How Do Eating Disorders Affect Mental Health

Behavioural Symptoms Of Anorexia Nervosa

Behavioural signs and symptoms may include:

• dieting behaviour dieting, counting kilojoules, reporting new food allergies and avoiding food groups that were once enjoyed
• binge eating
• hiding food
• misuse of laxatives, appetite suppressants, diuretics and enemas
• behaviour related to body image constantly checking in the mirror, pinching parts of the body to measure fat
• withdrawal from social interactions
• secrecy around eating saying they have eaten when they havent
• excessive and obsessive exercise even when sick or injured, or exhibiting distress if they cant exercise
• obsessive rituals around food cutting food into very small pieces or eating very slowly
• self-harm, use of substances and suicide attempts.

What If I Have An Eating Disorder

If you think you may have an eating disorder:

Tell someone. Tell a parent, teacher, counselor, or an adult you trust. Let them know what you’re going through. Ask them to help.

Get help early. When an eating disorder is caught early, a person has a better chance of recovery. Make an appointment with your doctor or an eating disorders specialist.

Go to all appointments. Treatment takes time and effort. Work hard to learn about yourself and your emotions. Ask questions any time you have them.

Be patient with yourself. There’s so much to learn, and change happens a little at a time. Take care of yourself and be with people who support you.

Urge To Engage In Dysfunctional Behaviors

With disordered thoughts often comes an urge to engage in dysfunctional behaviors that initially may feel soothing. Within a short time, however, these behaviors cause increased difficulties and stressors that make life even harder. Only by replacing these disordered behaviors with healthy coping skills can people effectively work on becoming recovered.

As eating disorders take a toll on the mind, symptoms tend to increase. Physical health complications also increase in tandem, resulting in a sharp decline in well being until these individuals seek anorexia nervosa treatment.

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How Do You Know If You Have An Eating Disorder

People with eating disorders commonly hide or deny that they are in distress. And, symptoms can be hard to detect in others.If you are concerned that you or someone you know might have an eating disorder, it is helpful to know how to identify some of the more common signs of distress or a decreased quality of life.Here are 10 common signs of distress that you might see in someone with an eating disorder:

In some cases, nutritional instability becomes a distress sign .

What Can I Do What Can I Do

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What’s The Difference Between An Eating Problem And An Eating Disorder

• An eating disorder is a medical diagnosis. This diagnosis is based on your eating patterns and includes medical tests on your weight, blood and body mass index . See our page on diagnosed eating disorders for more information.
• An eating problem is any relationship with food that you find difficult. This can be just as hard to live with as a diagnosed eating disorder.

Mental Health And Nutrition Research

Current treatments for mental health disorders and illnesses often include medication, therapy or a combination of the two. These treatments have proven efficacy, yet mental health issues continues to rise globally. Treating mental health challenges may require other, less traditional approaches. One approach that is continually being explored is the role of nutrition in mental health. Western dietary habits, which include heavily processed foods, large quantities of refined grains and soft drinks, and little to no fresh produce, increase the risk of depression and provide fewer physical and mental health benefits.Researchers are also studying the efficacy of individual nutrients on the treatment of mental health disorders. Some of the nutrients that are being studied include protein, omega-3 fatty acids, B vitamins, folate, zinc, iron and iodine. While individual treatment with specific macronutrients may be useful in a laboratory setting or under a medical professionals care, most people will benefit from taking a broader approach to nutrition, one that focuses on the quality of food choices and the overall dietary pattern.

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Treatment Of Anorexia Nervosa

Research is continuing into which treatment for anorexia nervosa might be most effective. There is no single treatment method that suits everyone. Evidence suggests that treatment will help most people to recover from the condition.

Evidence also suggests that it is best to get treatment started as early as possible, and that using a team of professionals with expertise in different fields is the best approach.

Once anorexia nervosa is diagnosed, your doctor will organise a team to help you on your way to recovery. This might include establishing a healthcare team of different professionals such as:

• a psychiatrist
• an occupational therapist.

Treatment needs to address both physical and psychological health. Common approaches include:

The aims of treatment include:

• restoring your healthy weight
• reversing any effects of malnutrition
• making sure you are physically safe and healthy
• making sure you are mentally healthy.

Most people with anorexia nervosa are treated outside a hospital setting. However, if the condition is severe, temporary treatment in a hospital might be needed. Outpatient treatment and day programs can also be very helpful in supporting people as they make changes to behavioural, thinking and eating patterns.

People with anorexia nervosa who have also experienced physical, emotional or sexual abuse are encouraged to seek help for the trauma they have experienced, as well as their eating disorder.

