Eating Disorders 
 โรคความผิดปกติของการกิน
 - Anorexia Nervosa
 - Bulimia Nervosa
 - Compulsive
   Overeating

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Eating disorders are characterized by severe 
disturbances in eating behavior. Thepractice of  an    
eating disorder can be viewed as a survival mechanism. 
Just as an alcoholic uses alcohol to cope, a person with  
an eating disorder can use eating, purging or restricting    
to deal with their problems. Some of the underlying issues 
that are associated with an eating disorder include low 
self-esteem, depression, feelings of loss of control, 
feelings of worthlessness, identity concerns, family 
communication problems and an inability to cope with 
emotions. The practice of an eating disorder 
may be an expression of something that the eating 
disordered individual has found  no other way of 
expressing. 

Eating disorders are complex diseases and not just a condition that can be treated 
with willpower. They meet the definition of a disease because like other diseases 
they have a particular destructive process for an individual, with a specific cause 
(that cause can be either known or unknown), and display characteristic symptoms. 
All eating disorders are primary diseases and not the secondary result of some 
other disorder. They are chronic conditions with an identifiable progression and 
predictable symptoms. Eating disorders arise out of the combination of genetic, 
sociological, and psychological factors. 

Genetic 
Many researchers believe that there is an inherited predisposition to having an 
eating 
disorder. Studies have shown that the co-occurrence of eating disorders among 
identical twins is greater than the co-occurrence among fraternal twins. Since 
identical twins are genetically more similar than fraternal twins, this would support an 
inherited component. Other research on the genetic component of eating disorders 
has focused on neurochemistry. Researchers have found that the neurotransmitters 
serotonin and neuroepinephrine are significantly decreased in acutely ill patients 
suffering from Anorexia and Bulimia Nervosa. These neurotransmitters also function 
abnormally in individuals afflicted with depression. This leads some researchers to 
believe there may a link between these two disorders. Besides creating a sense of 
physical and emotional satisfaction, the neurotransmitter serotonin also produces the 
effect of feeling full and having had enough food. 

Other brain chemicals have also been explored for their possible role in eating 
disorders. Individuals with eating disorders have been shown to have a higher than 
normal level of the hormones vasopressin and cortisol. Both these hormones are 
normally released in response to physical and possible emotional stress, and may 
contribute to some of the dysfunction seen in eating disordered individuals. Other 
research has found high levels of the neuropeptide-Y and peptide-YY to be elevated   
in individuals suffering from Anorexia and Bulimia. These chemicals have been shown 
to stimulate eating behavior in laboratory animals. The hormone cholecystokinin 
(CCK) has been found to be low in women with Bulimia and has caused laboratory 
animals to feel full and stop eating. 

Sociological 
Environmental conditions reinforce the practice of an eating disorder. We live in a 
society that reinforces the idea to be happy and successful we must be thin. Today, 
you cannot read a magazine or newspaper, turn on the television, listen to the radio, 
or shop at the mall without being assaulted with the message that fat is bad. During 
adolescence, a particularly vulnerable time to the development of an eating disorder, 
the influence of peers becomes important. Self monitoring and comparing ourselves  
to others becomes central to our psyche. Peer teasing and pressures to conform to 
the norm are common in the background of eating disorder individuals. As our bodies 
developed and changed, how others and we reacted to these changes influenced our 
eventual body acceptance. Other societal issues include dysfunctional families, 
sexual abuse, physical abuse, domineering coaches and controlling relationships. 

Psychological 
The practice of an eating disorder can be viewed as a survival mechanism. Just as   
an alcoholic uses alcohol to cope, a person with an eating disorder can use eating, 
purging or restricting to deal with feelings and emotions that may otherwise seem 
overwhelming. Through the practice of the eating disorder, the individual may feel a 
sense of partial control over their seemingly uncontrollable life. Some of the underlying 
issues that are associated with an eating disorder include low self-esteem, 
depression, feelings of loss of control, feelings of worthless, identity concerns, family 
communication problems and an inability to cope with emotions. The practice of an 
eating disorder may be an expression of something that the eating disordered 
individual has found no other way of expressing. 

