The scale doesn’t always tell the truth about weight problems.

Why do some people find it so difficult to lose weight? Is it due to an eating disorder? Or, is it something so complex that it is impossible to solve?

Causes of eating disorders

Eating disorders are more complex than just eating more than you should at each meal – or continually eating between meals; and, snacking late at night. Scientists haven’t been able to correlate the ’cause’ and ‘effect’ of eating disorders.

There are biological, environmental, nutritional, behavioral, social, exercise, and emotional issues that intertwine a myriad of causes. This variety of causes build on each other until control has been eliminated from your dietary and nutritional lifestyle.

Most people with eating disorders don’t believe they have a problem. There is no problem, therefore no action is required. Malnutrition and obesity have the same behaviors – just different ends of the spectrum.

People don’t choose to be malnourished or obese. It happens because of genetics and brain chemistry most of the time. Eating disorders can be inherited. Genetics appears to some degree in 50-80% of research.

Research has shown that brain chemistry is altered in many eating disorder patients. It should be pointed out, however, that eating disorders are predominant with other mental conditions, such as depression, anxiety, and obsessive-compulsive disorder (OCD). Personality traits have also been observed to predispose a person towards an eating disorder.


One would think that the brain would react differently to bingeing, purging, or extreme fasting, but it doesn’t. Anxiety is reduced and the actions are taken to achieve that ‘feeling’ is reinforced to continue that behavior.

Many brain chemistry problems can be brought back into normal ranges by proper nutrition. With an aggressive nutritional program, many patients with eating disorders have normalized their thinking and subsequent behavior.


How would you recognize an eating disorder in someone else? One would think that overeating is the main symptom. However, it is much more complex. You can see symptoms of an eating disorder before they become serious.

Food-related symptoms include dieting and constant diet changes; avoidance of joining others to eat; inflexibility regarding what, how much, and when to eat; needing to know the calories of every items they eat; interest in cooking and recipes without actually eating; secretive eating (foods and times); never available for family meals; anger at being forced to eat; food disappearing frequently, etc.

Note, one or more of these symptoms does not constitute an eating disorder – or, an early detection. Many people will eat only when they are hungry. Nutrition has a major impact on brain chemistry and should also be included in any assessment of too little or too much food at a meal.

Other symptoms include excessive exercise; failure to gain weight according to normal curves for their age; socially withdrawn; and, inability to describe emotions. This is a shortlist of symptoms and is for educational purposes only – not intended to diagnose a problem. See a medical professional.

People with eating disorders typically deny that they have a problem, or that anything is wrong. Early diagnosis and treatment will prevent further serious health problems.


Eating disorders occur most frequently in children, teenagers, and young adults. Women are more likely to develop eating disorders compared to men. Men account for 5-15% of patients with anorexia or bulimia. Women makeup 90%, give or take, of patients with anorexia or bulimia. Men account for up to 35% of patients with binge-eating disorder compared to 65% for women.

Success Rate

There is a high success rate with eating disorders. It is imperative that other psychiatric conditions be diagnosed and separated for optimal treatment. Anxiety disorders, substance abuse, despair, and depression can be causes of eating disorders. Psychiatric and medical treatments work well if diagnosed early and treated.

Eating and psychiatric disorders can lead to many heart and kidney problems, neurological complications, impaired physical development, electrolyte and fluid imbalances, and even death – by related disease or suicide.

Scientists have classified over three-dozen unique and specific types of eating disorders. The three main categories are anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified.

Anorexia nervosa is considered to be a brain disorder. Some researchers believe that in some cases it is linked to undiagnosed autism. Bulimics, on the other hand, tend to suffer from depression or general anxiety disorder.

Anorexia Nervosa

Anorexia nervosa symptoms include a persistent quest for a leaner and slenderer body to the point of emaciation, an unwillingness to maintain weight within normal standards, an intense fear of gaining weight, excessive dieting or exercise, misuse of laxatives, diuretics or enemas.