Eating Disorders & Anxiety

Often, people who have eating disorders demonstrate high levels of anxiety, emotional sensitivity, and self-restraint. Symptoms of anxiety may cause these individuals to exhibit worry or concern over future events, criticism from others, or the inability to relax in social situations.

Research shows that anxiety disorders are present in 48%-51% of individuals who have anorexia nervosa, 54%-81% of those who have bulimia nervosa, and 55%-65% of those who have binge-eating disorder. These statistics depict the significance of anxiety in the lives of those who are suffering from eating disorders, as this condition can be a complicating factor in the recovery process if left untreated.

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Restriction Of Food Intake

People with the restricting subtype of anorexia nervosa tend to severely reduce their energy intake or restrict the type of food they will eat. The signs can be different in each person, but they might include:

• restricting certain types of food such as carbohydrates or high-fat foods
• obsessively counting kilojoule intake
• excessively exercising.

Contributor: Staff At Mccallum Place

Eating disorders can cause individuals to experience a range of symptoms that can interfere with their ability to function. While many eating disorder symptoms are the result of disordered eating behaviors, there are many associated emotions that can lead to low self-esteem and difficulty participating socially. But, is there a connection between eating disorders and mental health issues?

There is a common link between eating disorders and mental health concerns, and individuals who suffer from both conditions can experience an increase in symptoms when one condition worsens. To effectively recover from these symptoms, individuals must receive well-rounded treatment that addresses all concerns.

Psychiatry Research completed a study with participants who had a history of anorexia nervosa, bulimia nervosa, or symptoms of both conditions. Results showed that a significant number of participants also had a history of a major affective disorder.

Findings also showed that some participants had histories of anxiety disorders, substance use disorders, and kleptomania. This data emphasizes the importance of in-depth patient evaluations and medical histories while also informing clinically comprehensive treatment.

Additional studies demonstrate the presence of other mental health concerns in individuals who have eating disorders. Research in the Journal of American College Health analyzed the overall health of college-age women who were struggling with eating disorders.

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How Common Are Eating Disorders And Substance Use Disorders

It is not uncommon for a person with an eating disorder to also suffer from a substance abuse problem.

• In 2014, Substance Use Disorder affected 21.5 million people, or 8.1% of the U.S. population.
• Of these people, nearly 40% also struggled with a mental disorder.

• Research has found that up to 50% of people diagnosed with an eating disorder will struggle with substance abuse, whereas only 9% of the general population is diagnosed with a substance use disorder.
• Conversely, 35% of substance abusers have been found to also have an eating disorder, compared to the 3% of the general population diagnosed with an eating disorder.

a person with an eating disorder is five times more likely to abuse drugs or a person with a substance abuse problem is 11 times more likely to have an eating disorder.

What Causes Eating Disorders

We do not know exactly what causes eating disorders.

You may be more likely to get an eating disorder if:

• you or a member of your family has a history of eating disorders, depression, or alcohol or drug misuse
• you’ve been criticised for your eating habits, body shape or weight
• you’re really worried about being slim, particularly if you also feel pressure from society or your job, for example, ballet dancers, models or athletes
• you have anxiety, low self-esteem, an obsessive personality or are a perfectionist
• you’ve been sexually abused

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Prevalence Of Eating Disorders In Adolescents

• Based on diagnostic interview data from National Comorbidity Survey Adolescent Supplement , Figure 3 shows the lifetime prevalence of eating disorders among U.S. adolescents aged 13 to 18 years.2
• The lifetime prevalence of eating disorders was 2.7%.
• Eating disorders were more than twice as prevalent among females than males .
• Prevalence increased modestly with age.
• In the NCS-A, eating disorders included anorexia nervosa, bulimia nervosa, and binge eating disorder.

Figure 3

Who Does It Affect

Eating disorders can affect anyone, but some people may be at higher risk. People who experience lower self-esteem or poor body image, perfectionism, or difficulties dealing with stress may be more likely to experience an eating disorder. A lack of positive social supports and other important connections may also play a big part. In some cases, eating disorders can go along with other mental illnesses.

Our beliefs around body image are also important. While the media may often portray thinness as an ideal body type, this alone doesnt cause an eating disorder. How we think about those messages and apply them to our lives is what affects our self-esteem and self-worth.

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Types Of Eating Disorders

The most common eating disorders are:

• anorexia nervosa trying to control your weight by not eating enough food, exercising too much, or doing both
• bulimia losing control over how much you eat and then taking drastic action to not put on weight
• binge eating disorder eating large portions of food until you feel uncomfortably full

Are There Clinical Trials Studying Eating Disorders

NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions, including eating disorders. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information about clinical research and how to find clinical trials being conducted around the country, visit NIMH’s clinical trials webpage.

