A Nurse's Guide to Eating Disorders

When a person has an abnormal relationship with food or exhibits unusual behavior related to the consumption of food, it is called an eating disorder. An eating disorder can affect people regardless of age, gender, or ethnicity. In the United States, it is a significant problem, as there are as many as ten million men and twice as many women who suffer from eating disorders during their lifetime. Eating disorders can have a negative impact on a person’s physical and mental health that often results in minor to severe medical problems. Additionally, eating disorders can even affect both personal and professional relationships.

Biological Causes

Biology plays a role in triggering eating disorders in a significant number of people, although the specific genes that may cause them are not yet known. Heredity is one factor that has been discovered as a cause, and chemical imbalances in the brain can also play a role. This means that people may inherit eating disorders if they have a family history of them, especially identical twin sisters, according to one study. Abnormal levels of hormones such as dopamine, norepinephrine and, most importantly, serotonin are also a factor in many cases. This is because neurotransmitters within the brain fail to properly convey chemicals like seratonin, resulting in low seratonin levels. Problems with the immune system can also be a factor; for example, lupus, multiple sclerosis, and rheumatoid arthritis are also associated with eating disorders.

Psychological Causes

There are a variety of psychological issues that could cause a person to develop an eating disorder. Anxiety, depression, or loneliness may drive someone to become bulimic, while low self-esteem may result in anorexia nervosa. Other forms of eating disorders may develop as a result of a person needing to have more control over some part of their life or because a person lacks any sense of self-control. Perfectionism and obsessive-compulsive disorders are other known causes of eating disorders.

Social/Environmental Causes

Social and environmental issues are a potent catalyst for eating disorders and can serve to magnify the risk when biological or psychological factors are also present. Pressure from a child’s parents to be thin and beautiful could trigger an eating disorder, as could frequent domestic disputes, ridicule by their peers about their weight and other forms of peer pressure, various forms of child abuse, or trouble with personal relationships. Societal pressures and arbitrary cultural norms dictating narrow standards of beauty also contribute to the development of eating disorders. Reading beauty reviews and opinions based on unrealistic or unattainable goals and looking at altered images in magazines are also damaging. Even sports activities can cause eating disorders due to the persistent demand for thinness as a part of fitness requirements.

Anorexia Nervosa

When a person has an abnormal fear of weight gain and it drives them to eat too little or to vomit up the food that they eat, it is a condition known as anorexia nervosa. They may also exercise excessively, refuse to eat at all, or resort to taking diuretic and laxative products to encourage bowel movements and urination. People who suffer from a distorted perception of their body weight are at risk of becoming anorexics as well as those who are obsessed with staying thin. Anorexia typically occurs among teenagers and pre-teens, and it affects females more than males.

Bulimia Nervosa

Bulimia nervosa is an eating disorder in which a person will eat a prodigious amount of food in one sitting and then try various ways of getting rid of the food. This condition is also called binging and purging for this reason. They may either vomit up their food or take laxatives to speed up bowel movements. Bulimia can be triggered by stress, diets, or an abnormal fear of gaining weight. It affects mainly women and can occur among older women as well.

Binge Eating

Binge eating is a disorder where a person eats excessively or uncontrollably on a long-term basis. Unlike anorexia or bulimia, there is no attempt to purge the food or to exercise to mitigate the potential weight gain. This disorder manifests during a person’s late teens or their young adult years and can occur as a consequence of extreme dieting, poor self-esteem, or depression. It often leads to feelings of regret, and the person may enter into a cycle of weight gain and then overeating again as a means of coping.


Overeating is an occasional behavior that is defined by consuming more food than is necessary, to the point of being more than full. It is a highly common occurrence, especially during holidays such as Christmas or Thanksgiving, but it can also include things like eating too much popcorn at the movies. People eat excessively for a variety of reasons, including the fact that they have been served an abundance of food, because it tastes good, to cope with stress, or due to something stressful like the breakup of a relationship. Overeating is a temporary problem that affects all races, age groups, and genders and is not associated with an actual disorder such as binge eating.

EDNOS (Eating Disorders Not Otherwise Specified)

For an eating disorder to be classified with a label such as anorexia, it must meet the specific definition or criteria for that condition. Often, a person’s diagnosis may fall short of meeting these definitions and may even present as a combination of the different categories. These people fall within the category of “eating disorder not otherwise specified,” or EDNOS. Examples of EDNOS include chewing large amounts of food and spitting it out repeatedly, being of normal weight but exhibiting anorexic behavior, and binging and purging less than twice weekly.