What are Eating Disorders?
Eating Disorders (ED) are serious mental disorders characterized by persistent disturbances in eating habits, accompanied by an excessive concern about weight, body shape or food. They are not a choice or a whim: they are complex illnesses with biological, psychological and social roots that seriously affect the physical and emotional health of those who experience them.
According to the World Health Organization (WHO), eating disorders affect about 9% of the world's population over a lifetime. In Spain, it is estimated that around 400,000 people have some type of eating disorder, and the number keeps growing, especially among adolescents and young adults. Early diagnosis and specialized treatment are essential for a good recovery.
As a psychologist specialized in eating disorders, I work with people fighting these disorders from an integrative approach that addresses both the relationship with food and the underlying emotional causes.
Main types of Eating Disorders
Eating disorders cover a wide range of conditions, each with its own specific features. These are the most common:
Anorexia Nervosa
Anorexia nervosa is characterized by severe restriction of food intake, an intense fear of gaining weight and a distortion of body image. People who have it see themselves as overweight despite being below a healthy weight. It can have very serious physical consequences such as malnutrition, osteoporosis, heart problems and, in the most severe cases, can be life-threatening.
There are two subtypes: restrictive (food restriction without purging behaviors) and purging (which combines restriction with self-induced vomiting, laxative or diuretic use).
Bulimia Nervosa
Bulimia nervosa is defined by recurrent episodes of binge eating (consuming large amounts of food with a sense of loss of control), followed by compensatory behaviors such as self-induced vomiting, laxative use, fasting or excessive exercise. Unlike anorexia, people with bulimia usually maintain a weight within the normal range, which makes the disorder less visible but equally dangerous.
Binge Eating Disorder
Binge eating disorder (BED) involves recurrent episodes of excessive intake with a sense of loss of control, but without compensatory behaviors. The person eats compulsively, often very quickly and until uncomfortably full, then experiencing intense feelings of guilt, shame and emotional distress. It is the most common eating disorder and is often associated with overweight or obesity.
Muscle Dysmorphia (Bigorexia)
Muscle dysmorphia, or bigorexia, is characterized by an obsessive concern with muscular development. Affected people perceive themselves as too thin or insufficiently muscular despite having above-average musculature. This leads them to train compulsively, follow extreme high-protein diets and, in many cases, use anabolic substances that are dangerous to their health.
Orthorexia
Orthorexia involves a pathological obsession with food considered "healthy" or "pure". The person progressively eliminates foods from their diet based on purity or quality criteria, which ends up creating a very restrictive diet, nutritional deficiencies and a significant impact on social and emotional life.
Warning signs: how to detect an eating disorder
Early detection is key for a good treatment outcome. These are the main warning signs that may indicate an eating disorder:
- Changes in eating: elimination of food groups, obsessive calorie counting, rigid rituals during meals, eating in secret or avoiding meals with family or friends.
- Excessive concern about the body: weighing oneself constantly, looking in the mirror compulsively, frequent negative comments about one's own body.
- Physical changes: significant weight loss or gain in a short time, hair loss, dry skin, dizziness, dental problems (in cases of recurrent vomiting).
- Emotional changes: irritability, social isolation, intense anxiety around meals, frequent mood swings.
- Compensatory behaviors: going to the bathroom immediately after every meal, excessive and compulsive exercise, use of laxatives or diuretics.
Causes of Eating Disorders
Eating disorders do not have a single cause. They are the result of the interaction of multiple factors:
Biological factors
Genetics plays an important role: having a first-degree relative with an eating disorder increases the risk of developing one. Alterations have also been identified in neurotransmitters such as serotonin and dopamine, which regulate mood, pleasure and satiety. Puberty and hormonal changes can also act as triggers.
Psychological factors
Low self-esteem, perfectionism, difficulty managing emotions, anxiety, depression and traumatic experiences are significant risk factors. Many people use food control as a way to manage difficult emotions or to feel that they are in control of something when the rest of life feels out of reach. Treatment with EMDR can be especially helpful when an eating disorder is linked to trauma.
Social and cultural factors
Social pressure to achieve an "ideal" body, diet culture, social media with their filters and edited images, bullying about physical appearance and the glorification of thinness contribute significantly to the development of eating disorders, especially among adolescents and young adults.
Treatment of Eating Disorders
Treating eating disorders requires a multidisciplinary approach that includes:
- Psychological therapy: cognitive-behavioral therapy (CBT) is the psychological treatment with the most evidence for eating disorders. It helps identify and modify distorted thoughts about body and food, develop a healthier relationship with eating and manage emotions in an adaptive way.
- EMDR: when an eating disorder is linked to traumatic experiences (abuse, bullying, neglect), EMDR helps process these memories and reduce their emotional impact.
- Nutritional follow-up: a dietitian-nutritionist specialized in eating disorders works alongside the psychologist to set appropriate, progressive eating guidelines.
- Family support: family involvement, especially in the case of adolescents, is essential. Family therapy helps create a supportive environment for recovery.
- Medication: in some cases, psychiatric medication (antidepressants, anxiolytics) can be useful as a complement to psychological therapy.
Eating disorders in adolescents: special attention
Adolescence is a particularly vulnerable stage for the development of eating disorders. The physical changes of puberty, peer pressure, social media and identity building create fertile ground for body dissatisfaction and risky eating behaviors.
If you notice signs of an eating disorder in your son or daughter — such as skipping meals, going to the bathroom after eating, compulsive exercise or excessive concern about weight — it is essential to act quickly. Early intervention makes a significant difference in prognosis. I offer specialized therapy for adolescents with an approach tailored to their needs.
Recovery is possible
I want to share a message of hope: recovery from an eating disorder is possible. The path is not easy or linear — there can be setbacks and difficult moments — but with appropriate treatment, the right support and the person's motivation, a healthy relationship with food and with one's own body can be reached.
If you or someone you love is struggling with an eating disorder, please do not hesitate to ask for help. I offer a free informational session where we can assess the situation together and decide on the best path forward. You can contact me both for in-person therapy in Igualada and for online therapy.