An eating disorder is a condition that affects one’s eating habits. These disorders can lead one to eat too much or too little. Though eating disorders usually occur in children and young adults, they have also been seen to affect adults later in life, with females being more affected than males. While an eating disorder is a treatable illness, it is usually accompanied by psychiatric disorders like depression or anxiety. Many who suffer an eating disorder may also experience health problems such as kidney or heart failure. Unfortunately, if not treated, this condition can lead to death.
Eating disorders have many alternative names, as there are many different types of this illness. Some common disorders include anorexia nervosa, bulimia nervosa, and binge eating or compulsive overeating.
The main symptoms include eating too much or too little, usually at extreme amounts.
Anorexia and Bulimia
Anorexia and bulimia both show the same symptoms. While a main sign of an eating disorder is rapid weight loss, it is important to note that a person suffering from this disorder may not appear to be underweight at all. These symptoms can be medical, psychological, and can be seen in one’s day to day living.
Obsession about food is one sign of an eating disorder. This is a situation where the patient goes to extremes worrying about calories and fat intake, weight problems, and has the need to continuously exercise. This may all be kept track of in a food diary. Obsessively reading books and visiting website about losing weight are also common.
Patients usually look for ways to get rid of the food they have eaten or they avoid eating at all. Activities such as running to the bathroom to vomit immediately after meals, binging or purging, and the use of laxatives or diet pills are all signs to be aware of. Some patients restrict the amount of food they eat or avoid eating altogether.
Finding ways to dispose of uneaten food is another alternative to not eating. Moving food around on a plate to make it look as though it is eaten, chewing it then spitting it out into a napkin to throw away or flushed down the toilet, or cutting food into small pieces are all examples. Some patients have secret eating patterns and tend to hide food in places like closets and under the bed in order to eat at a more preferred time.
Medically, the symptoms can be more of a serious threat. Patients tend to experience hair loss and a pale coloring of the skin. They may experience headaches, dizziness, sore throats and swollen glands. Other medical symptoms include low blood pressure, constipation, incontinence, loss of menstrual cycle, bruised knuckles, bloodshot eyes, or bruising under the eyes and on cheeks.
Personally, these patients may have low self-esteem and put themselves down. They may feel the constant need for acceptance from other people, thereby, feeling the need to be a perfectionist. They may also lose sexual desire, suffer mood swings, depression, and fatigue due to insomnia.
Patients who suffer binge eating often have associated psychological problems with the illness. The sense of fear is one symptom they have to struggle with. They fear not being able to control their eating habits or not being able to stop eating once they get started. They fear eating around others, which in turn, causes them to put themselves in isolation.
These patients feel a need for constant dieting and need to keep up on the most popular diet plans. They assume life will be perfect if they can lose weight because they feel that their failure in society is due to their weight. On the other hand, they may show secretive eating habits and store food in strange places such as in cabinets or in suitcases to eat at a more convenient time.
Medically, patients who overeat are often short of breath after light activity. They experience excessive sweating, high blood pressure, high cholesterol, leg or joint pain, and decreased mobility because of increased weight gain. Because of insomnia, patients usually feel tires, depressed, and experience mood swings and loss of sexual desire.
Causes of Eating Disorders
There is no one cause for someone having an eating disorder. Aside from being a weight problem, it can be associated with family pressures, genetics, cultural pressures, emotional and psychological factors, and personality disorders.
Negative family influences may be a problem with one acquiring an eating disorder. This can result from a mother having a previous eating disorder, a father criticizing a child’s weight, obesity being present in the family, abuse, families with addictions, and those with emotional disorders.
Genetics can play a great role in eating disorders. It is common to learn that many patients have family members suffering from the same problem. There have been specific chromosomes associated with anorexia and bulimia.
Hormonal abnormalities may be partly responsible for one’s susceptibility to the eating disorders. These chemical abnormalities can be found in the thyroid, reproductive areas, and regions of stress and appetite.
Major life changes can cause one to experience an eating disorder. This may result from the feeling of losing control one may feel over the death of a loved one, major illness of someone close to them, or from having to change schools.
There are many other factors that may cause one to become a victim of an eating disorder. Social problems, a traumatic event, psychiatric illnesses such as depression or anxiety, failure at school, work, or athletics can also contribute.
There are many risk factors\ which can lead one to become susceptible to an eating disorder. The age of the patient is mainly adolescent and young adult, with females being more predominant. It is present in all races and at all socioeconomic levels.
Certain personality disorders can put people at risk for the disorder. Those with Avoidant Personalities tend to be associated with anorexia nervosa. People with avoidant personalities tend to be perfectionists, being perceived as being ‘good’, and being afraid of criticism or humiliation. Other personality disorders that can lead to an eating disorder include Obsessive-Compulsive Personality, Borderline Personalities, and Narcissistic Personalities.
There are emotional disorders that can be the cause of the eating disorder or actually be the result of the disorder. These mainly involve issues with depression and anxiety. Examples include Obsessive-Compulsive Disorder, phobias, panic disorder, and post-traumatic stress disorder.
