About Eating Disorders

An eating disorder is a disorder characterized by abnormal eating behaviors and distorted concerns about weight and body shape. It can lead to symptoms and behaviors such as starvation, binge eating, vomiting, and excessive exercise for weight loss. It has become an even greater issue in modern society, where appearance and dieting are highly emphasized.

An eating disorder is, as the name suggests, a disorder in which eating behavior becomes abnormal, but it also involves disturbances in the perception of body weight and shape. Patients with eating disorders show an excessive preoccupation with body shape or weight, fear gaining weight in a pathological way, and place great importance on weight and body shape when evaluating themselves. As a result, it causes changes in food intake and absorption, ultimately leading to serious damage to physical health and psychosocial functioning. However, these symptoms should not be secondary to another physical illness or mental disorder.

Eating disorders are divided into anorexia nervosa, bulimia nervosa, and atypical binge-eating disorder. Pica, in which children eat nonfood substances such as dirt, and rumination disorder, in which eaten food is repeatedly regurgitated, may also be included in eating disorders in a broad sense.

Causes and Risk Factors

Eating disorders characteristically occur more often in young women from upper-middle-class backgrounds than in socioeconomically disadvantaged groups. Culturally, the number of cases has risen sharply over the past 20 years, and they have mainly occurred in developed countries. In the United States and other Western societies, about 0.5-1% of adolescents and young women have anorexia nervosa, and about 1-3% have bulimia nervosa.

Binge-eating disorder, in which a person temporarily eats much more than usual, is found in about 2-3% of the general population and is associated with obesity. Eating disorders are more common in women, with about 90-95% of cases being female. They are known to occur more often than in the general population among professional models, dancers, athletes, jockeys, and others whose occupations involve a high level of concern about body shape or weight. In Korea as well, overall sociocultural changes are increasing the prevalence of eating disorders: the rapid introduction of Western culture following economic development, along with the spread of dieting and various weight-control methods, changes in standards of femininity and beauty, changes in perceptions of obesity, and changes in the existing family system.

Binge-eating disorder, in which a person temporarily eats much more than usual, is found in about 2-3% of the general population and is associated with obesity. Eating disorders are more common in women, with about 90-95% of cases being female. They are known to occur more often than in the general population among professional models, dancers, athletes, jockeys, and others whose occupations involve a high level of concern about body shape or weight.

In Korea as well, overall sociocultural changes are increasing the prevalence of eating disorders: the rapid introduction of Western culture following economic development, along with the spread of dieting and various weight-control methods, changes in standards of femininity and beauty, changes in perceptions of obesity, and changes in the existing family system.

Whether it is anorexia nervosa or bulimia nervosa, the core of the problem can be said to be a distorted perception of food and weight. The most important function of eating is to provide energy to the body so that it can function in a healthy way.

For humans as well, eating can also mean love, relationships, comfort, pleasure, and entertainment. The problem in eating disorders is that the most important function of eating is ignored and used for other distorted meanings. In other words, low self-esteem, lack of confidence, and uncertainty about oneself are being addressed through external means such as food and weight.

Meanwhile, some view various biological changes—such as changes in neurotransmitters, problems in the various substances and pathways involved in appetite and satiety, changes in energy metabolism, and neuroendocrine changes—as factors that influence the cause and course of eating disorders.

Eating disorders are also considered to have a strong familial causal role, and some view them as a form of expression of family problems. However, there are also claims that some families do not show these characteristics and that the problems in the families of patients with eating disorders are actually secondary problems caused by the patient’s eating disorder.

Family characteristics of anorexia nervosa include excessive closeness among family members, rigidity, overinvolvement, postponing problems instead of solving them, and children becoming involved in the parents’ problems. By contrast, family characteristics of bulimia nervosa include unstable caregiving principles, emotionality, impulsiveness, and a chaotic lack of stability.

So far, I have explained eating disorders.

In the next installment, we will look at the symptoms of eating disorders.

Source: Korea Disease Control and Prevention Agency National Health Information Portal