no longer just bulimia and anoxeria when it comes to eating disorders.
The American Psychiatric Association introduced a new category of
eating disorders in the 1990s ó aptly named the Eating disorders not
otherwise specified (EDNOS). Some of the disorders under this umbrella
include orthorexia, pregorexia, binge eating, anorexia athletica and
drunkorexia. In fact, EDNOS are now the most commonly diagnosed eating
disorders, accounting for almost 60 percent of cases in a study
conducted by Behaviour Research and Therapy.
to as a fixation with healthy and/or righteous eating, orthorexia
includes an obsessiveness about not eating particular types of foods,
specifically fats, preservatives and food with added salts or sugars.
"Itís an unhealthy obsession with eating healthy foods,"
says Dr. Christopher Adams, a psychologist at Wheaton Franciscan
Behavioral Health in Milwaukee. "Thereís a compulsion involved
with it ó they have to do this, itís not something they can
control or will consider controlling." The determining factor in
diagnosing the disorder occurs when a patientís behavioral pattern
becomes harmful to them. "At that point, it becomes problematic.
Theyíre severely malnourished or emaciated," says Adams.
Women who suffer
from pregorexia carry out extreme diet or exercise patterns while
pregnant. Though extremely rare, individuals endanger not only their
personal health, but the health of their fetus. "Women engage in
restrictive eating during that time because they are fearful of weight
gain," says Dr. Tracey Lee Cornella-Carlson, a psychiatrist at
Rogers Memorial Hospital in Milwaukee. Women may also use pregnancy as
a justification for eating, adds Cornella-Carlson, leading to
excessive weight gain while pregnant.
As one of the
most common disorders in the EDNOS group, binge eating involves
compulsive overeating, typically to deal with negative emotions or
stress. "Patients canít resist the urge," says Adams.
"Theyíre not hungry. They only stop when they become
uncomfortable." The addictive quality of the disorder leads to
frequent consumption of unusually large amounts of food, and these
episodes are often followed by significant guilt or remorse, adds
Cornella-Carlson. Because of its increased prevalance in both men and
women, binge eating may be included as itís own separate disorder in
next springís DSM-V, the official manual used by psychologists and
psychiatrists in diagnosing diseases and disorders.
Also known as
hypergymnasia, anorexia athletica is an addiction to exercise. Those
who suffer from the disorder fear weight gain and compulsively
exercise to ease said fear. "Patients have a distorted or
inappropriate view of what you should do to maintain their
health," explains Adams. "They feel compelled to
overexercise." More often than not, the addiction interferes with
an individualís professional and personal life, and they voluntarily
choose exercise over work commitments or social gatherings.
Most apparent in
college-aged females, individuals who suffer from drunkorexia restrict
their food intake to reserve calories for alcohol and binge drinking.
"Itís an obsessive intention to not put on weight," says
Adams. "They will skip meals to save calories for anticipated
drinking." The disorder may lead to serious consequences, notes
Adams, including alcohol poisoning and uninhibited sexual behavior.
Despite the rise
in eating disorder diagnoses in the U.S., a high percentage of
individuals fail to seek treatment until the disorder has significant
physical or social impact on their lives. Many feel helpless; that
their actions are beyond their control. "There is a clear defense
system built around the behavior," says Adams. "They do not
see it as a problem until someone else confronts them." Cornella-Carlson
stresses the importance of positive reinforcement when treating her
patients. "I tell them they are blessed to be in treatment,
getting the help they need," she explains. "There is a
stigma associated with it (eating disorders) because it is a mental
illness. It takes a lot for people to realize they need help, and that
if they continue, they will have serious medical and psychological
his patients to expand their social network or have a greater
involvement in things that define who they are, such as a charity,
recreational sports team or group organization. "I tend to look
at these disorders as stress-related or self-perception disorders in
many ways," says Adams. "People who are substituting a sense
of well-being with compulsive behaviors around exercise and the kinds
of foods they eat often lack a compelling external reason or sense of
meaning or purpose that is sufficient for them."
A decline in
eating disorder diagnoses in the foreseeable future is not likely,
says Cornella-Carlson. When asked about ways to curb this trend,
Cornella-Carlson is quick to respond. "Education is key,"
she says. "We need to educate people more about eating disorders,
so teachers are more aware with students, parents are more aware with
It is the hope
that, with an increase in education, eating disorder diagnoses will
not only decrease, but that individuals who do suffer from an eating
disorder will choose to seek treatment sooner.