Serious health problems or death can result from having an eating disorder which has gotten out of control. Patients with bulimia have a better recovery outlook than those with anorexia. While treatment is possible, patients do relapse.
Bulimia Medical Problems
Medical problems associated with bulimia include tooth erosion, cavities, and gum problems. Patients usually experience water retention, swelling, and abdominal bloating, along with acute stomach distress. Females can experience irregular periods. With excessive vomiting or laxative use, there can be fluid loss and low potassium levels. This can lead to weakness, near paralysis, and lethal heart rhythms. Forced vomiting can cause esophagus damage such as rupture and weakened rectal walls.
Self-destructive behavior is also seen in patients with bulimia. This includes smoking, impulsive behaviors, and alcohol and substance abuse.
Anorexia Medical Problems
Anorexia nervosa is an extremely serious disorder which affects the body in many ways. There is no treatment that is 100% effective. Recovery can take years and some patients never recover. Many patients relapse because they retain their desire for perfection and weight loss. It has been researched that anorexia nervosa has the highest death rate of any psychiatric disorder.
A serious effect of anorexia is the hormonal changes. Many hormones are lowered such as the reproductive hormones, thyroid hormones, and growth hormones. Stress hormones tend to rise. For females, this causes changes to the menstrual cycle, infertility, and bone loss.
Suicide is a big concern for patients with anorexia. They tend to be at high risk for anxiety and depression, leading to alcohol and drug abuse.
Heart disease is a common cause of death in patients with anorexia. The disorder can cause dangerous heart rhythms, including brachycardia, which is the slowing of the heartbeat. It can also cause blood flow to be reduced, blood pressure to drop, and the heart muscles to lose size. An electrolyte imbalance can occur due to the reduction of fluids and mineral levels. These minerals, such as potassium and calcium, are essential for the electric currents which keep a normal heartbeat. An electrolyte imbalance can be life-threatening.
Severe anorexia can cause nerve damage to the brain and other parts of the body. Seizures, disordered thinking, and numbness in the hands or feet have been reported. Certain parts of the brain undergo structural changes during anorexia and while most of these changes return to normal after weight gain, some damage is permanent.
Other medical problems which can occur include anemia, gastrointestinal problems, organ failure, and complications for adolescents with diabetes type 1.
Test and Diagnosis Considerations
Admitting that one has an eating disorder is the first step toward a diagnosis. An Eating Disorder Examination (EDE) is a medical interview that may be conducted by the doctor to determine a patient’s eating habits. This may be accompanied with a self-supported Eating Disorders Examination-Questionnaire. The SCOFF questionnaire is another means to help identify young and old patients for anorexia nervosa or bulimia.
Bulimia nervosa can be diagnosed if the patient has two bulimic episodes per week for 3 months. Since bulimia can cause complications with teeth and gums, dentists can also aid in identifying the disorder.
Anorexia nervosa can be diagnosed if the patient refuses to maintain a normal body weight, fears becoming fat while underweight, low self-image, and loss of menstrual function for 3 months.
Once an eating disorder diagnosis has been made, doctors then test for any serious complications that may have resulted. These tests include a complete blood count, testing for electrolyte imbalances, test for protein levels, an EKG and chest x-ray, testing for liver, kidney, and thyroid problems, and a bone density test.
Medical treatments are available for eating disorders and some patients may need psychological treatment. It is important that each individual patient find a treatment plan that is right for him. Some patients may need constant monitoring and medications, counseling for nutrition, as well as therapy.
Therapy can be made available in an individual, group or family setting. While a professional therapist usually runs the group session, they can also be run by a recovered patient, a loved one of a person with an eating disorder, or a volunteer. While these sessions can take place in an inpatient or outpatient program, a therapist’s office, or with an independent support group, they can also take place in a university, high school, or a private home.
Psychiatrists, psychologist, social workers, and counselors can provide therapy for eating disorders. Most of these professionals have obtained degrees which fall within the fields of psychology, psychotherapy, social work, and counseling. While a therapist may not be a licensed individual, they can still provide support. The only disadvantage is that without a license, they are not permitted to prescribe medications.
Group & Individual Therapy
Group therapy is beneficial because it lets the patients know that they alone do not suffer this disorder. When attending a group therapy session, it is important to know what the goal and objectives are of the group because there are many different methods of treatment when it comes to group therapy. Support groups tend to cover topics such as strategies for coping, family issues, spirituality, and nutrition. Each individual patient needs to know what type of therapy he needs in order to make a good recovery.
Individual therapy is important for a patient in order to learn to be more confident and to learn how to cope with any anger, stress, or depression. There are many different methods to this type of therapy and it is important to know which one is right for the patient. The different types of individual therapy include the Psychoanalytic Therapy, the Nonpsychoanalytic Therapy, Cognitive-Behavior Therapy, and the Eclectic Approach-Combining All Theories. The Eclectic Approach-Combining All Theories is the most commonly used form of therapy because it combines a lot of aspects from the other theories.
Nutritional therapy can be offered from a nutritionist or dietician. The goal of this type of therapy is to help one improve their eating habits and to teach how to incorporate a healthy amount of exercise into the daily routine. The best type of nutritional therapy should be under the supervision of a doctor or therapist.