The anorexic’s brain cannot perceive reality. They see themselves as fat or overweight when it is obvious to everyone around them that they are scrawny and undernourished. Anorexics weigh themselves constantly. They eat very small servings of only certain foods.

Anorexics typically have osteopenia/osteoporosis (bone density diseases), brittle hair and nails, dry and/or yellowish skin, muscle weakness, severe constipation, slowed breathing and pulse, and low blood pressure. They typically feel cold all the time because their internal body temperature is below normal.

Successful treatments for anorexia nervosa include an aggressive educational program to understand the causes and effects of anorexia nervosa, gaining weight to normal levels, nutritional balance, behavior change to prevent/eliminate relapse, and appropriate treatment for any associated psychological issues. The most important first step is to regain the weight needed for the other treatments to be most effective.

Bulimia Nervosa

Bulimia nervosa is different than anorexia nervosa. Anorexics fall below normal weight standards for their age and height. Bulimics fall within the normal weight standards. Bulimics feel that they have no control over the food that they eat. They have binge-eating sessions followed by purging, excessive exercise, use of laxatives or diuretics, and fasting to compensate for their binge-eating.

These cycles, binge-eating, and purging occur several times a week. They fear to gain weight, just like anorexics. They are ashamed and disgusted with their weight and overall appearance. Most bulimic behavior is done secretly.

Bulimics create some unique problems with their binge-purge cycles. They have chronically inflamed or sore throats, swollen glands in their necks below their jaws, worn tooth enamel, electrolyte imbalances, gastrointestinal problems, intestinal distress, kidney problems, and severe dehydration.

Many bulimics have substance abuse issues, depression, and anxiety. Treatment includes nutritional counseling, appropriate medical and psychological treatments for accompanying mental problems. The main treatment is focused to change eating attitudes.

Binge-eating Disorder

The binge-eating disorder should not be confused with bulimia nervosa. Binge-eating disorder is distinguished by repeated binge-eating episodes.

Like bulimia nervosa, the same loss of control of eating is prevalent. However, there is no purging, excessive exercise, or use of diuretics or laxatives. People with binge-eating disorders are typically overweight. They suffer remorse, humiliation, and distress about their eating habits. This usually leads to more binge-eating.

Like other eating disorders, binge-eating disorders can coexist with the typical psychological ailments, such as depression and anxiety. Various personality disorders are also manifested with binge-eating disorder.

Many are obese with cardiovascular disease and hypertension. The treatments of binge-eating disorder are like bulimia nervosa. It is critical that the underlying emotional issues are addressed early. In many cases, appetite suppressants are prescribed.

There are over a dozen prescription appetite suppressant drugs. As with all prescription drugs, side effects abound. Non-prescription appetite suppressants worthy of your consideration are apples, flaxseeds, caffeine, water, chicken or vegetable soups, oatmeal, salmon, nuts, and proteins.

Other Eating Disorders

Other eating disorders are compulsive overeating, purging disorder, rumination, diabulimia, pica, night eating syndrome, and Orthorexia Nervosa. Several of these other related eating disorders are related to brain chemistry abnormalities.


How do you know if you successfully recovered from an eating disorder? Barring any serious brain damage, anorexia and bulimia are successfully treated every day. The earlier treatment is started, the better the results.

It used to be thought that eating disorder treatment would last for the rest of your life; or, that you could never fully recover from the disease. That is not true for the majority. Most treatments last months, not years.

Full recovery can be observed with manifestations of physical hunger driving eating habits rather than emotional hunger. Weight is restored to normal levels along with nutritional and metabolic metrics. Decisions regarding food are made based on caloric and nutrient intake.

Purging and other related behaviors are eliminated. Skin, dental and hair health return to normal ranges. Disproportionate exercise is gone. A wider variety of food is chosen on a regular basis. Full recovery is also seen in the ability to recognize eating behaviors and having the ability to prevent relapse or to seek further treatment. Weight and body image obsession have vanished.

It is best to seek professional help rather than trying this or that to fix a problem that has many causes and solutions. You might luck out and fix it yourself, but it is unlikely.

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