An eating disorder is a mental disorder defined by an abnormal eating behaviors that negatively affect a person’s physical or mental health. Eating disorders can occur in people of any age, sex, race and of all body weights, shapes and sizes. The physical, mental and emotional symptoms vary from person to person and by type of eating disorders. Treatment may combine cognitive therapy, medication and other therapies. An eating disorder is a serious, complex, mental health issue that one’s affects emotional and physical health. Eating disorders are treatable. People with untreated eating disorders may develop life-threatening problems in person.
Types of Eating Disorders
- Anorexia Nervosa
- Bulimia Nervosa
- Pica
Anorexia Nervosa
Anorexia Nervosa is an eating disorder which is characterized by voluntary refusal to eat, significant wight loss, an intense fear of becoming over weight and disturbed body image. Dietary restrictions can lead to nutritional deficiencies, which can severely affect overall health and result in potentially life threatening complications.
Incidence
Anorexia nervosa is seen about 5% of adolescent females and 5-10% of all males. The disorder starts by the age of 10-19 years.
Clinical Features
Clinical Manifestations of anorexia nervosa include-
- extreme weight loss
- Intense or irrational fear of weight gain
- listlessness, fatique, or exhaustion
- Low blood pressure
- lightheadedness or dizziness
- low body temperature with cold hands and feet or, possibly, hypothermia
- bloated or upset stomach
- swollen hands and feet
- hair loss
- loss of menstruation or less frequent periods
- infertility
- insomnia
- loss of bone density, increasing the risk of fractures
- britten nails
- constipation
- irregular or abnormal heart rhythms
- Lanugo, which is fine downy hair on the body
Risk Factors
Anorexia is more common in girls and women as compared to boys and men. However, boys and men have increasingly developed eating disorders, possibly related to growing social pressures.
Anorexia is also more common among teenagers. Still, people of any age can develop this eating disorder, though it’s rare in those over 40. Teenagers may be more at risk because of all the changes their bodies go through during puberty.
Certain factors increase the risk of anorexia, including:
Genetics- Changes in specific genes may put certain people at higher risk of anorexia. Those with a first-degree relative — a parent, sibling or child — who had the disorder have a much higher risk of anorexia.
Psychological health- If you have an eating disorder, an underlying psychological or mental health problem may be contributing to it. These problems can include:
- low self esteem
- anxiety
- depression
- obsessive compulsive disorder (OCD)
- impulsive behavior
Transitions– Change can bring emotional stress and increase the risk of anorexia nervosa. Whether it’s a new school, home or job, a relationship breakup, illness or death of a loved one.
Management
The initial goal of management is overall improvement in body weight, normalization of eating patterns and restoration of physical health by weight gain. So, the patient requires following interventions:
- Nutritional counselling by a dietician regarding healthy eating habits and balanced diet.
- Individual therapy to correct psychological thinking.
- Family therapy to correct disturbed patterns of interaction in family.
- Enhance self-esteem and self-worth of the individual.
- In certain cases, antidepressants and selective serotonin reuptake inhibitors (SSRI) prove to be effective.
Bulimia Nervosa
Bulimia disorder is a disorder of binge eating, where the person consumes large amount of food with lack of control followed by various compensatory behaviors (like self-induced vomiting) to control weight.
Incidence
Incidence of bulimia nervosa is higher than anorexia nervosa. Bulimia occurs in about 1-1.5% females with lower rates in males. The disorder is seen in age group of 15-30 years, with peak incidence at about 18-19 years of age.
Clinical Features
Clinical features of bulimia nervosa include:
- Constantly worrying or complaining about being fat
- Strict dieting or fasting after binge eating
- After binge eating the adolescents feel out of control, depressed, guilt and anxious.
- Self-induced vomiting and misuse of laxatives and diuretics also seen due to which the person looses the ability experience hunger.
- Fasting or excessive exercise as compensatory behaviors to prevent weight gain.
Risk Factors
Factors that increase your risk of bulimia may include:
- Biology. People with first-degree relatives (siblings, parents or children) with an eating disorder may be more likely to develop an eating disorder, suggesting a possible genetic link. Being overweight as a child or teen may increase the risk.
- Psychological and emotional issues. Psychological and emotional problems, such as depression, anxiety disorders or substance use disorders are closely linked with eating disorders. People with bulimia may feel negatively about themselves. In some cases, traumatic events and environmental stress may be contributing factors.
- Dieting. People who diet are at higher risk of developing eating disorders. Many people with bulimia severely restrict calories between binge episodes, which may trigger an urge to again binge eat and then purge. Other triggers for bingeing can include stress, poor body self-image, food and boredom.
Management
Management techniques are as follows:
- Behavioral modification is used to control binge eating and then induced vomiting.
- Dietary counselling may be helpful.
- Have regular, enjoyable family meals.
- Foster and reinforce a healthy body image in your children, no matter what their size or shape. Help them build confidence in ways other than their appearance.
- Cognitive therapy may be required, as bulimic individuals have distorted thoughts and beliefs related to food, weight, body image and self concept. Cognitive therapy helps in developing a sense of self, understanding of conflicts, developing realistic perception of one’s body and enhancing self-esteem and self-concept.
- Discourage dieting, especially when it involves unhealthy weight-control behaviors, such as fasting, using weight-loss supplements or laxatives, or self-induced vomiting.
- Talk with your primary care provider. He or she may be in a good position to identify early indicators of an eating disorder and help prevent its development.
- If you notice a relative or friend who seems to have food issues that could lead to or indicate an eating disorder, consider supportively talking to the person about these issues and ask how you can help.
- Selective serotonin reuptake inhibitors (SSRIs) drugs have been effective in reducing the urge to binge and in treating depression.