Dana Kiesel, Ph. D.

Getting Help with Eating Disorders

What Is An Eating Disorder?

Eating disorders come in three basic forms, Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder (also known as Compulsive Overeating). Additionally, there are eating disorders that can combine signs and symptoms from anorexia, bulimia, and/or binge eating disorder that may not be a full blown eating disorder, but can still be dangerous physically and emotionally.

Anorexia Nervosa

Anorexia Nervosa is characterized by self-starvation and excessive weight loss. Symptoms typically include refusal to maintain body weight at a minimally normal weight for body type, age and activity level. It also includes an extreme fear of being fat, still feeling fat despite dramatic weight loss, a loss of menstrual period and an intense concern about body weight and shape. There is usually a large distortion of body image—while others see the person with anorexia nervosa as dangerously thin, they continue to see themselves as fat.

Bulimia Nervosa

Bulimia Nervosa is the repeated cycle of often-secretive binge eating followed by purging. The binges include eating large amounts of food (usually eaten alone) in a short period of time and the purges include getting rid of the food and calories through vomiting, laxative and diuretic (water pills) abuse and over-exercising. Symptoms include repeated episodes of bingeing and purging (sometimes many times in one day), feeling out of control during a binge, purging after a binge (usually by vomiting, laxative use, diet pill or excessive exercise), frequent dieting, extreme concern with body weight and shape.

Binge Eating Disorder/Compulsive Overeating:

Binge eating is characterized by periods of uncontrolled, impulsive, or continuous overeating beyond the point of being full. There is no purging, but there are sometimes repetitive diets and often feelings of shame, guilt, depression or self-hatred after a binge. People who binge eat often struggle with anxiety, depression, and difficulty expressing their feelings. Body weight may vary from normal to obese.

Other Eating Disorders:

There is often a combination of signs and symptoms from anorexia, bulimia and binge eating disorder that may or may not reach a full syndrome eating disorder. This can be called Eating Disorder Not Otherwise Specified or it may simply be disordered eating. In either case, it often causes the person suffering from it great distress.

Medical Problems Caused By Eating Disorders

Anorexia Nervosa: Anorexia can slow the heart rate and lower blood pressure, increasing the chance of heart failure and death. Drug use to stimulate vomiting, bowel movements or urination also puts people at high risk for heart failure. Starvation can lead to heart failure, as well as damage to the brain. Hair and nails can grow brittle and skin may dry out and get a yellow tinge. The skin can develop a covering of soft hair called lanugo. Additionally, mild anemia, swollen joints, reduced muscle mass, and light-headedness also commonly occurs as a consequence of anorexia. Severe cases can lead to brittle bones and osteoporosis as a result of calcium loss.

Bulimia Nervosa: The acid in vomit can wear down the enamel on teeth causing severe dental problems including tooth loss. It can also inflame and damage the esophagus and enlarge the glands near the cheeks (given the appearance of swollen cheeks). Damage to the heart can occur from frequent vomiting. Major chemical imbalances can occur from the loss of minerals such as potassium resulting in irregular heartbeats, heart failure and death. Additionally, there is a risk of long-term constipation, peptic ulcers, and pancreatitis.

Binge-Eating Disorder: Binge-Eating Disorder, or compulsive overeating can cause high blood pressure and high cholesterol levels. Additionally, it can cause fatigue, joint pain, Type II Diabetes, gallbladder disease and heart disease.

Getting Help for an Eating Disorder

Whether you have an eating disorder or you are worried about someone you know with an eating disorder, it is extremely important to get professional help. There are several different paths to getting help including: finding a psychologist who can help who specializes in eating disorders, going to an M.D. who is familiar with or specializes in eating disorders, going to a nutritionist, and going to a psychiatrist for medication. If the eating disorder has caused the person’s health to get to a dangerous medical level, or the eating disorder has become completely out of the person’s control, another path is to go to an inpatient or residential treatment program until their health is stabilized. There are also day treatment programs available for people with eating disorders who need more than outpatient treatment, but are not at a crisis point of needing inpatient treatment. Each person and eating disorder is unique and will require a different path of treatment. Dr. Kiesel is well qualified to conduct an assessment and to refer the person with an eating disorder to the right setting. She works with other professionals and can put together a treatment team to best treat the eating disorder.

How To Talk To Someone You Suspect Has An Eating Disorder

Although it is often uncomfortable to confront a person whom you suspect has an eating disorder, it is the right thing to do because eating disorders can be so medically dangerous. Be positive and direct and state your concerns. However, also be aware that it is often the nature of an eating disorder for the person who has it to deny that it exists. Oftentimes, although the eating disorder causes the person pain, they are also very attached to the positives that it gives them. People often use their eating disorders—either by denying themselves food or by overeating and then purging—as a way to soothe their feelings or numb themselves from uncomfortable feelings. This is called affect regulation and it is part of what keeps people locked into their eating disorder. Don’t get discouraged if the person denies they have an eating disorder or gets mad at you and initially pushes you away. Oftentimes down the road in recovery, these very same people talk about how grateful they are that friends and loved ones confronted them even when they themselves were not quite ready to face their eating disorder. They often say things like “When my mother or friend confronted me, it was the first time I realized that others noticed what was going on and that I needed help. Although I was really mad at first, looking back on it, I know that’s what I needed and I am grateful now.”

Helpful Eating Disorder Website Links

Listed below are well known and respected links to websites where you can read further information about eating disorders:

National Eating Disorders Association: www.nationaleatingdisorders.org

Eating Disorder; Anorexia, Bulimia, Binge Eating: www.edreferral.com

MedlinePlus; Eating Disorders: www.nlm.nih.gov/medlineplus/eatingdisorders.html


National Eating Disorders Asssociation

Eating Disorders, National Mental Health Information Center

Page last updated on Sunday, February 3, 2019

©2008 by Dr. Dana Kiesel

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