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An eating disorder is a disturbance in eating behavior that endangers a person's physical and psychological health. Anorexia nervosa, bulimia nervosa and binge eating are chronic problems involving a preoccupation with food and eating. Approximately 0.9 percent of females and 0.3 of males in the United States develop anorexia nervosa during their lifetime, according to the National Institute of Mental Health. The lifetime risks for bulimia nervosa and binge eating are approximately 0.6 percent and 2.8 percent, respectively.
ANOREXIA NERVOSA
Anorexia nervosa is a self-starvation syndrome in which a person obsesses about thinness and severely restricts eating. People with anorexia have a distorted body image, believing they are "fat" despite being emaciated. Substantial loss of muscle mass occurs as the body breaks down muscle protein to provide the body's vital organs with needed calories. Extreme exercise, laxative abuse and diuretic abuse are common among people with anorexia. Despite their refusal to eat, people with anorexia are obsessed with food and often develop compulsive rituals involving eating. Anorexia typically begins in "tween" or teenage girls; an initial interest in weight reduction often develops into an obsession.
Several organ systems are affected by the malnutrition that occurs in people with anorexia. The severity of the abnormalities depends on the degree and duration of malnutrition. Females with anorexia usually fail to menstruate. If anorexia begins before puberty, sexual development is usually delayed. Other complications include constipation, cold intolerance, slow heart rate, low blood pressure, irregular heart beat, loss of brain mass, dry skin and hair loss. People with anorexia have an increased risk of premature death, usually due to heart failure.
BULIMIA NERVOSA
Bulimia nervosa is characterized by secretive, cyclic episodes of binge-eating large quantities of high-calorie foods followed by purging, which may include self-induced vomiting, diuretic abuse, laxative abuse and obsessive exercise. There may also be periods of severe food restriction. The frequency of binging and purging varies from a few times a week to several times daily. People with bulimia are usually of normal body weight or slightly overweight. As with anorexia, people with bulimia have a distorted body image. In contrast to people with anorexia, who turn away from food when facing problems, people with bulimia often look to food for comfort. Unlike people with anorexia, bulimics recognize that their behavior is abnormal.
The complications of bulimia arise from overeating, self-induced vomiting, and diuretic and laxative abuse. Common complications include loss of enamel from the teeth, frequent cavities, gum disease, abnormal sodium or potassium levels, abnormal bowel function, esophageal tears, acid reflux, dehydration and swollen salivary glands. Life-threatening heart rhythm abnormalities may develop.
BINGE EATING
Binge eating is similar to bulimia nervosa, except there is no purging. People with this disorder are, therefore, overweight or obese. They are obsessed with food and experience shame and guilt about their eating habits. Binge eating increases the risk of heart disease, diabetes, stroke and numerous other medical conditions.
TREATMENT
The treatment of eating disorders usually requires a team of experts, including nutritionists, psychotherapists and physicians. The goals of treatment are restoration of physical health and establishment of long-term, healthful eating patterns. Individual, group and family psychotherapy are typically included in eating disorder management. Antidepressants are often used in conjunction with psychotherapy. Residential treatment is useful for many people.
It is important to recognize and treat eating disorders as soon as possible. Unhealthy eating patterns become harder to break the longer a person takes part in them. If you or someone you know has an eating disorder, get help. These diseases can do a lot of damage to the body and mind if left untreated.
References
- National Institute of Mental Health: Eating Disorders Among Adults - Anorexia Nervosa
- National Institute of Mental Health: Eating Disorders Among Adults - Bulimia Nervosa
- National Institute of Mental Health: Eating Disorders Among Adults - Binge Eating Disorder
- National Institute of Mental Health: Eating Disorders
- National Alliance on Mental Illness: Anorexia Nervosa
- Essentials of Pathophysiology: Concepts of Altered Health States; Carol Mattson Porth, R.N., M.S.N., Ph.D., et al.
