Can Eating Disorders Evolve from One Type to Another? Jennifer Klesman

Eating disorders sometimes evolve from one type of disorder to another for a variety of reasons, and the process is multifaceted. It’s important to note that not everyone with an eating disorder will experience such a transition, and everyone’s experience is unique. However, some common reasons for the evolution of eating disorders include:

Common Features 

Many eating disorders share common features and therefore individuals may experience overlapping symptoms. For example, many eating disorders, regardless of diagnosis, can be driven by a desire to lose weight, societal pressures, or a desire to escape/numb.

Cyclical Nature of Eating Disorders 

For many individuals, eating disorders feel cyclical. Some eating disorders start with extreme restrictive eating behaviors (anorexia). Often, the extreme restriction leads to intense cravings and what feels like a loss of control around food (binge eating disorder). Some individuals who struggle with binge eating disorder may develop compensatory behaviors to manage the perceived impact of excessive caloric intake, which can look like laxative use, vomiting, or excessive exercise (bulimia nervosa). Please note: the above cyclical description is an overly simplistic overview of anorexia, binge eating disorder, and bulimia nervosa. 

Coping Mechanisms

Individuals with eating disorders often use their disordered eating behaviors to cope with underlying emotional or psychological distress. As these issues change or intensify, individuals may find that their initial coping mechanisms are no longer effective, leading them to adopt different disordered eating patterns in the process. 

Control and Perfectionism

Many eating disorders are associated with a desire for control and perfectionism. When individuals feel a loss of control in one aspect of their life, they may attempt to regain that control by targeting their eating behaviors. This can result in a shift from one type of eating disorder to another. 

Body Image Issues

    Shifts in body image can contribute to the evolution of eating disorders as the pressures to conform to certain societal standards shifts. Perceiving oneself as falling short in comparison to others may drive individuals to engage in behaviors that only exacerbate or influence disordered eating.

    Nature and Nurture 

    There is evidence suggesting a genetic predisposition to eating disorders exists as much as it is confirmed that environmental factors influence the evolution and intensity of eating disorders. Changes in an individual’s biology, including hormonal fluctuations, neurotransmitter imbalances, or other physiological factors are some nature factors. While life events, social influences, and cultural shifts are some nurture factors.

    Treatment/Recover Attempts

    Individuals undergoing treatment for an eating disorder may experience shifts in their symptoms as they progress through therapy. In some cases, this could involve transitioning from restrictive behaviors to binge eating or vice versa.

    Comorbidity

    Eating disorders often co-occur with other mental health conditions such as depression, anxiety, or substance abuse. Changes in the severity or manifestation of these comorbid conditions can influence the course of eating disorders.

    It is very important to emphasize that these explanations are generalizations, and each person’s experience with an eating disorder is unique. Professional help from therapists, dietitians, and physicians is crucial in understanding and addressing the underlying factors that contribute to the development and evolution of eating disorders. 

    Article by Bari Rothfeld, LCSW, CADC

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