Eating disorders
Definition:
Eating disorders are a group of serious conditions in which you're so preoccupied with food and weight that you can often focus on little else. The main types of eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.
Eating disorders can cause serious physical problems and, at their most severe, can even be life-threatening. Most people with eating disorders are females, but males can also have eating disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females.
Treatments for eating disorders usually involve psychotherapy, nutrition education, family counseling, medications and hospitalization.
Symptoms:
Eating disorders symptoms vary with the particular type of eating disorder.
Anorexia nervosa
When you have anorexia nervosa (an-o-REK-see-uh nur-VOH-suh), you're obsessed with food and being thin, sometimes to the point of deadly self-starvation.
Anorexia signs and symptoms may include:
When you have bulimia, you have episodes of bingeing and purging. During these episodes, you typically eat a large amount of food in a short duration and then try to rid yourself of the extra calories through vomiting or excessive exercise. You may be at a normal weight or even a bit overweight.
Bulimia signs and symptoms may include:
When you have binge-eating disorder, you regularly eat excessive amounts of food (binge), but don't try to compensate for this behavior with exercise or purging as someone with bulimia or anorexia might. You may eat when you're not hungry and continue eating even long after you're uncomfortably full. After a binge, you may feel guilty or ashamed, which can trigger a new round of bingeing. You may be a normal weight, overweight or obese.
Symptoms of binge-eating disorder may include:
Because of its powerful pull, an eating disorder can be difficult to manage or overcome by yourself. Eating disorders can virtually take over your life. You may think about food all the time, spend hours agonizing over what to eat and exercise to exhaustion. You may feel ashamed, sad, hopeless, drained, irritable and anxious. You may also have a host of physical problems because of your eating disorder, such as irregular heartbeats, fatigue, and bowel or menstrual troubles. If you're experiencing any of these problems, or if you think you may have an eating disorder, seek medical help.
Urging a loved one to seek treatment
Unfortunately, many people with eating disorders resist treatment. If you have a loved one you're worried about, urge him or her to talk to a doctor. Even if your loved one isn't ready to acknowledge having an issue with food, you may be able to open the door by expressing concern and a desire to listen. If you're concerned your child may have an eating disorder, contact his or her doctor about your concerns. You can get a referral to qualified mental health providers for treatment.
Keep in mind, however, that in children it's sometimes hard to tell what's an eating disorder and what's simply a whim, a new fad, or experimentation with a vegetarian diet or other eating styles. In addition, many girls and sometimes boys go on diets to lose weight, but stop dieting after a short time. If you're a parent or guardian, be careful not to mistake occasional dieting with an eating disorder. On the other hand, be alert for eating patterns and beliefs that may signal unhealthy behavior, as well as peer pressure that may trigger eating disorders.
Red flags that may indicate an eating disorder include:
Causes:
The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes. Possible causes of eating disorders include:
Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications. Complications may include:
Treatments and drugs:
Eating disorder treatment depends on your specific type of eating disorder. But in general, it typically includes psychotherapy, nutrition education and medication. If your life is at risk, you may need immediate hospitalization.
Psychotherapy
Individual psychotherapy can help you learn how to exchange unhealthy habits for healthy ones. You learn how to monitor your eating and your moods, develop problem-solving skills, and explore healthy ways to cope with stressful situations. Psychotherapy can also help improve your relationships and your mood. A type of psychotherapy called cognitive behavioral therapy is commonly used in eating disorder treatment, especially for bulimia nervosa and binge-eating disorder. Group therapy also may be helpful for some people.
Family-based therapy is the only effective treatment for children and adolescents with eating disorders. This type of therapy begins with the assumption that the person with the eating disorder is no longer capable of making sound decisions regarding his or her health and needs help from the family. An important part of family-based therapy is that your family is involved in making sure that your child or other family member is following healthy-eating patterns and is restoring weight. This type of therapy can help encourage support from concerned family members.
Weight restoration and nutrition education
If you're underweight due to an eating disorder, the first goal of treatment will be to start getting you back to a healthy weight. No matter what your weight, dietitians and other health care providers can give you information about a healthy diet and help design an eating plan that can help you achieve a healthy weight and instill normal-eating habits. If you have binge-eating disorder, you may benefit from medically supervised weight-loss programs.
