In this video I introduce 3 eating disorders: bulimia nervosa, binge–eating disorder, and anorexia nervosa. I briefly describe the symptoms of these disorders and how they may arise from complex interactions of biological factors like genes or hormones and environmental factors like stress, the family environment, and social & occupational pressures.

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Video Transcript

Hi, I’m Michael Corayer and this is Psych Exam Review. In previous videos I’ve talked about motivation for eating behavior and the complexity of hunger signaling and so in this video I’d like to introduce eating disorders.

This means I need to start with an important disclaimer that this video or any of my videos should never be considered medical advice. I’m not a doctor, I’m not a psychiatrist, and I make these videos purely for educational purposes. They’re to help you to understand complex psychological topics including mental health issues but they should never be used to diagnose or treat mental health issues. So if you think that you or someone you know is struggling with something like an eating disorder then I urge you to seek out the advice and help of trained mental health professionals.

So with that in mind we’ll take a look at some of the main symptoms of a few eating disorders and we’ll start with bulimia nervosa. One of the main symptoms of bulimia nervosa is binge eating very large quantities of food. Now you might wonder exactly what that means. How do we determine a large quantity of food? And the way that is generally determined is to consider it as an amount of food much greater than most people would eat in that setting. And that’s important because we have certain settings where most people will eat very large quantities of food. So if we think about a holiday like Thanksgiving, you see that most people are eating maybe thousands more calories than they would normally eat in a single meal, then that might not qualify as an episode of binge eating because most people would do that. Or if you look at someone who goes to an all-you-can-eat buffet and they eat a larger meal than normal, but most people tend to do that in that setting so that might not necessarily indicate that they are, you know, binge eating or they’re having an episode of binge eating. If, however, they were doing that in a setting where most people would eat much fewer calories, then in that case it might be considered binge eating.

Now this binge eating behavior is often followed by purging behaviors and this is mostly done through vomiting, but it can also be done through the use of laxatives or through excessive exercise. And so these are attempts to purge the body of these excess calories that have been taken in. So when I say excessive exercise I mean very excessive. We’re talking about maybe eight hours a day of exercising in an attempt to get rid of these calories. And so this is at a point where it’s not a healthy behavior. It’s not “ok, I, you know, need to go to the gym for 30 minutes or an hour because, you know, I ate dessert last night and I want to workout a little harder today.” This is very excessive amounts in order to be considered what’s called exercise bulimia.

And lastly we have the role of negative emotions. This is another symptom of bulimia nervosa. Patients who have bulimia nervosa often experience negative emotions of sadness, anxiety, and shame. Now it’s also possible to be diagnosed with what’s called “binge eating disorder” and this is a new disorder in that it was just added to the DSM-5 which was released in 2013 and this refers to a patient who has episodes of binge eating and they experience these negative emotions of sadness, anxiety, guilt, shame and yet they don’t have any compensatory purging behaviors. So they’re engaging in binge eating but they’re not purging following that. This could still be diagnosed as an eating disorder, in this case, this would be binge eating disorder.

And the last disorder that we’ll look at in this video is anorexia nervosa. And this “anorexia” you might recognize from my video on hunger signaling where I talk about the orexigenic signal turning on the hunger signal and the anorexigenic signal turning off the hunger signal. So this would come from the root meaning “without hunger” or “without appetite”. And that’s not quite accurate because patients who have anorexia nervosa do still experience hunger. They do still have appetite for food.

But the main symptom of anorexia nervosa is a fear of being fat and of gaining weight. And so in order to try to control this fear, the patients often engage in severe caloric restriction. So they try to eat very, very small amounts of food very, very low calories or even no calories at all for extended periods of time. Along with these symptoms of a fear of weight gain and the restriction, this behavioural symptom of restricting their calories, they also also have a distorted sense of their body shape and size. So patients who are struggling with anorexia nervosa will often report that they they feel much fatter and they believe that they’re overweight. Or they feel that they have a very high percentage of body fat when in fact they don’t. They may have a very unhealthily low level of body fat and yet they have this perception that they’re overweight or that they’re fat.

Now anorexia nervosa, unfortunately, has a high rate of mortality and this is in part because of death by starvation which can occur. But it’s also the case that patients with anorexia nervosa are also more likely to commit suicide. About one in five deaths associated with anorexia nervosa is from suicide and this also relates the idea that anorexia nervosa is comorbid with other diseases and disorders. And so that’s something we’ll talk about in more detail in a future unit when I talk about other psychological disorders.

But it’s important to note that it can be overcome with treatment even severe cases. So patients who struggle with eating disorders, they can overcome these there are treatments that can be successful, and therefore it’s quite important that people seek help if they need it. This may mean they need to overcome certain feelings of shame or embarrassment that can prevent them from seeking help. So in the case of eating disorders, patients often try to hide their eating disorder, they try to hide some of these behaviors like they’re purging behavior because they feel ashamed. Or they try to hide the fact that they’re restricting their calories as much as they actually are in the case of anorexia. So these feelings of shame and embarrassment can prevent people from seeking help, and so this means we need to try to reduce the stigma associated with these disorders and encourage people to seek help as soon as possible.

Now it’s also important to consider the complexity of these disorders. Often you’ll hear people say dismissive things about maybe somebody who’s very, very thin, somebody who might be suffering from anorexia nervosa that, you know, they just need to eat a cheeseburger or something. And it’s really not the case. It’s much more complex than that. It’s not the case the person just needs to eat more and they’ll be fine, or they just need to stop binge eating.

We have to remember that these are complex topics and so there are certainly biological factors involved. There’s the role of hormones, there could be genetic factors involved, but there’s also environmental factors things like stress, family environment, and there’s also cultural and occupational pressures. So certain occupations have higher incidence of things like eating disorders and so this means that we have to think about how these pressures are playing a role on people’s behaviors. Ok, so that’s a basic overview of some eating disorders, I hope you found this helpful, if so, please like the video and subscribe to the channel for more. Thanks for watching!