Clinical
Corner Ð What is an Eating Disorder?
Eating
Disorders include a range of conditions that involve an obsession with food,
weight and appearance to the degree that a person's heath, relationships and
daily activities are affected.
Though
commonly affecting young women, eating disorders are widespread and can impact
people of all ages and sexes. It is estimated that several million people in
the United States suffer from an eating disorder, and the statistics are
growing. The number of men with an eating disorder has more than doubled in the
last ten years.
Whether
a person restricts food intake, binges and purges, binge-eats, compulsively
overeats, excessively exercises, or abuses laxatives, these behaviors often are
symptoms and not the problem. They often develop as a way of coping with stress
or trauma, emotional pain, conflicts related to separation, low self esteem,
depression.
Bulimia
Bulimia
is a cycle of uncontrolled binge eating followed by purging through vomiting or
the use of laxatives. Individuals with bulimia are often of normal weight or
even slightly overweight. Bulimia can range from a mild and relatively
infrequent response to stress to an extremely debilitating pattern that absorbs
nearly all of a person's time, energy, and money. In its most severe forms,
binge eating and purging may occur ten or more times a day.
Bulimia
usually begins innocuously as an attempt to control weight. Purging may seem to
be a convenient means for a person to overeat without gaining weight. It can
quickly become a destructive process that cannot be controlled. Persons with
bulimia are often aware that their eating patterns are abnormal and out of
control and that their lives are dominated by their eating habits. They may
feel guilty and depressed after a binge. Over time, the cycle becomes more and
more dominant in the person's thoughts and behavior. It may impair personal
relationships and interfere with other activities, leading to depression,
isolation, and lowered self-esteem. Once caught in this pattern, the resulting
shame and sense of helplessness may make it difficult for the person to seek
the help that is needed.
Physical
effects can also be serious. Frequent vomiting can cause permanent tooth damage
from erosion of tooth enamel as well as damage to the tissues of the throat and
esophagus. Kidney problems and seizures are also possible. Electrolyte
imbalance with consequent risk of serious cardiac problems is also a
significant danger and frequent cause of death.
Anorexia-Nervosa
Anorexia
Nervosa is a disruption in normal eating habits characterized by an all
consuming fear of becoming "fat". It typically starts in teenage
women as a normal attempt to diet but gradually leads to more and more weight
loss, often more than 25% of original body weight. There is an intense
preoccupation with food and body size, which may involve compulsive exercising.
As this happens, many normal activities may stop. Menstruation ceases in women
and there are a number of physical symptoms of malnutrition such as lowered heart
rate, low blood pressure, decreased metabolic rate and sensations of coldness
particularly in the extremities.
People
with anorexia nervosa are obsessed with food and deny that they have a problem
or that they are too thin. They may be able to work or study and have some
social life but usually function far below their potential. Frequently they are
also depressed. Some persons with anorexia starve themselves to death. Others
check the downward spiral of weight loss and maintain a steady but seriously
underweight condition. In all cases, even severe weight loss does not diminish
the perception of being "fat".
Binge
Eating Disorder
An
illness that resembles bulimia is binge eating disorder. Like bulimia, the
disorder is characterized by episodes of uncontrolled eating or binging.
However, binge eating disorder differs from bulimia because its sufferers do
not purge their bodies of excess food.
Individuals
with binge eating disorder feel that they lose control of themselves when
eating. They eat large quantities of food and do not stop until they are
uncomfortably full. Usually, they have more difficulty losing weight and
keeping it off than do people with other serious weight problems. Most people
with the disorder are obese and have a history of weight fluctuations. Binge
eating disorder is found in about 2 percent on the general population--more
often in women than men. Recent research shows that binge eating disorder
occurs in about 30 percent of people participating in medically supervised
weight control programs.
People
with binge eating disorder are usually overweight, so they are prone to the
serious medical problems associated with obesity, such as high cholesterol,
high blood pressure, and diabetes. Obese individuals also have a higher risk
for gallbladder disease, heart disease, and some types of cancer. Research at
The National Institute of Mental Health and elsewhere has shown that
individuals with binge eating disorder have high rates of co-occurring
psychiatric illnesses--especially depression.
Source:
U.S.
Department of Health and Human Services - Public Health Service - National
Institutes of Health - National Institute of Mental Health