Hospitalization
If you have serious health problems or if you have anorexia and refuse to eat or gain weight, your doctor may recommend hospitalization. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.
Medications
Medication can't cure an eating disorder. However, medications may help you control urges to binge or purge or to manage excessive preoccupations with food and diet. Medications such as antidepressants and anti-anxiety medications may also help with symptoms of depression or anxiety, which are frequently associated with eating disorders.
Definition:
Eating disorders are a group of serious conditions in which you're so preoccupied with food and weight that you can often focus on little else. The main types of eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.
Eating disorders can cause serious physical problems and, at their most severe, can even be life-threatening. Most people with eating disorders are females, but males can also have eating disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females.
Treatments for eating disorders usually involve psychotherapy, nutrition education, family counseling, medications and hospitalization.
Symptoms:
Eating disorders symptoms vary with the particular type of eating disorder.
Anorexia nervosa
When you have anorexia nervosa (an-o-REK-see-uh nur-VOH-suh), you're obsessed with food and being thin, sometimes to the point of deadly self-starvation.
Anorexia signs and symptoms may include:
- Refusal to eat and denial of hunger
- An intense fear of gaining weight
- A negative or distorted self-image
- Excessive exercise
- Flat mood or lack of emotion
- Irritability
- Fear of eating in public
- Preoccupation with food
- Social withdrawal
- Thin appearance
- Trouble sleeping
- Soft, downy hair present on the body (lanugo)
- Menstrual irregularities or loss of menstruation (amenorrhea)
- Constipation
- Abdominal pain
- Dry skin
- Frequently being cold
- Irregular heart rhythms
- Low blood pressure
- Dehydration
When you have bulimia, you have episodes of bingeing and purging. During these episodes, you typically eat a large amount of food in a short duration and then try to rid yourself of the extra calories through vomiting or excessive exercise. You may be at a normal weight or even a bit overweight.
Bulimia signs and symptoms may include:
- Eating until the point of discomfort or pain, often with high-fat or sweet foods
- Self-induced vomiting
- Laxative use
- Excessive exercise
- An unhealthy focus on body shape and weight
- A distorted, excessively negative body image
- Low self-esteem
- Going to the bathroom after eating or during meals
- A feeling that you can't control your eating behavior
- Abnormal bowel functioning
- Damaged teeth and gums
- Swollen salivary glands in the cheeks
- Sores in the throat and mouth
- Dehydration
- Irregular heartbeat
- Sores, scars or calluses on the knuckles or hands
- Menstrual irregularities or loss of menstruation (amenorrhea)
- Constant dieting or fasting
- Possibly, drug or alcohol abuse
When you have binge-eating disorder, you regularly eat excessive amounts of food (binge), but don't try to compensate for this behavior with exercise or purging as someone with bulimia or anorexia might. You may eat when you're not hungry and continue eating even long after you're uncomfortably full. After a binge, you may feel guilty or ashamed, which can trigger a new round of bingeing. You may be a normal weight, overweight or obese.
Symptoms of binge-eating disorder may include:
- Eating to the point of discomfort or pain
- Eating much more food during a binge episode than during a normal meal or snack
- Eating faster during binge episodes
- Feeling that your eating behavior is out of control
- Frequently eating alone
- Feeling depressed, disgusted or upset over the amount eaten
Because of its powerful pull, an eating disorder can be difficult to manage or overcome by yourself. Eating disorders can virtually take over your life. You may think about food all the time, spend hours agonizing over what to eat and exercise to exhaustion. You may feel ashamed, sad, hopeless, drained, irritable and anxious. You may also have a host of physical problems because of your eating disorder, such as irregular heartbeats, fatigue, and bowel or menstrual troubles. If you're experiencing any of these problems, or if you think you may have an eating disorder, seek medical help.
Urging a loved one to seek treatment
Unfortunately, many people with eating disorders resist treatment. If you have a loved one you're worried about, urge him or her to talk to a doctor. Even if your loved one isn't ready to acknowledge having an issue with food, you may be able to open the door by expressing concern and a desire to listen. If you're concerned your child may have an eating disorder, contact his or her doctor about your concerns. You can get a referral to qualified mental health providers for treatment.
