Eating disorder
From Drug Rehab Wiki
An eating disorder is a behavioral disorder in which the person handles food in a way that is destructive, most commonly by either refusing to eat until the body is starved of essential nutrients (anorexia) or eating large amounts of food then purging through vomiting, laxatives, or a combination of the two.
Contents |
General Overview
The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines these types of eating disorders:
* 307.1 Anorexia nervosa * 307.51 Bulimia nervosa * 307.53 Rumination syndrome * 307.50 Eating disorder not otherwise specified (EDNOS)
Although highly publicized accounts of anorexic celebrities (mostly female Hollywood stars) have increased awareness of one type of eating disorder, there is still much ignorance about numerous other eating disorders. In fact, eating disorders are far from confined to celebrities, as about 8 million Americans suffer from the debilitating effects. It is estimated that nearly 15 percent of all young women are afflicted with some form of eating disorder. With such staggering numbers of sufferers, more light needs to be shed on the problem, including a greater understanding of what the different types of eating disorders are. First, however, here are a few more troubling statistics.
• Some 90 to 95 percent of anorexia sufferers are women
• Anorexia typically (85 percent of the time) begins between the ages of 18 and 30
• About 1 percent of young women between 10 and 20 years old are anorexic
• Among those afflicted with anorexia, 10 to 15 percent will ultimately die from the disease
• Nearly 1,000 women die from anorexia every year
• Within the anorectic population, 2 to 5 percent will commit suicide
• About 30 to 50 percent of patients in treatment for anorexia show signs of bulimia as well
• Some 10 to 15 percent of people with bulimia are male
• Bulimia affects about 4 percent of college-age women
• Eating disorders have the highest rates of deaths of psychological disorders
• Treatment helps 60 percent of eating disorder patients to recover
Anorexia
This eating disorder is broken down into two types: anorexia athletica and anorexia nervosa. Greek for “lack of appetite,” anorexia is a serious psychological disorder.
Anorexia athletica
Anorexia athletica is often a result of compulsive exercise. Its victims, mostly young women between the ages of 12 and 19, feel compelled to exercise, even when they don’t want to. In this regard, anorexia athletica is considered a type of exercise addiction. The condition involves exercise to the extreme – going far beyond the limits – to the extent that the sufferer feels anxious or guilty when missing workouts, even if they are sick or have an injury.
Typically, anorexia athletica victims are:
• Fanatic about their diet and weight
• Exercise far beyond what’s required for good health
• Define their self-worth by their levels of performance
• Never (or rarely) satisfied with their achievements, always pushing on to the next challenge, not even taking time to acknowledge victories
• Constantly striving for more difficult challenges
• Not enjoying exercise anymore
• Neglecting work, school and/or relationships in order to keep exercising
• Quick to make excuses for their obsessive exercising, justifying themselves as an “elite” athlete
Over time, anorectics may exhibit any or all of the following:
• Osteoporosis or osteopenia – a thinning of the bones
• Skin that’s yellowish and dry
• Brittle hair and nails
• Mild anemia
• Constipation that becomes severe
• Muscle weakness and loss
• Fine hair growth all over the body – a condition known as lanugo
• Low blood pressure
• Slowed pulse and breathing
• Drop in the body’s internal temperature – causing the individual to feel cold
• Lethargy
Anorexia Nervosa
Anorexia nervosa sufferers think of themselves as fat – despite obvious indications to the contrary. This eating disorder is identified by low body weight and a sense of a distorted body image. These anorectics starve and purge themselves in order to keep weight off – or lose as many pounds as possible in the shortest period of time. Diet gimmicks, any type of drug (including crystal meth) that induces rapid weight loss and excessive exercise are common.
Affecting primarily women, 10 percent of men are also victims of anorexia nervosa. This disorder has many psychological components, among which are fear of being fat, preoccupation with body size and food. Anorexia nervosa subjects its victims to life-threatening complications such as organ damage, heart problems, and long-term bone damage.
Without treatment at a specialized facility dealing with eating disorders, anorexia nervosa sufferers rarely recover. The anorectics cannot heal themselves and require extensive medical and psychological assistance. A progressive disease, the longer anorexia nervosa goes on untreated, the worse it becomes and the more difficult to treat.
Bulimia
Another type of eating disorder is bulimia nervosa, usually referred to simply as bulimia. The term “binge eating” is one symptom of a bulimic – eating as much as possible at a single setting. Typically what happens after a binge is that the bulimic, fearing weight gain and/or getting fat, seeks to eliminate what was just consumed, a process known as purging. In purging, the person deliberately initiates the gag reflex to vomit up the food.
