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How Nurses Can Uncover Clues to Eating Disorders

An estimated 30 million Americans develop an eating disorders over a lifetime, and you may be surprised who they are. They’re not just teenagers. Many adults and seniors have eating disorders, which often coexist with mood disorders, and sometimes with substance abuse. An estimated 25% are men. Military personnel often get eating disorders, particularly after returning from active duty. And overachieving athletes may be controlling their weight in very unhealthy ways, despite looking like the picture of health.

Would you recognize someone with an eating disorder? He or she may want help, but may try to hide their food habits out of shame and embarrassment.

What are the three main types of eating disorders?

Anorexia Nervosa

Anorexia typically afflicts young women and teenage girls, and is typified by extreme dieting and weight loss, sometimes to the point of starvation — at which time, a diagnosis is obvious. At the heart of the disorder is a deeply distorted body image of what the person looks like compared to what he or she thinks is the ideal.

Bulimia Nervosa

Bulimia is often hardest to detect because many of those affected maintain a normal body weight and seem to eat normally in public. In private, however, they will binge on all the worst foods until they feel stuffed and ashamed. Then they purge the calories by inducing vomiting, through chronic use of diuretics and laxatives, and through excessive exercise. The damage from gastric acid often shows first on teeth enamel, which becomes soft and discolored.

Binge Eating Disorder

Binge eaters may be recognized by friends of family, as they consume large amounts of food in a short period — often in public. About 40% of binge eaters are male. Although they are often obese, they can be of any weight, depending on the stage of their disorder and whether they are secretly purging.

In the clinical setting, patients with eating disorders often seek help in very passive ways, by dropping hints and pointing to signs they hope you will recognize.

What are the signs of an eating disorder?

  • Seems overly concerned about weight, rather than health
  • Body image does not accurately reflect weight status
  • Doesn’t like to eat in public
  • Confesses to eating alone
  • Hides food
  • Goes to the bathroom right after eating
  • Feels compelled to exercise all the time
  • Displays mood swings
  • Uses laxatives and diuretics without medical indications

Asking questions about favorite foods, restaurants, food-based activities, how they like their bodies, etc, will often encourage a patient to reveal one or more signs of an eating disorder. If you get a positive response, focus other questions more specifically to see if additional signs are also present, (eg, do you ever feel bad about yourself after eating?)

Always assure patients that they shouldn’t feel ashamed about having an eating disorder — between 50% to 80% are genetically predisposed — and that their disorder can be successfully managed.

Learn more about eating disorders by visiting these sites:

Last updated on 9/22/19.

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