Eating Disorders

Often hidden, and discussed in whispers, these conditions are devastating for the sufferers and their families alike. The causes vary, but the results are frighteningly similar.

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Disorders related to eating affect both the individual's physical and psychological state, often in dramatic and serious ways. Extremes in eating habits may result in ill-health or death. Two such extremes are gross under-eating: Anorexia Nervosa, and binge-purge eating: Bulimia.

The number of people with these conditions is growing at an alarming and largely unexplained rate, although some researchers believe that modern society's obsession with thinness may in part be responsible.

Anorexia and bulimia might also be triggered by an inability to cope with a situation in life, such as puberty, the first sexual encounter, ridicule over weight, death of a loved one, or living up to the expectations of parents.

Common to both conditions is a preoccupation with food and an intense fear of weight gain. Various rituals and acts to lose or control weight include abstaining from food, vomiting, taking diuretics (fluid loss pills) and exercising vigorously to the point of exhaustion.

Both medical and psychological help is required to deal with these complex and potentially life-threatening conditions.

Anorexia Nervosa

Anorexia Nervosa is a syndrome which results in self-imposed starvation. It occurs primarily in women aged from puberty to the early thirties. It is characterised by extreme weight loss, body-image disturbance and an intense fear of becoming obese.

The name derives from the Greek anorexia - loss of appetite, and Nervosa - morbid mental state. As much as 25% or more of body weight may be lost over several months.

A strong perceptual distortion occurs as anorectics see themselves as being overweight even though it is patently obvious to others that they are too thin. Their fear of becoming obese does not diminish as weight loss progresses. They also distort hunger awareness and, after having eaten a small portion of food, quickly feel bloated and nauseous.

However, anorexia may not always be a reaction to being overweight. Other reasons could include fear of increased responsibility at puberty, or starving to death to assert themselves in an over-protective family instead of engaging in other typical adolescent behaviour, such as running away from home or arguing back. Research indicates that even lack of proper mourning for a dead relative can precipitate Anorexia Nervosa in some people.

Symptoms of Anorexia Nervosa

Excessive weight loss – 25 percent or more of body weight
Unhealthy-looking hair, skin and nails
Dental problems and gum disease
Absence of menstruation
Extreme sensitivity to cold, as there is a lack of fat to insulate
Fine body hair on legs and arms-to prevent heat loss.
Emotional and behavioural changes:
Denial of the problem
Overuse of laxatives or diuretics
Odd eating habits
Poor self-esteem
Lack of confidence, depression
Social isolation
Obsessed with exercise

Behaviour patterns

Anorectics use fad-diets, abuse laxatives and diuretics, and may make themselves vomit. Their preoccupation with food usually prompts peculiar food-related eating patterns. For example, to stretch out eating time, they may move food about on the plate and crumble or cut food into tiny pieces. They prefer not to eat with the rest of the family. Sometime they become gourmet cooks and prepare elaborate meals for others whilst eating low-calorie food themselves.

Socially, the anorectic person may isolate herself from friends and family. Because anorectics generally lack self-confidence, they may become depressed and even contemplate suicide. They are typically model children, eager to please, and good students.

Engaging in extreme physical activity is another method the anorectic person might adopt to burn calories and get rid of fatty tissue. Indeed, obsessive behaviour with daily physical activity and fitness may be another category of Anorexia Nervosa, even thought there is no cut down in food.

Health Problems

Malnutrition stops the body's normal growth and development. Thus in anorectic women, menstruation usually ceases often before weight loss becomes noticeable. Blood pressure and respiratory rates slow down and thyroid function diminishes, resulting in brittle hair and nails, dry skin, slowed pulse rate, cold intolerance and constipation. The electrolyte imbalance can become so severe that irregular heart rhythm, heart failure and decreased bone density occur. Other symptoms can include mild anaemia, swelling of the joints, reduced muscle mass and light-headedness.

Loss of taste and appetite occurs when the body stores of zinc are depleted by malnutrition. This exacerbates the anorexia. A zinc supplement as part of treatment will help to reverse the anorexia.

Often symptoms are concealed so that others may not be aware of their distress. It is this inability to recognise the problem that often makes it life-threatening. Up to 10 percent of people with anorexia will die.

Treatment and Therapy

Because people with anorexia usually deny they have a problem, it is commonly left to family or friends to seek professional help and initiate treatment. Severe cases may require hospitalisation.

