Eating Disorders

Basics

Restriction of intake, leading to low body weight
Intense fear of gaining weight or becoming fat, or behavior that prevents weight gain
Distorted body image, undue influence of weight and shape on self-esteem, or denial of seriousness of low body weight
Lifetime prevalence: 1.4% of females, 0.12% of males in the US
Onset adolescence to young adult

Recurrent episodes of binge eating characterized by both:
- Eating an unusually large amount of food in a discrete period of time
- A sense of loss of control over eating during the episode
Recurrent inappropriate compensatory behaviors used to prevent weight gain:
- Self-induced vomiting
- Misuse of laxatives or enemas
- Diuretics
- Diet pills
- Fasting
- Excessive exercise
Averages at least once a week for 3 mo
Self-evaluation excessively influenced by weight or body shape
Lifetime prevalence: 0.46% of females, 0.08% of males in the US
Commonly onset in late adolescence or early adulthood

Recurrent episodes of binge eating characterized by:
- Eating a larger than usual amount of food in a discrete period of time
- A sense of loss of control over eating during the episode
Binge eating episodes associated with 3 or more of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of embarrassment about how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty after overeating
Marked distress over binge eating
Occurs on average at least once a week for 3 mo
No compensatory behavior
Lifetime prevalence: 1.25% of females and 0.42% males in the US
Onset in late adolescence or early adulthood

Genetic predisposition and neurochemical dysregulation
Cultural emphasis on thinness as a valued attribute has been implicated
Temperament or personality attributes of perfectionism, anxiety, and behavioral rigidity have been described
Family conflict or stress is a frequent element
Neurochemical (serotonin) and neuroendocrine (leptin, HPA axis) abnormalities have been reported
Dieting is a frequent immediate precipitant

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