INTRODUCTION

Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape.

Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individualís well-being. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.

Disordered eating issues can develop during any stage in life but typically appear during the teen years or young adulthood. Classified as a medical illness, appropriate treatment can be highly effectual for many of the specific types of eating disorders. Although these conditions are treatable, the symptoms and consequences can be detrimental and deadly if not addressed. Eating disorders commonly coexist with other conditions, such as anxiety disorders, substance abuse, or depression.

TYPES OF EATING DISORDERS

Eating disorders are a group of related conditions that cause serious emotional and physical problems. Each condition involves extreme food and weight issues; however, each has unique symptoms that separate it from the others.

Anorexia Nervosa. People with anorexia will deny themselves food to the point of self-starvation as they obsesses about weight loss. With anorexia, a person will deny hunger and refuse to eat, practice binge eating and purging behaviors or exercise to the point of exhaustion as they attempts to limit, eliminate or ďburnĒ calories.

The emotional symptoms of anorexia include irritability, social withdrawal, lack of mood or emotion, not able to understand the seriousness of the situation, fear of eating in public and obsessions with food and exercise. Often food rituals are developed or whole categories of food are eliminated from the personís diet, out of fear of being ďfat".

Anorexia can take a heavy physical toll. Very low food intake and inadequate nutrition causes a person to become very thin. The body is forced to slow down to conserve energy causing irregularities or loss of menstruation, constipation and abdominal pain, irregular heart rhythms, low blood pressure, dehydration and trouble sleeping. Some people with anorexia might also use binge eating and purge behaviors, while others only restrict eating.

Bulimia Nervosa. People living with bulimia will feel out of control when binging on very large amounts of food during short periods of time, and then desperately try to rid themselves of the extra calories using forced vomiting, abusing laxatives or excessive exercise. This becomes a repeating cycle that controls many aspects of the personís life and has a very negative effect both emotionally and physically. People living with bulimia are usually normal weight or even a bit overweight.

The emotional symptoms of bulimia include low self-esteem overly linked to body image, feelings of being out of control, feeling guilty or shameful about eating and withdrawal from friends and family.

Like anorexia, bulimia will inflict physical damage. The binging and purging can severely harm the parts of the body involved in eating and digesting food, teeth are damaged by frequent vomiting, and acid reflux is common. Excessive purging can cause dehydration that effect the bodyís electrolytes and leads to cardiac arrhythmias, heart failure and even death.

Binge Eating Disorder (BED). A person with BED losses control over their eating and eats a very large amount of food in a short period of time. They may also eat large amounts of food even when he isn't hungry or after he is uncomfortably full. This causes them to feel embarrassed, disgusted, depressed or guilty about their behavior. A person with BED, after an episode of binge eating, does not attempt to purge or exercise excessively like someone living with anorexia or bulimia would. A person with binge eating disorder may be normal weight, overweight or obese.

 

Rumination disorder

Rumination disorder is repeatedly and persistently regurgitating food after eating, but it's not due to a medical condition or another eating disorder such as anorexia, bulimia or binge-eating disorder. Food is brought back up into the mouth without nausea or gagging, and regurgitation may not be intentional. Sometimes regurgitated food is rechewed and reswallowed or spit out.

The disorder may result in malnutrition if the food is spit out or if the person eats significantly less to prevent the behavior. The occurrence of rumination disorder may be more common in infancy or in people who have an intellectual disability.

Avoidant/restrictive food intake disorder

This disorder is characterized by failing to meet your minimum daily nutrition requirements because you don't have an interest in eating; you avoid food with certain sensory characteristics, such as color, texture, smell or taste; or you're concerned about the consequences of eating, such as fear of choking. Food is not avoided because of fear of gaining weight. The disorder can result in significant weight loss or failure to gain weight in childhood, as well as nutritional deficiencies that can cause health problems.

