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Considering Eating Disorders as Psychiatric Disorders

Woman checking her body

An estimated 30 million people nationwide have or have had an eating disorder. Twenty million women and 10 million men report having had an eating disorder at some point in their lives. Furthermore, in a study of about 500 adolescent females, approximately 13% reported experiencing an eating disorder by age 20. But what do we know about eating disorders?

What Are Eating Disorders?

Eating disorders are serious but treatable conditions defined by unhealthy eating habits. They are prevalent in people of all ages, ethnicities, religions, genders and body types.

The majority of eating disorders involve a magnified focus on food, body image and weight, leading to eating behaviors that negatively impact one’s overall health. These behaviors are quite dangerous because they can significantly inhibit the capacity of the body to receive sufficient nutrients. For this reason, eating disorders harm many different parts of the body, including the heart, digestive system, bones, teeth, and mouth. Chronic eating disorders may also cause other complications or contribute to other diseases.

The three main eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Anorexia nervosa

Anorexia nervosa — commonly called anorexia — is an eating disorder characterized by notably low body weight, an intense worry surrounding weight gain, and a distorted perception of weight. People with anorexia may severely restrict the amount of food they eat or engage in binge eating and purging behaviors.

Bulimia nervosa

Bulimia nervosa — often called bulimia — is an eating disorder characterized by bingeing on large quantities of food, and then purging in order to prevent weight gain.  Purging behaviors may include vomiting, excessive exercise, or an inappropriate use of laxatives.

Binge-eating disorder

Binge-eating disorder is an eating disorder characterized by the consumption of substantial amounts of food frequently and feeling unable to stop eating.

The Connection Between Eating Disorders and Mental Health

Eating disorders are mental health disorders

While eating disorders seem to revolve around food, they are actually complex mental health conditions that often require medical and psychological intervention. To paint a picture of the complexity of an eating disorder’s mental health component, the time taken to treat someone with severe anorexia nervosa can be almost double the amount of time for someone with a physical health condition, such as heart problems or cancer.

Eating disorders accompany mental health disorders

Additionally, people experiencing eating disorders often have comorbid mental health concerns such as anxiety, depression, obsessive-compulsive disorder (OCD), and substance use disorders. The tie between depression and eating disorders is strong. Research reveals that 32-39% of individuals with anorexia nervosa, 36-50% of individuals with bulimia nervosa, and 33% of individuals with binge eating disorder also have a diagnosis of a major depressive disorder.

Eating disorders and mental health conditions, such as depression, can trigger and perpetuate the symptoms of one another. This is in part due to the forcible impact eating disorders have on mood. For example, the characteristic malnourishment seen in anorexia can change brain chemical activity, which can cause  negative shifts in mood. Consequently, that consistent shift in mood can induce depression. Furthermore, the hallmarks of eating disorders — negative body image and low self-esteem  — can stir feelings of anxiety and depression.

Eating disorders cause social disconnection

Eating disorders can affect connections between individuals and the people around them. When someone is deeply engaged in an eating disorder, relationships with others are strained. According to Ashley Solomon, PsyD, CEDS, “individuals in recovery will reflect that during the course of the disorder they hid away from everyone and anyone that might have threatened the disorder. Or they were too busy engaging in eating disorder symptoms to socialize. Or they just didn’t have the emotional or physical energy to see friends or family.” This isolation can further contribute to symptoms of depression and anxiety.

Eating disorders distort awareness of body and mind

Many people with eating disorders have a difficult time seeing themselves accurately.  For example, looking in mirrors or at photographs can produce a different, self-distorted image than what is really there. Those with eating disorders may also have difficulties in assessing how they think and feel.

Treatment for Eating Disorders

It is essential to seek treatment early for eating disorders. Treatment for eating disorders often includes a range of measures such as, psychotherapy, medical care, nutritional counseling, medications, or a combination of these methods. Typically, treatment goals include:

  • Restoring adequate nutrition
  • Bringing weight to a healthy level
  • Reducing excessive exercise
  • Stopping binge-purge and binge-eating behaviors

While full recovery is possible, anorexia nervosa is notoriously difficult to treat, with high relapse rates, low remission rates, and many sufferers denying treatment.

Additionally, treatment should also focus on the management of any co-occurring mental health disorders that often accompany eating disorders, such as anxiety, depression, OCD, etc. Tending to these comorbid mental health conditions is a big piece of the puzzle.

Pharmacogenomics Role in Mental Health Treatment 

A number of medications may be utilized in the treatment of eating disorders and/or the comorbid mental health conditions that often accompany these disorders. However, psychiatric medication is not a one size fits all solution, including when addressing the psychiatric challenges that accompany an eating disorder.

There is a way to personalize the decision-making process of utilizing medication(s) for mental health challenges. It’s known as pharmacogenomics (PGx). A PGx test provides valuable genetic information to help a provider make more informed drug selection and dose decisions based on their patients’ genetic profile when treating a multitude of mental health disease states.

Providers can use Genomind PGx testing to assess 24 genes related to medication:

  • tolerability (adverse drug events, like side effects)
  • response (efficacy)
  • metabolism (dosage)

Plus, with Genomind Precision Medicine Software, providers can evaluate drug-drug and gene-drug interaction data for 99% of the most commonly prescribed medications. They can even factor in patients’ lifestyle choices like caffeine intake and smoking

Pharmacogenomics can help providers customize their patients’ treatment plans, and provide hope for those dealing with mental health conditions.

If you or a loved one is experiencing an eating disorder, or another mental health concern such as anxiety, depression, OCD, or substance abuse, meet with your health care provider to discuss the possibility of a PGx test.

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