (2007) recognized as its own eating disorder. However, the American Diabetes Association has realized that insulin omission is a debilitating method to purge food consumed for a while.

Short Term Warning Signs/Symptoms

  • Constant urination
  • Constant thirst
  • Excessive appetite
  • High blood glucose levels (often over 600)
  • Weakness
  • Fatigue
  • Large amounts of glucose in the urine
  • Inability to concentrate
  • Electrolyte disturbance
  • Severe ketonuria, and, in DKA, severe ketonemia
  • Low sodium levels

Medium term Symptoms:

Prevalent when diabulimia has not been treated, therefore will also include short term symptoms

  • Muscle atrophy
  • GERD
  • Indigestion
  • Severe weight loss
  • Proteinuria
  • Moderate to severe dehydration
  • Edema with fluid replacement
  • High cholesterol
  • Death

Long term:

If a person with Type 1 diabetes with diabulimia is still alive after a medium term — which is usually due to phases where insulin is injected and phases of diabulimia (also known as a relapse) — then the following symptoms can also be expected:

  • Severe kidney damage
  • Blindness
  • Severe neuropathy
  • Extreme fatigue
  • Edema (during blood sugars controlled phases)
  • Heart problems
  • High cholesterol
  • Osteoporosis

“Diabolical Diabulimia”

A Personal Story