Ms. Emily Barbara Kalb, MSW

Anorexia nervosa, frequently referred to as anorexia, is a disorder where people severely restrict the types and quantity of food they eat. Those with anorexia have an extreme fear of eating and gaining weight and may repeatedly weigh themselves or engage in harmful behaviors such as excessive exercise or starvation. Those with anorexia often find themselves preoccupied with food, but unable to consume a healthy amount of it. This results in symptoms such as abnormally low BMI, vitamin deficiency, fatigue, fainting, and amenorrhea (lack of menstruation in women). Anorexia may cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). Left untreated, anorexia can lead to organ failure, brain damage, and even death.

Bulimia nervosa, typically called bulimia, is a disorder where people binge (eat large quantities of food) and purge the food that they just consumed by vomiting, laxative abuse, fasting, or excessive exercise. This behavior is usually motivated by a feeling of powerlessness over eating and a fear of weight gain or desire for weight loss. Bulimia can occur in underweight, normal weight, and overweight people. Symptoms of bulimia include acid reflux, intestinal distress, dehydration from purging, amenorrhea, and dental erosion from vomiting. Some people with bulimia have swollen parotid glands (salivary glands near the cheeks) and red scars and marks on the backs of their knuckles. Electrolyte imbalance from bulimia can be particularly severe and may lead to heart attack or stroke.

Binge eating disorder (BED) is the most common eating disorder. People with BED feel that they are unable to control the amount of food they eat and may continue to binge after reaching a point of fullness. BED binges (consuming large amounts of food) are often accompanied by feelings of sadness, guilt, and shame. Symptoms of BED include obesity, acid reflux, weight gain, and dissatisfaction with one's body. People with BED tend to experience cycles of negative emotions and binges. Binges or BED episodes can be provoked by stress, boredom, restrictive dieting, depression, and other triggers.

Other common eating disorders include:

• Pica, eating things that are not food, such as paper, ice, or soil
• Avoidant/Restrictive Food Intake Disorder (ARFID), disinterest in eating and avoidance of food
• Other Specified Feeding or Eating Disorder (OSFED), abnormal eating that does not fall under any disorder

Many people with eating disorders do not consciously develop them, and have difficulty seeking treatment. For this reason, it's important to detect and treat eating disorders as early as possible. Treatment for eating disorders can vary from therapy visits to inpatient treatment, depending on the disorder and its severity. Treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.

Humans begin to gain self-esteem in childhood from being cared for by adults and reaching natural milestones such as learning how to tie one's shoes. Self-esteem evolves through adolescence and adulthood, and can change drastically based on one's positive and negative experiences. It's important to develop healthy self-esteem to navigate through challenges, make decisions, and gain motivation to pursue interests.

Self-esteem issues can influence one's emotions, behavior, relationships, and world view. Self-esteem issues frequently arise from low self-esteem. Low self-esteem can be caused by factors such as trauma, caregiver neglect, abuse, bullying, and academic, social, or professional difficulties. Stressful life events such as parental divorce, caregiver conflict, and financial problems may also contribute to low self-esteem. In recent years, researchers have highlighted the influence of social media in negatively impacting adolescents' mental health. Common signs of low self-esteem include:

• Focusing on failures instead of accomplishments
• Feeling triggered when making mistakes
• Constantly comparing oneself to others in a negative way
• Lacking confidence

Excessive self-esteem can also be problematic in that it can hinder one's ability to form relationships with others. People with extremely high self-esteem may appear to be conceited or entitled. Some researchers suggest very high self-esteem can lead people to engage in more risk-taking behaviors. Causes of excessive self-esteem are less well-known, but may include upbringing, personality, and cognitive biases.

Fortunately, self-esteem issues can be readily addressed at any time. Positive self-affirmations recognizing one's own accomplishments can raise low self-esteem. Accepting one's own weaknesses and imperfections can benefit those with both low and high self-esteem. People with self-esteem issues often find therapy is an effective means to improve their self-esteem and mental health. Cognitive behavioral therapy (CBT) can help people with self-esteem issues identify and change destructive patterns of thought. Support groups, family counseling, and antidepressant medication may also help with self-esteem issues.

Maintaining a positive outlook and belief in oneself can go a long way towards forming healthy self-esteem. Developing a strong sense of self can be important for well-being and contributes to overall happiness and success in life.