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Eating disorders

Eating disorders are complex. From the outset it should be understood that they are real, treatable medical illnesses and potentially fatal. However, unlike many other illnesses the cause of an eating disorder is often a complicated mix of psychological, physiological and social factors. Eating disorders often appear in the early teens (for both girls and guys) and start out slow. The sufferer will often begin by eating smaller or larger amounts than normal which then spirals out of control. Disorders are usually divided into four categories: Anorexia Nervosa, Bulimia Nervosa, Binge Eating and eating disorders not otherwise specified (EDNOS).

+   Causes

There are a number of causes for eating disorders, and often it’s a combination of several different psychological, physical and social factors

  • Low self esteem, confidence and feelings of incompetence
  • Attempts to control food in order to cope with overwhelming feelings and emotions
    • Difficulty expressing emotions
  • Bullying, abuse (both physical or sexual) and teasing
  • Depression or anxiety
  • Racial or ethnic prejudice
  • Troubled relationships with family, partners or friends
  • Stress
  • Cultural norms
    • Narrow definitions of beauty
    • Focus on external appearance
    • Portrayal of beauty and worth in the media as being based on external attributes
  • Biological factors (unclear evidence)
    • Possible genetic links to eating disorders
    • Imbalance in digestion and appetite hormones

+   Anorexia Nervosa

This is probably the most well known of the disorders. It is typified by self-starvation and excessive weight loss. If left untreated Anorexia Nervosa can be life threatening.  Sufferers are 18 times more likely to die early compared with people of similar age in the general population.

Symptoms

Can be split into both the physical and psychological

    Physical Symptoms

  • Extremely low body weight
  • Loss of periods in women
  • Slow heart rate
  • Low blood pressure
  • Muscle loss
  • Fainting
  • Tiredness and weakness
  • Dry hair and skin
  • Excessive exercise regime despite
    • Weather
    • Injury
    • Illness

    Psychological Symptoms

  • Intense fear of weight gain (even if underweight)
  • Undue influence of weight or shape on self-evaluation and feelings of self-worth
  • Preoccupation with weight, food, calories and dieting
    • Frequent comments
    • Anxiety
  • Development of food rituals
  • Excuses to avoid mealtimes

Health Consequences

There are serious consequences related with dramatic weight loss. Your body relies on nutrition from food to keep it healthy, maintain muscle and provide energy for daily living. Denying your body food can lead to:

  • Severe dehydration and eventually kidney failure
  • Fainting, tiredness and weakness
  • Muscle loss
    • Including heart muscle loss
  • Your heart rate can become abnormally slow and your blood pressure may drop. This increases your risk of heart failure
  • Osteoporosis – leading to dry and brittle bones and increasing your chance of bone fracture
  • Dry hair and skin
  • Lanugo - If your body fat drops too low you may grow a thin layer of downy hair. This is your body’s attempt to try and keep warm.  A role that fat usually plays
  • Loss of periods in girls
    • Risk of long term infertility
  • Extreme weight loss can even cause
    • multi-organ failure
    • brain damage

+   Bulimia Nervosa

Bulimia is recognised as a frequent intake of large amounts of food alongside a sense of loss of control of eating behaviour. This loss of control leads to inappropriate compensatory behaviours for the large food intake such as self-induced vomiting or use of laxatives. As with other eating disorders it has some potentially life threatening consequences

Symptoms

    Physical Behaviours and Symptoms

  • Compensation behaviours
    • Self induced vomiting
    • Laxative and diuretic abuse
    • Fasting
    • Obsessive or compulsive exercise regime (Often regardless of injuries, weather or illness)
  • Disappearance of large amounts of food
  • Evidence of ‘purging’ or compensatory behaviours
    • Frequent bathroom trips
    • Smell or signs of vomiting (damage caused by stomach acid)
      • Calluses on the knuckles and back of hands
      • Staining and discolouration of the teeth
      • Burnt, chapped lips
  • Unusual swelling in the jaw and cheek areas

    Psychological Symptoms

  • Intense fear of weight gain (even if underweight)
  • Undue influence of weight or shape on self-evaluation and feelings of self-worth
  • Preoccupation with weight, food, calories and dieting
    • Frequent comments
    • Anxiety

Health Consequences

  • If bulimic behaviour leads to extreme weight loss it can cause many of the same consequences as seen in Anorexia
  • Imbalance of electrolytes due to dehydration and laxative abuse can cause an irregular heart beat and possibly heart failure
  • Inflammation and possible rupture of the oesophagus (due to damage from stomach acid)
  • Tooth decay and staining (due to stomach acid damage)
  • Chronic irregular bowel movement or constipation as a result of laxative abuse
  • Gastric rupture (rupture of part of your stomach) although this is uncommon.

+   Binge Eating

Binge eating is typified by eating large amounts of food even when not hungry or already full and often in very short periods of time

Symptoms

    Physical Behaviours and Symptoms

  • Episodes of eating large amounts of food in a short period of time
  • Eating when not hungry
  • High blood pressure
  • Heart disease
  • High cholesterol
  • Diabetes
  • Gallbladder disease
  • Musculoskeletal problems

    Psychological Symptoms

  • Feeling out of control of eating behaviour while binging
  • Eating alone due to embarrassment
  • Feeling depressed and guilty about behaviour

Health Consequences

  • High blood pressure
  • Heart disease
  • High cholesterol
  • Diabetes
  • Gallbladder disease
  • Obesity and it side effects
  • Musculoskeletal problems

+   Eating Disorder Not Otherwise Specified (EDNOS)

When you have only some of the symptoms of an eating disorder, or your symptoms don’t fall under one particular category of eating disorder, you are often said to have ENDOS. People with ENDOS still have an illness that needs to be treated, it just doesn’t have defined list of symptoms. The treatment for ENDOS cases is often similar to those for other eating disorders but as with all eating disorders treatment should be tailored to individuals and their needs.

+   Treatment

Once you recognize that you or someone you know needs help, you can start taking steps to recovery. Treatment of an eating disorder is a little different to that of other medical illnesses. Treatments for eating disorders are not uniform and they are usually tailored for individual psychological, physical and social needs. In general however, they may include any of the below techniques:

  • Adequate nutrition
    • In some cases this requires hospitalisation
  • Medication
    • Anti-depressants
    • Mood stabilizers
  • Reduction in exercise
  • Ending purging and other physical behaviours
  • Counseling – to treat underlying psychological issues
    • Nutritional counseling
    • Individual counseling
    • Group counseling
    • Family counseling

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