In the last three decades, the incidence of eating disorders has increased dramatically in the United States. According to research, eating disorders affect nearly 5 million Americans per year, though this is likely an underestimate. Eating disorders, which include diagnoses such as anorexia nervosa, bulimia nervosa, bulimarexia, and compulsive over-eating, affect far more girls and women than boys and men, but research by Katz (2003) suggests that even by those statistics, approximately 1 million boys and men will struggle with eating disorders this year.

Anorexia Nervosa

• Anorexia refers to the act of self-starvation as a means to manage ambivalent feelings about the self and the physical form. It may represent an extreme form of control when the individual perceives their environment as chaotic or out-of-control.
• Those suffering from anorexia may starve themselves, use laxatives, force themselves to vomit, and compulsively exercise. Most of these behaviors are done in complete secrecy. Baggy and oversized clothing may be used to hide the results of this behavior until drastic consequences occur (passing out in public, breaking bones during normal activity).
• Anorectic people may be obsessed with food and feeding others, while they may refuse to feed themselves. Those suffering from anorexia may have complex rituals associated with food and eating, most of which they cannot or will not practice in front of others.
• According to the research, anorexia affects .5 to 3.5% of the female population. Of those with anorexia, 10-25% will die as a result of the disease or its complications.
• The most effective treatment for anorexia is provided in specialized inpatient programs. Medical evaluation and close monitoring ensures that the disease is halted as quickly as possible, and that further systemic damage is avoided. Nutrition counseling, in combination with individual, group and family psychotherapy improve the chances of the anorexic individual to make a full recovery.
• Many of the eating disorders facilities utilize step-down facilities (half-way houses) so that anorectic clients can continue to receive vital programming while learning to live more independently than allowed on the inpatient units. Following this transition, anorectic clients may choose to continue their treatment in outpatient psychotherapy. Focus is typically on maintaining healthy eating habits, gaining and maintaining weight, healthy expression of emotions, managing body image issues, and facilitating healthy family function.

Bulimia Nervosa

• According to research, between 1 to 4% of women experience bulimia at some point in their lives. Nearly 20% of college coeds suffer from bulimia, or binge-eating.
• Bulimia is typically described as the binge/purge cycle: consuming large amounts of food, then prompting vomiting in order to avoid weight gain.
• While anorectic women may be easy to spot, bulimic individuals may more easily hide their disordered eating, because they are consuming food, and retaining at least some of the calories, allowing them to maintain a slightly more normal appearance and/or weight.
• Though bulimia does not appear as deadly as anorexia (whose sufferers often die as a result of heart attack or starvation), there are significant consequences associated with this disorder. Due to the frequent exposure to stomach acids, teeth loosen, decay easily, and fall out in those suffering with bulimia. Additionally, self-induced vomiting loosens the esophageal sphincter, and can permanently impact the individual’s ability to keep food down once swallowed. Those with bulimia may experience endocrinological issues, and may have difficulty stabilizing hormones, and maintaining a regular menstrual cycle (although amenorrhea is more commonly associated with anorexia).
• Like anorexia, bulimia is probably best treated in the specialty inpatient setting. The treatment process and gals are similar to that identified for the anorectic client.

Bulimarexia

• This term describes the eating disordered individual who alternates between the self-starvation of anorexia and the desperate desire to consume associated with bulimia. While some anorectic clients may sit idly, refusing to eat and starving themselves to death, the individual with bulimarexia will transition between starving, consuming, then purging. The vicious cycle is the trademark of this disorder, and it is by far, the most vigorous and lethal of all the eating disorders.
• Treatment for bulimarexia incorporates protocols used for those suffering with anorexia, as well as those used for those dealing with bulimia.

Compulsive Overeating

• While many of us have gone to a terrific restaurant and overconsumed, claiming that the “food was just too good!”, those who overeat compulsively, don’t just do so when they’re out to dine, or even when the food tastes great. Those with compulsive overeating disorders typically eat to numb, anesthetize, or stuff their feelings. This may require vast amounts of food, frequent feedings, or specific types of food to accomplish this goal. Often, those with this disorder also struggle with unhealthy or limited relationships.
• The treatment for compulsive overeating may include individual and group psychotherapy, nutritional programming, success coaching, and community support (Overeaters Anonymous and Weight Watchers both offer emotional support to the individual with COE).