Eating Disorders
WHAT IS AN EATING DISORDER?
Eating disorders are a group of serious and complicated illnesses that affect a small percentage of people, mostly adolescent and young adult women. These disorders present a severe threat to a person’s health and can result in dangerous physical problems and even death. The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.
-Anorexia nervosa
People who develop anorexia nervosa have an intense fear of gaining weight and being fat. They have a distorted view of their actual body weight, which is 85 percent or less of the normal weight for their age and height. They base their self-esteem on their own evaluation of their weight. They deny the reality of their physical condition and its physical effects, which includes at least three missed menstrual cycles.
There are two subcategories of anorexia nervosa: the restricting type and the binge eating/purging type. People with the restricting type control their weight by limiting the amount of food they eat and by increasing their activity, usually by exercising excessively and compulsively. People with the binge eating/purging type control their weight not only by limiting the amount of food they eat but by bingeing on occasion. Rather than exercising, they purge by making themselves vomit or by using diuretics, laxatives, or enemas. About a third of anorexics eventually develop bulimia nervosa.
-Bulimia nervosa
Most people who develop bulimia nervosa are adolescent and young adult women. Bulimics are overly concerned about their body shape and weight, basing their self-image on how they look. Unlike anorexics, bulimics may be of normal or above-average body weight. They are obsessed with food, engaging in episodes of bingeing during which they feel out of control. To avoid weight gain, bulimics of the purging type attempt to compensate for bingeing by making themselves vomit, by consuming laxatives or diuretics, or by giving themselves enemas. The nonpurging types compensate for their bingeing by fasting or exercising excessively. Unlike anorexics, most bulimics are aware that their behavior is neither normal nor healthy, often feeling depressed, ashamed, and isolated. They develop a complicated way of life to accommodate the bingeing-and-purging cycle.
-Binge eating disorder
Binge eating disorder, also known as compulsive overeating, is thought to be the most common type of eating disorder. It is similar to bulimia nervosa in that one eats large amounts of food in a short period of time, but unlike bulimia nervosa, there usually is no purging behavior. As a result, people with binge eating disorder usually experience rapid weight gain, weight fluctuations and obesity. They often become secretive with food, hoarding it and eating it alone. They generally feel ashamed of their eating behavior and may avoid social situations that are likely to involve eating. They may also develop depression and anxiety. Unlike the other eating disorders, binge eating disorder affects both adolescents and adults.
EATING DISORDERS: THE PHYSICAL EFFECTS
Eating disorders can cause the following physical effects:
- Acid reflux disorder
- Anemia
- Blood sugar changes (high or low)
- Blurred vision
- Brittle nails
- Calluses on fingers
- Death
- Dehydration
- Depression
- Diabetes
- Digestive problems (cramps, bloating, constipation, diarrhea)
- Dizziness
- Dry skin and hair
- Electrolyte imbalances
- Esophagus deterioration
- Extreme fatigue
- Fainting
- Gum disease
- Hair loss
- Headaches
- High blood pressure
- Hyperactivity
- Incontinence
- Insomnia
- Kidney infection and failure
- Lanugo (developing hair on face, back, and arms)
- Liver failure
- Low blood pressure
- Lowered body temperature
- Malnutrition
- Menstrual problems, pregnancy complications, and infertility
- Muscle atrophy
- Osteoporosis and Osteopenia
- Pancreatitis
- Peptic ulcers
- Seizures
- Stomach erosion, perforation, or rupture
- Swelling of the face, cheeks, legs, and feet
- TMJ syndrome
- Tooth enamel erosion
WHO IS AT RISK FOR DEVELOPING AN EATING DISORDER?
We live in a culture that values thinness and physical beauty rather than one’s inner qualities. Indeed, it is difficult to escape our society’s message that one’s values are based, in part, on the shape and beauty of one’s body. Young girls are most susceptible to this message, which is even more powerful when there is a lack of emotional support from family and friends. People who develop eating disorders tend to have the following characteristics:
- Low self-esteem
- Need for approval
- Need for control of their feelings and environment
- Perfectionism
- Feelings of not deserving pleasure and happiness
- Disappointment in oneself and feelings of being a failure
- Difficulty in controlling impulses
- Depression, anxiety, and loneliness
- Not being able to express feelings
- Disturbed body image—obsession with thinness and an extreme fear of gaining weight or of being fat
- Past experiences of being shamed for being overweight or too fat
- Family members who are or were obsessed with food and weight
- Parents with unrealistic expectations
- Transference of emotional problems to obsession with food and weight
- Past experiences of sexual or physical abuse
- Most people who develop anorexia nervosa and bulimia nervosa are adolescent and young adult women.
WHAT IS THE TREATMENT FOR EATING DISORDERS?
Eating disorders are extremely serious and dangerous and require treatment by a qualified licensed professional. It is important to obtain treatment as early as possible to maximize chances of a complete recovery. People who allow an eating disorder to progress beyond the early stages may become seriously ill and even die.
The best treatment for an eating disorder is a combination of methods tailored specifically for the individual patient. The course of treatment depends on the client’s situation and needs, as well as on the severity of the illness. The following treatment methods are the most effective:
- Medical treatment for physical symptoms. Patients who have complications caused by extreme weight loss or are suffering from the effects of bingeing and purging must seek the help of a qualified physician. Many patients need treatment at a hospital or center that specializes in treating people with eating disorders.
- Cognitive behavioral therapy. Patients learn techniques to change their behavior and also change their responses to stressful situations.
- Relationship counseling. The patient learns ways to relate to others in a healthier, more productive way.
- Self-help groups. Groups such as Overeaters Anonymous provide support for people with eating disorders.
- Medication. Many people with eating disorders also suffer from depression, anxiety disorders, and other psychiatric problems. These conditions must be treated in conjunction with the eating disorder. Medication for these disorders can be very effective.
- Education. It is critical for patients to learn the facts about eating disorders, as well as proper nutrition and skills for managing triggers.
WHERE CAN I GO FOR MORE INFORMATION?
Costin, Carolyn. The Eating Disorder Sourcebook: A Comprehensive Guide to the Causes, Treatments, and Prevention of Eating Disorders. New York: McGraw-Hill, 1999.
Natenshon, Abigail. When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers. New York: Jossey-Bass, 1999.
Siegel, Michelle, Brisman, Judith, and Weinshel, Margot. Surviving an Eating Disorder: Strategies for Family and Friends. New York: HarperCollins, 1997.