Through the interaction of the various components an eating disorder can be developed. 


Eating disorders are usually divided into three categories: Anorexia Nervosa, 
Bulimia Nervosa and Compulsive Overeating. 

Anorexia Nervosa
Anorexia is a disorder where the main characteristic is the 
restriction of food and the refusal to maintain a minimal normal 
body weight. Any actual gain or even perceived gain of weight 
is met with intense fear by the Anorexic. Not only is there a true 
feeling of fear, but also once in the grasp of the disorder, 
Anorexics experience body image distortions. Those areas of 
the body usually representing maturity or sexuality including the 
buttocks, hips, thighs and breast are visualized by the Anorexic 
as being fat. For some Anorexics, weight loss is so severe there is a loss of menses. In the obsessive pursuit of thinness, Anorexics participate in 
restrictive dieting, compulsive exercise, and laxative and diuretic abuse. If Anorexia 
Nervosa is left untreated, it can be fatal.

Bulimia Nervosa
Bulimics are caught in the devastating and addictive 
binge-purge cycle. The Bulimic eats compulsively and then 
purges through self-induced vomiting, use of laxatives, 
diuretics, diet pills, ipecac, strict diets, fasts, chew-spitting, 
vigorous exercise, or other compensatory behaviors to 
prevent weight gain. Binges usually consist of the 
consumption of large amounts of food in a short period of 
time. Binge eating usually occurs in secret. Bulimics, like 
Anorexics, are also obsessively involved with their body shape and weight. The 
medical complications of the binge-purge cycle can be severe and like Anorexia 
can be fatal.

Compulsive Overeating
Compulsive Overeaters are often caught in the vicious cycle of binge eating and 
depression. They often use food as a coping mechanism to deal with their feelings. 
Binge eating temporarily relieves the stress of these feelings, but is unfortunately 
followed by feelings of guilt, shame, disgust, and depression. Binge eating, like 
 Bulimia, often occurs in secret. It is not uncommon for Compulsive Overeaters to eat
normally or restrictively in front of others and then make up for eating less by bingeing 
in secret. For other Compulsive Overeaters, binges consist of “grazing” on foods all 
day long. Similar to Anorexics and Bulimics, Compulsive Overeaters are constantly 
struggling and unhappy with their weight. The number on the scale often determines 
how they feel about themselves. Medical complications can also be severe and even 
life threatening for Compulsive Overeaters


Signs & Symptoms of Eating Disorders 
Individuals suffering from eating disorders may be unaware that they have a disorder  
or may have difficulty asking for help. Below are some "danger signs" to help 
determine if you or a loved one could be at risk for having an eating disorder. If three  
or more of the following symptoms apply to you or a loved one please contact us.  
You or your loved one may be at risk of having an eating disorder.

Anorexia Nervosa  
is a disorder where the main characteristic is the restriction of food and the refusal 
to maintain a minimal normal body weight. Most Anorexics lose weight by restricting 
their food intake. Anorexics may start by limiting or excluding foods that they 
perceive as having high fat or caloric content.

Once the disorder of Anorexia Nervosa takes hold, the individual usually ends up 
with an extremely restrictive diet that is sometimes limited to only a small number of 
foods. Additional methods of weight loss for Anorexics can include vomiting, laxative 
abuse, diuretic abuse, insulin abuse, chew-spitting, and excessive exercise.

For individuals suffering from Anorexia Nervosa, any actual gain or even perceived 
gain of weight is met with intense fear of becoming fat. With Anorexia Nervosa, 
weight loss usually does not lesson the fear, and in fact, the fear often increases 
following the weight loss. Not only is there a true feeling of fear, but also once in the 
grasp of the disorder, Anorexics experience body image distortions. Most 
individuals suffering from Anorexia have an overall feeling of being overweight.

