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Eating Disorders in Adults
Overview
An eating disorder is a serious but treatable medical and psychological condition involving unhealthy patterns of eating and dieting. People with eating disorders have distorted thoughts about their bodies and food. This can lead to extreme behaviors and cause physical and emotional problems.
Some people develop eating disorders during their teenage years. Without treatment, this may continue into adulthood. Others develop eating disorders as adults. A growing number of adults are seeking help for eating disorders.
Most eating disorders are about much more than food. They can appear when you’re dealing with difficult issues in your life.
Treatment includes:
- Psychological counseling
- Nutritional counseling
- Medical monitoring
- Medication for related conditions, such as depression
Types
The most common types of eating disorders are:
- Anorexia nervosa. You don’t eat enough to meet your body’s basic energy needs.
- Bulimia nervosa. Cycles of overeating followed by behaviors that compensate for overeating. Some people make themselves vomit or use laxatives. Others exercise excessively or starve themselves.
- Binge eating disorder. Patterns of uncontrolled overeating, marked by feelings of shame and disgust.
Causes and Risk Factors
Eating disorders are complex and:
- May begin with a focus on food and losing weight. However, they’re usually about much more than food.
- Are often an attempt to have control, consistency, and comfort in your life. This is more likely to happen if life feels out of control and chaotic.
- Are caused by physical, emotional, and social issues.
Anyone can develop an eating disorder. You’re more likely to develop an eating disorder if you:
- Don’t eat meals at set times. Skipping meals can be a risk factor as well.
- Are overly influenced by cultural messages promoting “thin ideal” bodies and “healthy eating” diets.
- Do sports or activities that emphasize low body weight (such as ballet or gymnastics).
- Experience a stressful life event. This may include the death of a parent or divorce.
- Have family members with eating disorders, addiction, or other mental health diagnoses.
- Have lost and gained a significant amount of weight from time to time.
- Have been bullied or have experienced weight bias based on the size or shape of your body.
Psychological risk factors include:
- Low self-esteem.
- Troubled relationships. This may include violence or abuse.
- Ongoing stress, depression, or anxiety.
- Alcohol or drug use.
- Emotional problems.
- Cultural, family, and peer pressures.
Symptoms
There are several behavioral, physical, and psychological symptoms associated with eating disorders.
Behavioral symptoms
When you have an eating disorder, you may:
- Weigh yourself often.
- Obsess about the food you eat.
- Try to control the type of food you eat or the quantity of food you eat.
- Experience strong feelings of guilt associated with positive changes.
- Have a distorted body image. You may see yourself as overweight when you are underweight. Some people feel disconnected from their body.
- Prefer to eat alone. That way no one can see how much or how little you eat.
- Eat regularly but not maintain a healthy weight.
- Push food around your plate.
- Purge after eating. Some people make themselves vomit or use laxatives.
- Make efforts to hide your eating habits or purging habits.
Physical symptoms
Eating disorders cause malnutrition. This can lead to:
- Irregular heart rate, blood pressure, or lab values.
- Unhealthy weight.
- Brittle hair and fingernails. Skin may also thin.
- Thinning bones (osteoporosis). In teens, bones may not finish growing normally.
- Menstruation issues. Periods may stop or be less regular.
- Cognitive changes.
Psychological symptoms
Psychological concerns may occur with an eating disorder. These include:
- Depression
- Anxiety
- Obsessive-compulsive disorder (OCD)
- Drug or alcohol use or dependence
Diagnosis
Eating disorders are diagnosed by your symptoms. Your doctor will review your medical history and perform a physical exam.
We’ll check your:
- Weight and height
- Heart rate
- Blood pressure
- Teeth, skin, hair, and nails for normal growth
We’ll ask you about your:
- Eating and exercise habits.
- Physical symptoms.
- Menstrual cycle.
- Sleeping and eating patterns.
- Mood (if you’re sad, anxious, or stressed).
- Daily exercise routine.
- Feelings about your body. This helps us to assess your body image.
In addition, we may order:
- Blood tests
- An X-ray to check your bone health
- Tests to check for heart and kidney problems
Psychological Evaluation
Depression, anxiety, and other mental health concerns often occur along with an eating disorder. We may ask if you:
- Feel upset after eating?
- Eat in secret or hoard food?
- Take laxatives or diuretics?
- Vomit after eating to feel better?
Diagnosing an eating disorder is difficult when you feel you must keep it a secret. It’s easier to treat an eating disorder if you get help early on. If you think you might have an eating disorder, call the Mental Health Department at your local medical center to schedule an appointment right away. Remember that we’re here to help, not to judge you.
Treatment
We typically treat eating disorders with psychological and nutritional counseling, medical treatment, and medications (if needed).
Eating disorders are more difficult to treat when they develop during adulthood because you may:
- Feel shame about what you and society see as a “teenager’s problem.”
- Not want treatment. Some people are protective of the illness or minimize its impact.
- Need repeated treatment. The problem often comes back.
Treatment is most successful when the problem is recognized and treated with adequate support early on.
Mental health counseling
Counseling is an important part of treatment. It’s essential that you attend your scheduled counseling sessions.
The purpose of counseling is to:
- Identify the emotional issues and thinking patterns that may have triggered the eating disorder.
- Learn better coping skills.
We may recommend several types of counseling.
Cognitive-behavioral therapy helps you:
- Change thought patterns.
- Learn positive, healthy ways of coping.
Group therapy encourages you to:
- Share similar challenges with others who have eating disorders.
- Get support from others.
Individual therapy helps you work through your own specific issues. This may include relationship issues.
Nutritional counseling
The goal of nutritional counseling is to help you:
- Become responsible for your own healthy eating.
- Understand the value of eating well-balanced meals.
- Accept foods you may be avoiding in your eating disorder.
Nutritional counseling typically includes:
- Keeping a daily food diary.
- Learning about basic nutrition.
- Planning daily menus.
- Setting reasonable goals for treatment progress.
We’ll monitor your overall health during regular medical visits.
Medications
Medications for eating disorders and other associated conditions are complex. Your doctor may prescribe medication based on your eating disorder and other factors.
It's important that you:
- Take medication as prescribed.
- Let your doctor know if you have any problems with the medication.
- Tell your doctor about any other prescription and nonprescription medicines you currently take. Some medications can cause harm when taken together or when taken while actively engaging in eating disorder behaviors.
Some of these medications may heighten thoughts of suicide, especially in young adults. Call us right away if you have suicidal thoughts when taking prescribed medications.
When to Call Us
If you have symptoms or concerns about an eating disorder, don’t wait to ask for help. Contact your doctor or the Mental Health Department at your local medical center. We’ll assess your needs and help you get the care that’s right for you. You don’t need a referral from your doctor to access mental health services.
Additional References
Related Health Tools
Disclaimer
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.