ANA HEALTHY NURSE, HEALTHY NATION BLOG - Nurses' Guide to Recognizing and Addressing Eating Disorders
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When most people think of eating disorders, conditions like anorexia nervosa or bulimia nervosa may come to mind. But two lesser known (and underdiscussed) conditions include binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID).
“Binge eating is very common, especially with the standard American diet,” says Tieshia DuRant, DNP, FNP-C (pictured at left), who treats many patients with eating disorders and completed a dissertation on the subject. “It’s not getting enough attention, and we as clinicians need to do a better job of understanding and addressing these kinds of eating disorders.”
What Is Binge Eating Disorder (BED)?
BED is when someone eats unusually large amounts of food in a short timeframe and feels like they can't control it, leading to discomfort and distress. It's different from occasional overeating, and it has a mental health component.
As the most common eating disorder in the United States, binge eating impacts people across different racial and ethnic backgrounds. The National Institutes of Health (NIH) says that about 1.25% of adult females and 0.42% of adult males grapple with this disorder, and it affects around 1.6% of teenagers aged 13 to 18. The NIH also reports that:
- The average age at which binge eating disorder begins is 25 years old
- Nearly two-thirds of people who fulfill the criteria for the disorder have binge eating episodes that last one year or more
The most common symptoms of BED include:
- Consuming large amounts of food rapidly
- Feeling a lack of control during eating episodes
- Eating even when not physically hungry
- Distress after overeating
This eating disorder is dangerous because it can contribute to many short-term and long-term health risks. In the short term, binge eating disorder can lead to discomfort, bloating, and emotional distress. Many people may experience guilt, shame, or anxiety immediately after a binge episode.
Over the long term, BED can contribute to health issues such as obesity, diabetes, heart disease, and high blood pressure. It may also lead to mental health concerns such as depression and anxiety. Social isolation and difficulties in personal relationships are also common.
“Binge eating is often linked to chronic stress, so people usually are self-aware that they have an issue with this,” says Tieshia. “They’re likely gaining weight, not managing their stress, and not sleeping well. When they’re not sleeping well, the hormone that produces carbohydrate cravings increases, which contributes to even more binge eating.”
Nurses are especially susceptible to BED. The demanding work environment, long hours, and exposure to emotionally challenging situations can contribute to chronic stress. Coping mechanisms like turning to food for comfort is a common response to stress for any person. When you add irregular schedules and limited break time to the mix, it’s easy for unhealthy eating habits to unfold.
What Is Avoidant/Restrictive Food Intake Disorder (ARFID)?
ARFID involves behavior that limits food choices, avoids certain textures or smells, and restricts eating patterns — all of which lead to insufficient nutrition. It can happen to anyone, including nurses, but it's more common in kids and teens.
Children with ARFID don't consume enough calories for proper growth and development. Later in life, during adulthood, their bodies don't get enough calories to sustain every day bodily functions.
People with ARFID might be picky eaters, avoid certain foods, and feel anxious about eating new things. Anyone who has been under extreme stress, has anxiety, or has sensory issues is more at risk for ARFID.
An Underlying Contributor to Eating Disorders: Mental Health
Eating disorders aren’t just physical — they’re intertwined with mental and emotional health. It’s clear to see the entanglement when we consider that binge eating disorder is often impacted by:
- An emotional coping mechanism: BED often serves as a coping mechanism for managing emotions like stress, anxiety, or sadness. Individuals may use food to comfort or numb themselves.
- Lack of control: The feeling of a lack of control during binge episodes can contribute to distress and guilt. Individuals may grapple with shame and negative emotions following episodes of overeating.
- Body image and self-esteem: BED is often associated with body image concerns and low self-esteem. Negative perceptions of one's body can contribute to a cycle of emotional distress and binge eating.
ARFID is also often impacted by mental and emotional components, such as:
- Anxiety and fear: ARFID is characterized by anxiety or fear associated with eating certain foods or textures. This anxiety can be rooted in sensory sensitivities, past negative experiences, or fear of adverse consequences.
- An emotional response to food: Individuals with ARFID may have rigid food preferences or aversions, often related to the sensory experience of eating. These preferences are driven by emotional responses to specific foods.
- Psychological impact: ARFID can lead to social isolation, which further impacts mental health. The avoidance of certain foods or eating in social settings can contribute to feelings of anxiety, embarrassment, or shame.
The Role of Compassion When Seeking Help for an Eating Disorder
Because there are many health impacts of eating disorders, it’s important to get help early to prevent lasting problems.
“It starts with us — we’re holding the standards for health, and we want to make sure we’re taking care of ourselves and each other,” says Tieshia. “Whether you think you might have an eating disorder, or you’re worried about a colleague or loved one, it’s important to lead with compassion.”
Take action with the following steps:
- Recognize the signs: Self-awareness is key. Take note of any changes in eating habits, extreme dieting, or emotional distress related to food.
- Consult a health care professional: Reach out to a health care provider or counselor who is experienced in treating eating disorders. They can provide guidance, treatment, and support tailored to your situation.
- Access resources: Lean on reputable resources like the National Eating Disorders Association (NEDA) or talk to a health care provider for more information.
- Talk to someone: Share your concerns with a trusted colleague, friend, or family member. There is no shame in expressing what you're going through.
- Consider support groups: Connect with others who share similar experiences. Support groups can provide understanding and encouragement.
- Involve a supervisor: If you're concerned about a colleague, approach a supervisor or HR department with empathy and express your concerns. This will help ensure they get the support they need.
“If you’re concerned about a colleague, first consider social determinants of health, like whether they have access to healthy, whole foods,” says Tieshia. “For example, if they don’t have regular access to food, and the one time they do, they binge, that’s a factor to consider. Remember to have compassion and understanding.”
Whether for yourself or a loved one, seeking help is a sign of strength. Recovery is possible with the right support network and treatment. During National Eating Disorder Awareness Week (Feb 26 – March 1) and beyond, prioritize your well-being and encourage colleagues to do the same.
Explore more information and resources on healthy eating and nutrition:
- One Bite At A Time: Better Nutrition For Nurses
- How Registered Dietitians And Nurses Are Collaborating To Fight Malnutrition
- Food & Nutrition Services And Nursing: Why Collaboration Is Key
- 5 Food Pairings To Give Your Meals A Nutrition Boost
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Blog Nutrition
02/05/2024 1:31pm CST
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when I started in nursing I would binge eat all the time, exp late evening when I would get off work after not eating most days
@Virda Swales, BSN what helped you stop?