Keep in mind, however, that in children it's sometimes hard to tell what's an eating disorder and what's simply a whim, a new fad, or experimentation with a vegetarian diet or other eating styles. In addition, many girls and sometimes boys go on diets to lose weight, but stop dieting after a short time. If you're a parent or guardian, be careful not to mistake occasional dieting with an eating disorder. On the other hand, be alert for eating patterns and beliefs that may signal unhealthy behavior, as well as peer pressure that may trigger eating disorders.
Red flags that may indicate an eating disorder include:
- Skipping meals
- Making excuses for not eating
- Eating only a few certain "safe" foods, usually those low in fat and calories
- Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
- Cooking elaborate meals for others, but refusing to eat them themselves
- Collecting recipes
- Withdrawing from normal social activities
- Persistent worry or complaining about being fat
- A distorted body image, such as complaining about being fat despite being underweight
- Not wanting to eat in public
- Frequent checking in the mirror for perceived flaws
- Wearing baggy or layered clothing
- Repeatedly eating large amounts of sweet or high-fat foods
- Use of syrup of ipecac, laxatives, the over-the-counter weight-loss drug orlistat (Alli), or over-the-counter drugs that can cause fluid loss, such as menstrual symptom relief medications
- Use of dietary supplements or herbal products for weight loss
- Food hoarding
- Leaving during meals to use the toilet
- Eating in secret
Causes:
The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes. Possible causes of eating disorders include:
- Biology. There may be genes that make certain
people more vulnerable to developing eating disorders. People with
first-degree relatives — siblings or parents — with an eating disorder
may be more likely to develop an eating disorder, too, suggesting a
possible genetic link. In addition, there's some evidence that
serotonin, a naturally occurring brain chemical, may influence eating
behaviors.
- Psychological and emotional health. People with
eating disorders may have psychological and emotional problems that
contribute to the disorder. They may have low self-esteem,
perfectionism, impulsive behavior and troubled relationships.
- Society. The modern Western cultural environment often cultivates and reinforces a desire for thinness. Success and worth are often equated with being thin in popular culture. Peer pressure and what people see in the media may fuel this desire to be thin, particularly among young girls.
Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications. Complications may include:
- Death
- Heart problems
- Multiple organ failure
- Depression
- Suicidal thoughts or behavior
- Absence of menstruation (amenorrhea)
- Bone loss
- Stunted growth
- Digestive problems
- Kidney damage
- Severe tooth decay
- High or low blood pressure
Treatments and drugs:
Eating disorder treatment depends on your specific type of eating disorder. But in general, it typically includes psychotherapy, nutrition education and medication. If your life is at risk, you may need immediate hospitalization.
Psychotherapy
Individual psychotherapy can help you learn how to exchange unhealthy habits for healthy ones. You learn how to monitor your eating and your moods, develop problem-solving skills, and explore healthy ways to cope with stressful situations. Psychotherapy can also help improve your relationships and your mood. A type of psychotherapy called cognitive behavioral therapy is commonly used in eating disorder treatment, especially for bulimia nervosa and binge-eating disorder. Group therapy also may be helpful for some people.
Family-based therapy is the only effective treatment for children and adolescents with eating disorders. This type of therapy begins with the assumption that the person with the eating disorder is no longer capable of making sound decisions regarding his or her health and needs help from the family. An important part of family-based therapy is that your family is involved in making sure that your child or other family member is following healthy-eating patterns and is restoring weight. This type of therapy can help encourage support from concerned family members.
Weight restoration and nutrition education
If you're underweight due to an eating disorder, the first goal of treatment will be to start getting you back to a healthy weight. No matter what your weight, dietitians and other health care providers can give you information about a healthy diet and help design an eating plan that can help you achieve a healthy weight and instill normal-eating habits. If you have binge-eating disorder, you may benefit from medically supervised weight-loss programs.
Hospitalization
If you have serious health problems or if you have anorexia and refuse to eat or gain weight, your doctor may recommend hospitalization. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.
Medications
Medication can't cure an eating disorder. However, medications may help you control urges to binge or purge or to manage excessive preoccupations with food and diet. Medications such as antidepressants and anti-anxiety medications may also help with symptoms of depression or anxiety, which are frequently associated with eating disorders.
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