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Eating disorder

An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health. These behaviors may include eating too much food or too little food, as well as body image issues. Types of eating disorders include binge eating disorder, where the person suffering keeps eating large amounts in a short period of time typically while not being hungry, often leading to weight gain; anorexia nervosa, where the person has an intense fear of gaining weight, thus restricts food and/or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging), in an attempt to not gain any weight; pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD.

The causes of eating disorders are not clear, although both biological and environmental factors appear to play a role. Cultural idealization of thinness is believed to contribute to some eating disorders. Individuals who have experienced sexual abuse are also more likely to develop eating disorders. Some disorders such as pica and rumination disorder occur more often in people with intellectual disabilities.

Treatment can be effective for many eating disorders. Treatment varies by disorder and may involve counseling, dietary advice, reducing excessive exercise, and the reduction of efforts to eliminate food. Medications may be used to help with some of the associated symptoms. Hospitalization may be needed in more serious cases. About 70% of people with anorexia and 50% of people with bulimia recover within five years. Only 10% of people with eating disorders receive treatment, and of those, approximately 80% do not receive the proper care. Many are sent home weeks earlier than the recommended stay and are not provided with the necessary treatment. Recovery from binge eating disorder is less clear and estimated at 20% to 60%. Both anorexia and bulimia increase the risk of death.

Estimates of the prevalence of eating disorders vary widely, reflecting differences in gender, age, and culture as well as methods used for diagnosis and measurement. In the developed world, anorexia affects about 0.4% and bulimia affects about 1.3% of young women in a given year. Binge eating disorder affects about 1.6% of women and 0.8% of men in a given year. According to one analysis, the percent of women who will have anorexia at some point in their lives may be up to 4%, or up to 2% for bulimia and binge eating disorders. Rates of eating disorders appear to be lower in less developed countries. Anorexia and bulimia occur nearly ten times more often in females than males. The typical onset of eating disorders is in late childhood to early adulthood. Rates of other eating disorders are not clear.

These eating disorders are specified as mental disorders in standard medical manuals, including the ICD-10 and the DSM-5.

Pubertal and post-pubertal females with anorexia often experience amenorrhea, that is, the loss of menstrual periods, due to the extreme weight loss these individuals face. Although amenorrhea was a required criterion for a diagnosis of anorexia in the DSM-IV, it was dropped in the DSM-5 due to its exclusive nature, as male, post-menopause women, or individuals who do not menstruate for other reasons would fail to meet this criterion. Females with bulimia may also experience amenorrhea, although the cause is not clear.

Symptoms and complications vary according to the nature and severity of the eating disorder:

Associated physical symptoms of eating disorders include weakness, fatigue, sensitivity to cold, reduced beard growth in men, reduction in waking erections, reduced libido, weight loss and growth failure.

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