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Published May 1, 2024

Eating disorders not limited to anorexia nervosa and bulimia

National Eating Disorders Awareness Week kicks off at the University.

This week, University groups will observe National Eating Disorders Awareness Week, which brings information about all types of eating disorders to the public.

Eating disorders are not limited to women with anorexia nervosa and bulimia. The disorders include a wide variety of unhealthy eating behaviors and can affect men as well as women.

There are many people who have disordered eating but don’t meet the full criteria for anorexia nervosa or bulimia, said Kerri Boutelle, STAR Adolescent Eating Disorder and Weight Management Clinic director.

These people are classified as having “eating disorders not otherwise specified.”

Irene Alton, a nutritionist at Children’s Hospital in Minneapolis and Health Start in St. Paul, said eating disorders besides anorexia and bulimia can also be signs of harmful health problems.

“If someone doesn’t fit the criteria of anorexia or bulimia, it doesn’t mean that they don’t have a serious problem,” Alton said.

Boutelle said those with otherwise unspecified eating disorders are the hardest group to treat because they comprise a wide variety of behaviors.

For some, the sole symptom might be worrying more about what they eat than the general population does. Others might regularly induce themselves to vomit but might not have been doing so for the three months a bulimia diagnosis would warrant, she said.

“Most women worry about body image,” Boutelle said. “But it’s when it starts to impair their daily activities – that’s when it becomes of concern.”

If food causes someone stress, they should talk to a professional about it, she said.

“This is the kind of thing you don’t want to do alone,” she said.

The clinic treats young people between ages 12 and 25, including University students. Boutelle estimated 80 percent of those seen at the center have eating disorders not otherwise specified.

Despite the prevalence of the disorders, they are not widely recognized, because they have such a broad definition, she said.

“It’s hard to diagnose, because it’s so amorphous,” she said.

Alton said the otherwise unspecified eating disorders should receive more attention because if they go untreated, they can develop into anorexia nervosa or bulimia.

One example of an eating disorder not otherwise specified is binge eating disorder.

The symptoms of the disorder include eating large quantities of food in a short period of time. The person cannot control what or how much he or she eats, said Nancy Raymond, University National Center of Excellence in Women’s Health director.

Unlike bulimia, the person does not compensate for what he or she eats by vomiting, excessively exercising or using laxatives, she said.

Scott Crow, a professor of psychiatry and an investigator at the Minnesota Obesity Center, said that although binge eating is more common than other eating disorders, people do not give it the same amount of attention. People see overeating as “normal,” especially in overweight people, he said.

But both Crow and Raymond stressed that while binge eating disorder can lead to obesity, not all obese people have the disorder.

Crow said binge eating should be given more attention because it makes a person’s weight go up and negatively affects his or her self-esteem and stress levels. Raymond said obese people with binge eating disorder have higher rates of psychiatric problems than people in the general population and obese people without the disorder.

Other eating disorders that often go unrecognized are eating disorders among men. The Eating Disorders Institute at Methodist Hospital has seen an increase in the number of men and boys with eating disorders in the last few years, said Shannon Simper, the institute’s outreach marketing and development specialist.

Approximately 1 million men in the United States struggle with eating disorders, she said.

Because men are increasingly objectified in the media, the pressure for men to have muscular bodies is also increasing, she said.

“A lot more men are struggling with body dissatisfaction,” she said. “They look and feel inadequate, because they don’t fit that ideal.”

Simper said eating disorders among men have not received much attention because eating disorders have traditionally been thought of as a female illness. Also, it’s tougher for men to ask for help, she said.

Simper said she hopes more people become aware that men suffer from eating disorders.

“It opens the door for men and boys to seek help,” she said.

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