Some Anorexics have an understanding that they are thin, but are concerned that 
parts of their bodies are fat. Those areas of the body usually representing maturity 
or sexuality including the buttocks, hips, thighs, and breasts are visualized by the 
Anorexic as being fat. An individual with Anorexia Nervosa will often obsessively 
check their body size and weight through frequent weighing, measuring, pinching, 
and viewing themselves in a mirror.

With Anorexia self-esteem and self worth is tied directly to the Anorexic's body 
shape and weight. For an Anorexic, weight loss is viewed as a success, a sign of 
extraordinary self-discipline, and control over life. Conversely, any real or perceived 
weight gain is seen as a personal failure and loss of control for the Anorexic.

For some Anorexics, weight loss is so severe there is a loss of menstruation. 
Medical complications for individuals with Anorexia Nervosa can be severe and 
even life threatening. Some of the more common potential medical complications 
include emaciation, bradycardia, hypotension, hypothermia, impaired renal 
functioning and gastrointestinal problems. For a complete list of potential medical 
problems for Anorexia Nervosa, visit our Medical Complications page.

If Anorexia Nervosa is left untreated, it can be fatal.

Bulimia nervosa, 
more commonly known as bulimia, is a psychological condition in which the subject 
engages in recurrent binge eating followed by intentionally doing one or more of the 
following in order to compensate for the intake of the food and prevent weight gain: 

vomiting 
inappropriate use of laxatives, enemas, diuretics or other medication 
excessive exercising 
fasting 
A person is classified as bulimic when he or she feels incapable of controlling the 
urge to binge, even during the binge itself, when he or she consumes a larger 
amount of food than a person would normally consume at one sitting, and when 
such behavior occurs at least twice per week for three months. 

Bulimia is a pathology having to do with body image and the desperate desire to 
appear thin. The majority of bulimic patients are young females from 10 to 30 years 
old, although the disorder can occur in people of all ages and both sexes. 

Bulimia Nervosa is a disorder where the main characteristics are binge eating and 
compensatory behaviors in order to prevent weight gain. Bulimics are caught in the 
devastating and addictive binge-purge cycle.

For individuals suffering from Bulimia Nervosa, the binge can be seen as a reward 
within itself and a way to cope with daily stresses and feelings. Bulimic binges 
usually consist of a larger than normal quantity of food, that typically are high in 
caloric intake. For individuals with Bulimia Nervosa, the binge eating usually occurs 
in secrecy and rarely in the presence of others.

The types of food vary but are often sweet and/or high in fat content. Some binges 
are planned in advance by the Bulimic, but generally they are impulsive. Triggers 
for binges in Bulimia Nervosa include dysphoric mood, interpersonal stressors, 
boredom, prolonged dieting, and body image dissatisfaction.

The binge eating in Bulimia Nervosa may temporarily numb the negative feelings, 
but this state is quickly followed by feelings of failure. The Bulimic is often ashamed 
of their binges and views the Bulimic behavior as a loss of control and a reason for 
low self-esteem. This is why it is often hard for Bulimics to come forward and seek 
help.

Individuals suffering from Bulimia Nervosa follow their binge-eating behavior with 
compensatory behaviors in an attempt to counteract the binge episodes. The most 
common form of compensatory behavior for individuals suffering from Bulimia 
Nervosa is vomiting. The Bulimic usually induces vomiting directly following the 
binge.

For the Bulimic, the act of purging may temporarily reduce the feeling of fullness 
and reduce their fear of weight gain from the binge. Some individuals with Bulimia 
Nervosa even look forward to the purging behavior as they enjoy the feeling of 
release the purging behavior temporarily affords.

Other compensatory behaviors that individuals with Bulimia Nervosa use in an 
attempt to prevent weight gain include use of laxatives, enemas, diuretics, diet pills, 
ipecac, strict diets, fasts, insulin abuse, chew-spitting, and vigorous exercise.