Eating Disorders Not Otherwise Specified (EDNOS):People with EDNOS suffer some symptoms of the above disorders but do not fit all the criteria to be diagnosed with anorexia, bulimia or binge-eating disorder. For instance someone suffering from atypical anorexiamay be avoiding food for a long period of time but may not be severely underweight. Another example would be of a person who purges after eating even small amounts of food while maintaining a healthy weight.

CAUSES

Eating disorders are very complex conditions, and scientists are still learning about the causes. Although eating disorders all have food and weight issues in common, most experts now believe that eating disorders are caused by people attempting to cope with overwhelming feelings and painful emotions by controlling food. Unfortunately, this will eventually damage a personís physical and emotional health, self-esteem and sense of control.

Factors that may be involved in developing an eating disorder include:

RISK FACTORS

Teenage girls and young women are more likely than teenage boys and young men to have anorexia or bulimia, but males can have eating disorders, too. Although eating disorders can occur across a broad age range, they often develop in the teens and early 20s.

Certain factors may increase the risk of developing an eating disorder, including:

         Family history. Eating disorders are significantly more likely to occur in people who have parents or siblings who've had an eating disorder.

         Other mental health disorders. People with an eating disorder often have a history of an anxiety disorder, depression or obsessive-compulsive disorder.

         Dieting and starvation. Dieting is a risk factor for developing an eating disorder. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. There is strong evidence that many of the symptoms of an eating disorder are actually symptoms of starvation. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.

         Stress. Whether it's heading off to college, moving, landing a new job, or a family or relationship issue, change can bring stress, which may increase your risk of an eating disorder.

PREVENTION

Although there's no sure way to prevent eating disorders, here are some strategies to help your child develop healthy-eating behaviors:

         Avoid dieting around your child. Family dining habits may influence the relationships children develop with food. Eating meals together gives you an opportunity to teach your child about the pitfalls of dieting and encourages eating a balanced diet in reasonable portions.

         Talk to your child. For example, there are numerous websites that promote dangerous ideas, such as viewing anorexia as a lifestyle choice rather than an eating disorder. It's crucial to correct any misperceptions like this and to talk to your child about the risks of unhealthy eating choices.

         Cultivate and reinforce a healthy body image in your child, whatever his or her shape or size. Talk to your child about self-image and offer reassurance that body shapes can vary. Avoid criticizing your own body in front of your child. Messages of acceptance and respect can help build healthy self-esteem and resilience that will carry children through the rocky periods of the teen years.

         Enlist the help of your child's doctor. At well-child visits, doctors may be able to identify early indicators of an eating disorder. They can ask children questions about their eating habits and satisfaction with their appearance during routine medical appointments, for instance. These visits should include checks of height and weight percentiles and body mass index, which can alert you and your child's doctor to any significant changes.

TREATMENTS

Because of the severity and complexities of these conditions, a comprehensive and professional treatment team specializing in eating disorders is often fundamental in establishing healing and recovery.

Treatment plans are utilized in addressing the many concerns a man or woman may be facing in the restoration of their health and well-being and are often tailored to meet individual needs.

Treatment for an ED is usually comprised of one or more of the following and addressed with medical doctors, nutritionists, and therapists for complete care:

         Medical Care and Monitoring-The highest concern in the treatment of eating disorders is addressing any health issues that may have been a consequence of eating disordered behaviors.

         Nutrition: This would involve weight restoration and stabilization, guidance for normal eating, and the integration of an individualized meal plan.

         Therapy: Different forms of psychotherapy, such as individual, family, or group, can be helpful in addressing the underlying causes of eating disorders. Therapy is a fundamental piece of treatment because it affords an individual in recovery the opportunity to address and heal from traumatic life events and learn healthier coping skills and methods for expressing emotions, communicating and maintaining healthy relationships.

         Medications: Some medications may be effective in helping resolve mood or anxiety symptoms that can occur with an eating disorder or in reducing binge-eating and purging behaviors.

Varying levels of treatment, ranging from outpatient support groups to inpatient treatment centers, are available and based on the severity of the eating disorder. In any case, recognizing and addressing the ED are crucial in being able to begin treatment.