Eating disorders: when food and weight take control
WHAT EXACTLY ARE EATING DISORDERS?
In an effort to stay healthy, many people try to control the amounts of food they eat as well as their body weight and shape. Some people experience short-term alterations in their eating patterns as a reaction to a stressful life situation, or when dieting to improve their appearance and/or health. People with an eating disorder, however, think about food, weight, and body image constantly and usually have medical and psychological issues related to eating.
There are three primary types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. They can disrupt school, work, and relationships and cause serious health problems that may require ongoing medical care and even hospitalization. In severe cases they can cause permanent disability and even death.
HOW COMMON ARE EATING DISORDERS?
About 90 percent are females between ages 13 and 30 are though to have or have had, an eating disorder. However, eating disorders can also in occur in males and in people both younger and older. About 86 percent of all cases start by age 20. Eating disorders can last from several months to many years.
Although eating disorders are most common among the white upper and middle class, they occur in people of all racial, ethnic, and socioeconomic backgrounds. The rate of eating disorders is higher in certain occupations, such as dance, gymnastics, and modeling, where there is excessive pressure to maintain a specific weight and appearance.
WHAT ARE THE SYMPTOMS OF EATING DISORDERS?
Anorexia Nervosa
- Excessive weight loss or lack of normal weight gain, often to the point of starvation
- Intense fear of gaining weight
- Distorted body image--for example, seeing oneself as too fat even when underweight
- Obsessive controlling of calories and fat even when underweight
- Unusual eating habits, such as cutting food into tiny bites
- Excessive or compulsive exercising
- Absence of at least three consecutive menstrual periods
Some people with anorexia also binge eat and then make themselves vomit (purge) to keep their weight low.
Bulimia Nervosa
- Frequent episodes of binge eating (eating an abnormally large amount of food within two hours or less)
- Feeling out of control while bingeing
- Excessive concern with body weight and shape
- Unusual eating habits, such as hoarding food and eating in secret
- Frequent episodes of self-induced vomiting or misusing laxatives or diuretics to prevent weight gain
- Attempts to control weight by excessive exercising, misusing diet pills, or fasting
People with bulimia often maintain a fairly normal weight by purging and/or excessive dieting, exercising, or fasting.
Binge Eating Disorder
- Frequent episodes of binge eating
- Little or no use of behaviors to control weight, such as purging, excessive exercising or fasting, although may try dieting
- Feeling guilty, depressed, or disgusted with oneself because of the binge eating and concern about being overweight
- Eating large amounts when not hungry
- Eating rapidly and until uncomfortably full
Until several years ago, this disorder was called "compulsive overeating." Many people with binge eating disorder are overweight.
WHAT CAUSES EATING DISORDERS?
Combinations of certain factors make some people vulnerable to developing an eating disorder. These factors fall into four broad categories: sociocultural, biological, family environment, and psychological. The disorder often begins when vulnerable individuals are going through a difficult life change or event.
According to Laura Weisberg, Ph.D., director of the eating disorders program at Westwood Lodge Hospital in Westwood, Massachusetts, "once an eating disorder develops, the behaviors and feelings keep reinforcing each other and may become ways of coping with other life problems. A self-perpetuating cycle is then created."
BUT EATING DISORDERS CAN BE TREATED, RIGHT?
Based on a thorough medical exam and psychological evaluation, an individualized treatment plan is developed. Several of the following approaches are usually combined.
- Health or medical problems attended:First, any medical problems are treated. Then, the psychological issues that are the cause of or caused by the eating disorder are explored. Nutrition counseling is provided to help reestablish healthy eating and meal-planning practices. Medication may also be prescribed. Support groups for people with eating disorders and for their family and friends can also be helpful.
- Psychotherapy:
Several different types of psychotherapy may be used in individual, group, or family sessions. Cognitive behavioral therapy can help to develop healthy ways of thinking and patterns of behavior, especially with food and relationships. Other kinds of psychotherapy focus on underlying psychological issues, such as self-esteem. In some cases, a combination of more than one type of psychotherapy is the most successful approach.
- Medication:
The most widely used medications for eating disorders are antidepressants. They are particularly helpful with bulimia and binge eating disorder because they treat mood-related symptoms and suppress the craving to binge. In cases of anorexia, they may help decrease the obsessions and anxiety related to eating.
Approximately 70% to 80% of people with eating disorders have some success with treatment. However, the extent and speed of response vary with the individual, and relapses are common.
"Early detection and diagnosis are crucial to treat an eating disorder before it becomes a deeply ingrained cycle. This may prevent serious medical and psychological problems from developing," says Weisberg. So, if you think you may have an eating disorder, make an appointment to talk with your doctor or a mental health professional. If you suspect someone you know may have an eating disorder, encourage her or him to seek professional help.
