Eating disorders are becoming an increasing problem in the developed world. The critical issue in treating eating disorders is to recognize and address the problem as soon as it is discovered. Unhealthy eating patterns become harder to break the longer they persist.
ANOREXIA NERVOSA
What is it?
Anorexia nervosa is a health problem that results in self-starvation. Anorexia is not a new syndrome and has existed since medieval times. Essentially, an individual deliberately loses an excessive amount of weight (20% or more of their original body weight), and exhibits muscle wasting. Anorexia is caused by a distorted perception of self image, an intense fear of becoming fat even when excessively thin. Although the desire to eat food can be intense, the hunger pangs are ignored. Despite their refusal to eat, people with anorexia become obsessed with food, often fantasizing about it.
Anorexia is more prevalent in the young, especially in females. The disorder typically begins in adolescence, in individuals who are either overweight or perceive themselves to be fat. An interest in weight loss quickly becomes an obsession, with skipped meals and often excessive exercise. Teasing by peers or family members can also play a part. Low self-esteem, feelings of guilt, and problems with drug and or alcohol abuse may also contribute to this disorder.
Complications
Many organs in the body can be affected by the malnutrition that results from anorexia. The severity of the abnormalities tends to be related to the degree of malnutrition and can be reversed with a progressive return to a normal eating pattern. In woman, the initial manifestations of anorexia are “amenorrhoea” (cessation of menstruation), and the loss of secondary sexual characteristics due to decreased levels of estrogen. Other health complications include; decreased heart size, irregular heart beat, slow heart rate, low blood pressure, hair loss, dry skin, constipation and cold intolerance. The risk of death increases as weight decreases to less than 35% of ideal weight, often due to heart failure. Some unfortunate victims literally starve themselves to death.
Treatment
A major issue it treating anorexia is the refusal of the patient to recognize that they have an illness. There is no preferred single form of treatment. Psychological interventions are often helpful in leading the patient to discover that they are genuinely ill. In more recent times medical researchers have discovered that people with eating disorders frequently have a chemical imbalance in the brain similar to that found in people with depression.
BULIMIA
What is it?
Bulimia literally means “ox hunger”. It is characterized by secretive eating “binges”. These frequently consist of consumption of large quantities of high carbohydrate, easy-to-eat foods, such as ice cream, cakes and biscuits. In a single binge, foods supplying 10,000 to 15,000 calories or more can be consumed. The binge usually occurs in several stages: anticipation and planning, anxiety, impatience to begin eating, rapid and uncontrollable consumption, relief and relaxation, disappointment and finally shame. This is followed by self-induced vomiting; and/or a period of dieting to prevent weight gain, use of laxatives to induce diarrhea and obsessive exercise. People who experience the binge-purge syndrome are usually women in their late teens through to the mid-thirties. Although their weights may fluctuate, they do not drop to the dangerously low levels seen in people with anorexia nervosa.
Emotions that drive people to bulimia range from fear of not being able to stop eating to worries about gaining too much weight. Suffers also experience feelings of anger, guilt, sadness, shame and low self esteem. In contrast to people with anorexia, people with bulimia turn to food as a way of dealing with difficult issues or problems. But unlike anorexia, they do recognize that their eating behavior is abnormal.
Complications
Complications associated with bulimia include those resulting from overeating, self-induced vomiting, and diuretic and laxative abuse. Among the complications associated with the binge-purge syndrome are dental, body fluid, and salivary gland disorders. Dental abnormalities, such as sensitive teeth, dental decay and gum disease result from frequent vomiting. This is due to the high acid content of vomit, which degrades tooth enamel and damages gum tissue. Excessive use of laxatives can disrupt normal bowel patterns and can lead to gastrointestinal problems. Abuse of diuretic drugs can alter the body’s acid-base balance and result in electrolyte and mineral disturbances. Complications such as tearing of the esophagus, rupturing of the stomach, and the development life-threatening irregularities of the heart rhythm may also occur.
Treatment
Therapy involves reducing the number of binge-purge episodes by improving self-esteem, allaying concerns about weight change and dealing with underlying psychological issues. The primary goal of therapy is to establish a regular healthy eating pattern. Patients who have been successfully treated for bulimia have benefited from careful planning of meals, avoidance of high sugar foods, regular exercise, and from psychotherapy.
Related Pages
Eating disorders at BBC
