The link between eating disorder and mental illness and how to care for your mental health

 Key takeaways

• Eating disorders are mental disorders that usually occur with other mental health conditions like depression, anxiety, and suicide. 
• Eating disorders are curable. However, the earlier the diagnosis is made and treatment is started, the better the chances of making a full recovery. 
• Seek help for eating disorders if you constantly think negatively about your eating habits and weight, if you have suicidal thoughts, or if your family believes you've lost a lot of weight but you feel you're overweight. 

Eating disorders are harmful mental disorders that affect physical health and impair psychological and social functioning. These disorders are responsible for causing one death every 52 minutes.

Anorexia nervosa stands out among this group of disorders as the leading cause of death, and it’s responsible for the second-highest mortality rate among mental illnesses.

 Are eating disorders mental or psychological issues?

Yes, eating disorders are mental health issues. Mental health conditions like depression, anxiety, and suicide attempts occur more frequently in people with eating disorders.

 The link between eating disorders and mental health

Research shows that some mental traits increase the risk of having certain eating disorders, and these eating disorders, in turn, coexist with certain mental illnesses such as depression, anxiety, ADHD, and suicidal thoughts. Here are some psychological traits that increase a person’s chances of developing an eating disorder:

• Impulsivity: Not caring about the consequences of one's actions or being impulsive has been linked to anorexia nervosa and bulimia nervosa.
• Perfectionism: Setting unattainable goals or unrealistic expectations for oneself is one of the strongest risk factors for eating disorders. 
• Emotional dysregulation: Being unable to regulate how one feels and being emotionally unaware is a risk factor for all types of eating disorders.
• Substance abuse: Studies show that about 50% of people with eating disorders use illicit drugs, and 35% of people who cannot function properly without using these unprescribed drugs (drug dependence) have eating disorders.
• Depression and anxiety: 90% of people with eating disorders are depressed, and 67% of them also experience anxiety disorders.
• Body image issues: People who are dissatisfied with their bodies have a higher risk of developing eating disorders. 
• Avoidant behavior: This group includes people who would rather not think about their problems or find solutions to them and may have higher risks of having eating disorders. They also avoid difficult thoughts and may use food as a way to feel better. 

 What are the most common eating disorders?

The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder, says Sarah Boss (MD), a clinical director, psychiatrist, psychotherapist, and somatic experiencing practitioner at The Balance Luxury Rehab.

 1. Anorexia nervosa

Anorexia nervosa is a condition where people eat very little food, exercise excessively, and have fears of being overweight while actually being underweight. People with this condition constantly think about what they weigh and typically have a body mass index of less than 18.5, even as adults. 

The two types of anorexia are: 

Restrictive: Individuals with restrictive anorexia don’t eat as much as they should. They may also turn to excessive exercise and often fast to avoid gaining healthy weight. 

Binge-purge: In addition to restricting their food intake, people with this type of anorexia also go through alternate episodes of binge eating and purging. This may be done with the aid of diuretics, laxatives, or vomiting. 

People with anorexia may experience life-threatening complications such as anemia, muscle weakness, bone thinning, and cardiac abnormalities. Apart from opioid use disorder, anorexia nervosa has the highest mortality rate among other psychiatric disorders. 

 2. Bulimia nervosa

Bulimia nervosa is an eating disorder where people alternate between eating overly large quantities of food and purging (compensatory actions to lose the food). Food-binging episodes may last for weeks before they switch to obsessively trying to prevent weight gain. 

These purging actions include starvation (not eating or eating tiny quantities of food), vomiting, excessive exercise, and the use of laxatives. Unlike anorexia, which is defined by low body weight, people with this bulimia may have a normal weight or be overweight. This makes the condition more difficult to recognize.

Most of the complications of bulimia arise from their unhealthy methods of losing weight. For example, they may have tooth decay, an inflamed throat, and acid reflux from constantly throwing up. The use of laxatives and diuretics can also lead to disrupted electrolyte balance, dehydration, and intestinal problems. 

 3. Binge eating disorder

People with binge eating disorders eat enormous amounts of food while feeling a loss of control over their actions. Their binge eating episodes don't end in purging, unlike those with bulimia nervosa. They tend to be overweight or obese.

Binge eating disorder is often accompanied by shame and guilt about their eating habits, so they may prefer to eat alone. Common signs of this condition include eating even when not hungry or until one is uncomfortably full. They may also try different ways to lose weight, but are largely unsuccessful.  

