Anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) are psychiatric diagnoses that involve a significant disturbance in the perception of body shape and weight which leads to an abnormal or obsessive relationship with food, exercise, and self-image.
Anorexia nervosa is characterized by the refusal to maintain minimally normal weight for age and height (weight less than 85% of expected); an intense fear of gaining weight; a denial of the seriousness of the current low body weight; and, in postmenarcheal women, an absence of monthly menstruation.
Bulimia nervosa is characterized by recurrent episodes of binge eating followed by inappropriate behaviors to prevent weight gain such as self-induced vomiting; misuse of laxatives, diuretics, and enemas; fasting; and/or excessive exercise.
Eating disorder not otherwise specified has many of the characteristics of anorexia nervosa and/or bulimia nervosa, without meeting the strict parameters of those diagnoses. While EDNOS is not as well known as the other eating disorders, it is a more significant problem than anorexia or bulimia.
Depression, anxiety, and substance abuse often accompany these disorders. In addition, significant physical complications can also occur. If a student’s eating disorder jeopardizes his/her physical and emotional health, the student may need to leave school and enter intensive treatment.
Some of the symptoms associated with eating disorders are significant weight loss (15% or more) from original body weight; the inability to concentrate; chronic fatigue; decreased strength of immune system and susceptibility to illness; an obsession with food that dominates the student’s life; extreme moodiness; excessive vulnerability to stress; tendency to socially withdraw; repetitive injuries and pain from compulsive/excessive exercise; and extreme perfectionism and/or rigidity.
When you suspect a student may have an eating disorder:
- When possible, speak to the student in private.
- Be supportive and express your concern about the student’s health. Provide specific examples of behaviors or symptoms that are of concern.
- Refer the student to Women's Services & Resources (801.422.4877; wsr.byu.edu) for consultation and information about the Fed Up with Food Support Group.
- Consult with Counseling and Psychological Services (801.422.3035) if you want advice on how or when to intervene with a student.
- Consider encouraging the student to meet with a physician at Student Health Services (801.422.2771).
- Reassure a student that his/her obsessions are normal and therefore nothing to worry about.
- Scare the student into changing or getting help. With eating disorders, fear seldom motivates change.
- Make jokes about eating disorders or about fat people to students.
- Make positive comments about a student’s weight loss. It is difficult to discern if you are rewarding healthy behavior or encouraging a hidden disorder.
Other Resources/Suggested Reading:
The Happiness Trap
The Illustrated Happiness Trap