America’s obsession with weight is creating a new array of eating disorders — and higher numbers of people diagnosed as well.

Eating disorders are a form of mental illness and cause one death every 60 minutes in the United States. More than 30 million Americans suffer from eating disorders — and the list of conditions has expanded now to include definitions that may surprise many people who consider their binge eating a “normal” activity.

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While the most immediately concerning eating disorder is anorexia, which is characterized by severely low weight, many average weight and obese people suffer from eating disorders, too.

“There is a significant relationship between eating disorders and obesity,” Julie Friedman, Ph.D., executive director of binge eating treatment and recovery for EatingRecoveryCenter.com, told LifeZette. “Thirty-three percent of people with bulimia nervosa and 87 percent of those with binge eating disorder are overweight or obese. So there seems to be a contribution of eating disordered behaviors to the pathophysiology of weight gain.”

Families that battle obesity, where the children or parents are obese, are at an increased risk for bulimia nervosa and binge eating disorder.

Families that battle obesity, where the children or parents are obese, are at an increased risk for bulimia nervosa and binge eating disorder (BED), noted Friedman.

“Weight control and weight concern become part of the family dialogue and dieting behaviors, which predispose one to an eating disorder, begin earlier and are modeled by parents,” she said.

Related: Healthy School Lunch Debate Is Now Causing Eating Disorders?

Cultural stereotypes in families and peer groups can also exacerbate weight concerns and dieting behaviors, both of which can contribute to eating disorder behavior, Friedman said.

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‘Compulsive Need to Eat’
Relatively newly defined, binge eating disorder is characterized by consuming large amounts of food frequently and feeling unable to stop. With BED, overeating is not followed by excessive exercise or purging, which is characteristic of bulimia nervosa.

Although most people overeat on occasion, and many regularly consume more calories than their body needs, BED is characterized by a compulsive need to eat.

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Night eating syndrome is another disorder common in a higher weight population, and particularly affects pre- and post-bariatric surgery patients.

When dieters display perfectionist tendencies, any diet can easily become an obsession, which is an eating disorder called orthorexia — where fixation over the “right” foods becomes extreme. Orthorexics may avoid social situations or groups where they feel control is not possible, which can lead to isolation and broken relationships.

Recognizing a Problem
Making more realistic goals centered on health is a good first step for anyone wanting a lower weight. But anyone exhibiting obsessiveness or compulsivity with food may need evaluation and treatment for eating disorders first.

Some of the psychological and behavioral signs of an eating disorder are:

  • sudden, dramatic weight loss or fluctuation
  • a constant feeling of being cold, even in warm weather
  • negative self-talk, especially about one’s body
  • changes in mood and desire to interact with others socially
  • compulsive or excessive exercising
  • fixating the conversation on food
  • avoiding certain once-enjoyed foods
  • unusual behaviors at meal times, either food rituals or avoiding meals
  • using restrooms right after meals, or showing signs of purging (swollen cheeks, marks/scars on knuckles)
  • hoarding food, or exhibiting signs of food hoarding

While dieting often leads to overemphasis on food and eating — which can morph into an eating disorder — Friedman said the root of it is being unhappy with one’s body.

“Body dissatisfaction leads to both obesity and eating disorder behaviors and some of our obesity interventions seem to promote this,” she said. “Depression, anxiety, and substance use are related to both obesity and eating disorders.”

Awareness is key and Friedman urges anyone with concerns about a family member or child possibly having an eating disorder to address it rather than wait.

Pat Barone, MCC, is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating, who helps clients heal food addictions.