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How Are Diet And Mental Health Linked

The relationship between our diet and our mental health is complex. However, research shows a link between what we eat and how we feel.

Eating well can help you feel better. You don’t have to make big changes to your diet, but see if you can try some of these tips.

• Eat regularly. This can stop your blood sugar level dropping, which can make you feel tired and bad-tempered.
• Stay hydrated. Even mild dehydration can affect your mood, energy level and ability to concentrate.
• Eat the right balance of fats. Your brain needs healthy fats to keep working well. They’re found in things such as olive oil, rapeseed oil, nuts, seeds, oily fish, avocados, milk and eggs. Avoid trans fats – often found in processed or packaged foods – as they can be bad for your mood and your heart health.
• Include more wholegrains, fruits and vegetables in your diet. They contain the vitamins and minerals your brain and body need to stay well.
• Include some protein with every meal. It contains an amino acid that your brain uses to help regulate your mood.
• Look after your gut health. Your gut can reflect how you’re feeling: if you’re stressed, it can speed up or slow down. Healthy food for your gut includes fruit, vegetables, beans and probiotics.
• Be aware of how caffeine can affect your mood. It can cause sleep problems, especially if you drink it close to bedtime, and some people find it makes them irritable and anxious too. Caffeine is found in coffee, tea, cola, energy drinks and chocolate.

Statistical Methods And Measurement Caveats

This webpage presents data from the following sources.

National Comorbidity Survey Replication

Diagnostic Assessment and Population:

• The NCS-R is a nationally representative, face-to-face, household survey conducted between February 2001 and April 2003 with a response rate of 70.9%. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview , a fully structured lay-administered diagnostic interview that generates both International Classification of Diseases, 10th Revision, and DSM-IV diagnoses. The DSM-IV criteria were used here. Participants for the main interview totaled 9,282 English-speaking, non-institutionalized, civilian respondents. Eating disorders were assessed in a subsample of 2,980 respondents. The Sheehan Disability Scales assessed disability in work role performance, household maintenance, social life, and intimate relationships on 010 scales. The NCS-R was led by Harvard University.

Survey Non-response:

• In 2001-2002, non-response was 29.1% of primary respondents and 19.6% of secondary respondents. Reasons for non-response to interviewing include: refusal to participate respondent was reluctant- too busy but did not refuse circumstantial, such as intellectual developmental disability or overseas work assignment and household units that were never contacted .
• For more information, see PMID: 15297905 and the NIMH NCS-R study page.

Survey Non-response:

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Taking Action For Change

Learn more about the different types of eating disorder

There are different types of eating disorder – including binge eating disorder, anorexia nervosa, bulimia nervosa, and other specified feeding or eating disorder . Each one has specific characteristics and potentially different treatments. Anyone, regardless of their age, gender or ethnicity, can develop an eating disorder.

Psychotherapy can be effective

Psychotherapy can be used to help control and reshape your behaviours, emotions, and patterns of thinking. Sessions are usually run by a psychologist. However, these approaches may also be used by other health professionals including psychiatrists, psychotherapists, and counsellors.

Nutritional management is an important part of recovery

Nutritional management ensures you are getting enough nourishment and helps you develop healthy eating habits, thoughts, and behaviours. A nutritionist or a dietitian will usually support you in managing your diet and will help you with meal planning. Apps like Recovery Record can be a useful way for you and your treatment team to manage your daily nutrition.

Family approaches are common for younger people

For younger people, early intervention approaches that involve your whole family in understanding the disorder and supporting your recovery have been shown to be most effective. Family approaches can also be effective for adults and bring together family or close friends as part of a support network.

Developing coping strategies

The Big Question Is Why

While there is a need for further research, observational studies suggest, overall, that there is a link between what people eat and their mental health. Why nutrition may have this effect is still unknown, though.

There are several theories on how diet may influence mood or the risk of conditions such as depression and anxiety.

Some scientists believe that the inflammatory effects of certain dietary patterns might help explain the relationship between diet and mental health.

Several mental health conditions appear to have links with increased levels of inflammation. The authors of journal articles in

of the neurotransmitter serotonin, which affects mood.

Furthermore, early research shows a potential link between a healthy gut microbiome and lower rates of depression.

As diet plays a major role in the health and diversity of the gut microbiome, this theory is a promising explanation for how what we eat may be affecting our mental well-being.

Finally, there is the possibility that diet plays a more indirect role in mental health.

It may be that individuals with healthful diets are more likely to engage in behaviors that are also linked with a reduced risk of mental health conditions, such as engaging in regular physical activity, practicing good sleep habits, and refraining from smoking.

It is important to keep in mind that many factors can influence both eating habits and mental health.

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