Bulimics, like Anorexics, are also obsessively involved with their body shape and 
weight. An individual with Bulimia Nervosa will often obsessively check their body 
size and weight through frequent weighing, measuring, pinching, and viewing 
themselves in a mirror. For the Bulimic, the individual's self worth is directly tied to 
their body shape and weight.

Compulsive Overeaters  
are often caught in the vicious cycle of binge eating and depression. With 
Compulsive Overeating food is used as a coping mechanism to deal with 
uncomfortable feelings. Many Compulsive Overeaters speak of using the 
Compulsive Overeating episodes as a way to numb all that is going on around them. 
The amount of food eaten and duration can vary greatly for a Compulsive Overeater.


For many individuals suffering from Compulsive Overeating, binges may not be able 
to be broken into specific episodes but rather days where the individual eats more 
than normal throughout the day. Triggers for Compulsive Overeating include 
depression, anxiety, interpersonal stressors, boredom, prolonged dieting, and body 
image dissatisfaction.

Compulsive Overeating may temporarily relieve the stress of these unwanted 
feelings, but for the Compulsive Overeater the overeating episodes are unfortunately 
followed by feelings of guilt, shame, disgust, and further depression. For the 
Compulsive Overeater, episodes of Compulsive Overeating usually occur in secret 
and any evidence is often hidden from others.

It is not uncommon for Compulsive Overeaters to eat normally or even restrictively in 
front of others and then make up for eating less by Compulsively Overeating in 
private at a later time. Compulsive Overeating late at night, when others are asleep 
or frequenting fast food restaurants and convenience stores alone, can also be 
common. Many Compulsive Overeaters even have a secret stash of junk food 
hidden for their personal use.

Similar to Anorexics and Bulimics, Compulsive Overeaters are constantly struggling 
and unhappy with their weight. With Compulsive Overeating, the number read on the 
scale often determines how the Compulsive Overeater feels about themself. 
Constant dieting and restricting food becomes a way of life for the Compulsive 
Overeater.

Each new diet is tried in hope that it will be the one that works to combat the 
Compulsive Overeating. At first, there may even be some weight loss success for 
the Compulsive Overeater with the diet, but unfortunately in most cases each diet 
ends in failure and all the lost weight is regained. Thus continues the devastating 
cycle for the Compulsive Overeater.

Medical complications from the Compulsive Overeating behavior can be severe 
and even life threatening for Compulsive Overeaters. Diabetes, hypertension and 
cardiac problems are just a few of the dangerous complications of Compulsive 
Overeating.

Like Anorexia Nervosa and Bulimia Nervosa, Compulsive Overeating is a disease 
and cannot be cured with willpower alone.

Night Eating Syndrome  
is a disorder where the affected individual wakes multiple times during the night and 
is unable to fall back asleep unless they eat something. Foods eaten during the 
binge are often high caloric in content and unhealthy. The night eating behavior 
seems totally beyond the effected individual’s control. For these individuals, 35% 
or more of their calories are eaten after dinnertime. Following the night binge, the 
person is often not hungry in the morning. Individuals suffering from Night Eating 
Syndrome are often caught in the vicious cycle of binge eating during the night and 
eating less during the day. Triggers for Night Eating Syndrome include depression, 
anxiety, interpersonal stressors, boredom, prolonged dieting, and body image 
dissatisfaction. Night eating may temporarily relieve the stress of these unwanted 
feelings, but for the night eater these episodes are unfortunately followed by feelings 
of guilt, shame, disgust, and further depression. For the person suffering from Night 
Eating Syndrome, the eating episodes usually occur in secret and any evidence is 
often hidden from others. Similar to Anorexics, Bulimics, and Compulsive 
Overeaters, individuals suffering from Night Eating Syndrome are often struggling 
and unhappy with their weight. It is estimated that up to one percent of the population 
may be suffering from Night Eating Syndrome. Like Anorexia Nervosa Bulimia 
Nervosa, and Compulsive Overeating, Night Eating Syndrome is a disease and 
cannot be cured with willpower alone.