Treatment programs involve nutritional therapy, family therapy, medication, behaviour modification and individual and group psychotherapy.

Underlying psychological problems need to be resolved if the anorectic person is to gain confidence in her ability to control her life. To alleviate feelings of depression, guilt and anxiety, she must face up to life's problems, as well as develop a realistic image of her body. A supportive family and home environment is essential.

Under no circumstances should a person with Anorexia Nervosa be allowed on a weight-loss program.

Bulimia

Like Anorexia Nervosa, Bulimia is a syndrome which results in a life-threatening eating disorder centred around a morbid fear of becoming fat. It is characterised by secretive binge eating episodes followed by self-induced vomiting, fasting, or the use of diuretics or laxatives.

Many young anorectics develop bulimic symptoms, but unlike anorectics, they recognise that their behaviour is abnormal. It’s not always apparent that someone has Bulimia, as she won’t necessarily lose weight.

Bulimia is predominantly a female disorder occurring from adolescence through to adult life. It is claimed that some 10 percent of young Western women may have suffered bulimia at some time and many more experienced uncontrolled episodes of binge eating which they felt unable to control.

Those who are constantly under pressure to maintain a low body weight or svelte figure are most vulnerable to bulimia. Models, ballet dancers, jockeys, wrestlers, gymnasts and actresses are over-represented in the statistics.

Personality Traits

Typically the bulimic person is a high achiever, has marked parental dependence, is socially ambitious and has some difficulty in establishing personal relationships. Often feelings of worthlessness prompt bulimic behaviour, such as. not having lived up to the academic and social expectations of demanding parents who are openly inclined to disparage the achievements of their children.

Other traits may include depressed moods, feelings of guilt and sometimes suicidal thoughts. Impulsive and anti-social behaviour could involve drug or alcohol abuse, kleptomania and sexual promiscuity.

Behaviour Patterns

Bulimics find they can’t stop eating voluntarily and eat rapidly and secretly. Usually food is gobbled down as inconspicuously as possible. A single binge of 4,000-5,000 calories is not unusual, with sufferers sometimes downing up to 20,000 calories in one session!

Binge foods are high in calories, e.g. sweets, fatty foods, ice cream, cakes and chocolates. These binges are usually terminated by self-induced vomiting, cathartics or diuretics.

Health Problems

This frequent vomiting and diarrhoea disturbs the body's fluid and electrolyte balance causing severe medical problems and even death. The acid present in the mouth from constant vomiting is enough to eat away tooth enamel and cause dental problems.

Feelings of abdominal pain and drowsiness often follow binges, as well as psychological reactions such as self-disgust, guilt and depression.

Between binges, it is not uncommon for the bulimic to fast or exercise excessively. Sometimes her weight will fluctuate up to 4.5kg (10lbs).

It’s not unusual for periods to be irregular and for the bulimic to lose interest in sex. Despite all this, body weight usually remains within the normal range. Bulimia can be treated successfully so long as people with bulimia recognise their problem and be willing to seek and accept help.

Do you have a problem?

Ask yourself the following questions. If you answer yes to a number of these it’s probably a good idea to have a chat with your doctor.

Do you feel helpless in the presence of food?
Are you a binge eater?
Do you try a new diet and always end up gaining the weight you lost?
Do you try to control your weight by vomiting, using laxatives or diuretics, over-exercise, or episodes of starvation?
Do you eat when you are depressed?
Do you feel guilty after a binge?
Do you lie about what you eat?
Do you eat sensibly around other people then pig out when you are alone?

Where to go for help

The first person to talk to is your GP, who can give you a lot more information, and maybe refer you to a psychiatrist, clinical psychologist or a hospital with a specialised treatment program. If you can’t face your family doctor, contact your State’s Mental Health Services.

Early treatment is important for recovery. As anorexia and bulimia become more and more entrenched, damage to the body becomes less and less reversible.

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References :

This article was compiled in consultation with CalorieKing.com.au experts and in reference to the following sources:

http://www.eatingdisorders.org.au/
http://www.edf.org.au/menu.htm
http://www.cedd.org.au/
http://www.thebrontefoundation.com.au/
http://www.thebutterflyfoundation.org.au/
http://www.recoveryispossible.com.au/index.htm
http://www.edasa.org.au/
http://www.isis.org.au/
http://www.eda.org.au/
http://www.eden.org.nz/

Last updated: June 13th, 2007