 Mental and emotional signs of eating disorders

Recognizing the presence of an eating disorder can be challenging, as individuals may attempt to conceal their behaviors or minimize the severity of their symptoms, says Marissa Moore (MA), a licensed professional counselor, therapist, and mental health consultant writer at Mentalyc.

However, some common mental and emotional signs of eating disorders include:

• Depression due to food and eating
• Anxiety about one's weight
• Guilt and shame because of one's eating habits
• Always thinking about how eating could affect one's weight
• Being embarrassed and unable to eat around people
• Obsessively thinking about one's weight and body image
• Image distortion, like thinking you're overweight when you're actually underweight
• Extreme fear of gaining weight
• Low self-esteem 
• Body dissatisfaction

 Are eating disorders curable?

Yes, eating disorders are curable with proper management. The chances of making a full recovery are higher with early detection of these disorders. 

Apart from the different healthcare professionals involved in managing eating disorders, getting support from family and friends aids in one's healing journey. Research shows that involving one's family in the treatment of eating disorders increases the chances of making a full recovery. 

 Healthcare professionals involved in treating eating disorders

Diagnosing and treating eating disorders requires a team of experts from different fields that may include:

 Family physicians or general practitioners

A general practitioner (GP) is often the first healthcare professional people see regarding their health problems. They usually diagnose an eating disorder, refer patients to psychiatrists for further evaluation, and assemble a team of other healthcare professionals to manage the patient.

The physician also rules out other diseases that may have similar symptoms by taking a detailed medical history and running tests on the patient.

 Psychiatrists

Psychiatrists can also make the diagnosis of eating disorders. They have a major role in treating these conditions, including talk therapy and medication.

A psychiatrist will discuss the patient’s fears about eating, and can also diagnose other psychiatric conditions that may accompany the eating disorder. Some of the medications they prescribe are antidepressants and antipsychotics.

 Registered dietitians

Consulting a registered dietitian is crucial to adequately managing eating disorders. After a period of prolonged fasting, malnourished patients cannot immediately return to eating food in regular quantities, or they may develop medical complications.

Dietitians tell patients what foods are safe to eat and what quantities to eat until their body systems return to normal (refeeding). They're also involved in helping patients regulate their eating habits.

 Psychotherapists

These professionals often use cognitive behavioral therapy (CBT), a form of psychotherapy, to help eating disorder patients identify and manage negative thoughts regarding food, weight, and body image.

This helps patients improve their coping skills and change harmful behavioral patterns that worsen eating disorders.

 Tips for taking care of your mental health

Given the link between eating disorders and other mental health conditions, understanding how to maintain your psychological well-being is crucial. This may help lower your risk of developing disordered eating patterns. 

Some ways to protect your mental health are:

• Take care of your physical health, as it’s intertwined with your mental health. Be active for at least 30 minutes every day. You can take morning walks, jog, run, or skip ropes.
• Get enough sleep every day. Having a regular sleep schedule helps you rest better, so you wake up feeling refreshed, which will improve your mood and mental health generally.
• Talk to a loved one that you trust. Sharing your concerns and problems will make you feel better and may also help you figure out practical solutions.
• Don't take harmful substances like cocaine and other drugs. Though they may make you feel better briefly, the long-term consequences can affect your mental health for years. Limit your alcohol intake as well.
• Avoid constantly listening to news stories, especially bad news. Whether on television or social media, reduce how much news you consume so it doesn't negatively affect the quality of your life. 
• Eat a balanced diet with lots of fruits and vegetables. This nourishes your body and mind, ensuring you stay physically and mentally fit.
• Seek professional help if you find that you’re struggling mentally. There's no shame in that, and with expert assistance, you can work your way back to a healthy mental state.    

 When to seek help for eating disorders

Eating disorders are debilitating mental illnesses. The first step to healing from them is accepting that there is indeed a problem. Seek help for eating disorders if you experience any of the following:

• You're constantly bothered about your weight and body image.
• You make yourself vomit every time you eat.
• You're ashamed of how much food you eat, so you never eat around anyone.
• Your loved ones say you've lost a lot of weight, but you believe you're overweight. 
• You have suicidal thoughts because of your eating habits and weight.
• You've attempted suicide because of body dissatisfaction. 

 Last words

Eating disorders are mental health conditions affecting millions of people from various backgrounds worldwide. The presence of other mental health issues like depression and anxiety is a risk factor for developing these disorders.

Diagnosing and treating eating disorders is a team effort, often requiring family physicians, psychiatrists, dietitians, and psychotherapists. Receiving the support of family and friends helps speed the recovery journey.