Other ways of purging include excessive use of laxatives, taking water pills, drinking very little water, excessive exercising and refusal to eat anything – until the next binge episode, which is again followed by a purge routine.
Treatment for bulimia has psychological components, as the bulimic needs to learn to accept his or her normal body weight and to control the urges to binge and purge. The disease is often difficult to detect, since sufferers are very secretive about their behavior. They usually appear as normal-weight individuals with no eating problems whatsoever. At the root of their bulimia, however, is the fear of losing their control over a type of psychological crutch that has given them comfort.
Bulimics may:
• Have low self-esteem
• Experience profound shame over their behavior, leading them to hide the behavior at all costs
• Maintain rigid perfectionist expectations – I’m bad because I eat too muc.
• Make extremely negative statements about their appearance
• Become guilty and agitated when they eat even a normal food portion
• Withdraw from social situations, especially those that make it almost impossible for them to binge/purge without others suspecting
Symptoms of bulimia may include the following:
• Chronically inflamed sore throat
• Decayed teeth and/or worn tooth enamel, a consequence of constant exposure to stomach acids
• Distress and irritation of the intestines due to laxative abuse
• Gastroesophageal reflux disorder
• Kidney problems from abuse of diuretics
• Severe dehydration from loss of fluids during purging
• Swollen neck glands and those below the jaw
Binge Eating Disorder
Somewhat related to bulimia in the sense of eating large quantities of food, binge eating disorder does not involve purging. A binge eater consumes food far beyond the point of being satisfied. This is also uncontrolled, continuous or impulsive eating. Compulsive overeaters generally experience great shame and self-hatred after an eating binge – but they continue to overeat after perhaps a period of dieting or engaging in frequent fasting.
Binge eaters also often suffer from depression, anxiety, and loneliness. Their body weight may fluctuate greatly. It is important to note that not every person who is obese or overweight is a binge eater.
Common characteristics of the binge eater include:
• Eating to the point of extreme discomfort
• Eating what most people would consider to be an excessive amount of food
• A feeling that their eating habits are out of control
• Overeating even when not hungry
• Being extremely secretive about how much and what food is consumed
• Feeling guilty, ashamed and embarrassed, as well as disgusted and depressed over how much is eaten
Compulsive Overeating
When a person consumes an excessive amount of food (binges) in a short period of time, often thousands of calories beyond normal food consumption, this is classic compulsive overeating. Like other addictions, compulsive overeating is often used to mask or hide from emotions, to fill a void felt inside, and to cope with daily stresses and problems.
Compulsive overeaters do for various reasons: to feel emotionally comfortable (albeit temporarily), they eat too fast, to make sure they get their money’s worth at a restaurant or when dining out, they’re not paying attention to how much they’re eating, or they feel that eating more is somehow better than eating less.
Many of those afflicted with compulsive overeating find help at Overeaters Anonymous, a 12-step group that concentrates on helping its members into recovery. Treatment from eating disorder facilities seeks to assist the compulsive overeater to better recognize and manage hunger cues, often utilizing cognitive behavioral therapy (CBT).
Over Exercise
This eating disorder involves too much exercise, to the point of complete physical exhaustion. The person who compulsively exercises centers their life on exercise, instead of incorporating exercise into their normal routine. Work, school, social engagements or appointments, even time with family is sacrificed so that the compulsive exerciser can spend all his or her time concentrating on exercise.
Over exercise causes more than just social isolation, however. Many instances of muscle sprains and strains, stress fractures, and lowered or compromised immune system due to over fatigue and over exercise result.
NES or Night Eating
Night eating syndrome, or NES, is estimated to afflict as many as 6 million Americans. A newly identified eating disorder, NES is characterized by obsessively consuming more than half of daily caloric intake after 8 p.m. More troubling is the statistic that 33 percent of the morbidly obese – those individuals who are more than 100 pounds overweight – are afflicted with this eating disorder.
NES sufferers are typically not hungry in the morning. Come nighttime, however, and their agitation and insomnia quickly lead to overconsumption of food. Those afflicted with night eating disorder may be attempting to compensate for feelings of anxiety, depression, or stress, and seek (without intending to) to medicate themselves by eating. Rapid consumption of carbohydrates jump starts the brain’s production of serotonin – which makes the person sleepy. Can’t sleep? The NES sufferer just loads up on empty calories – night after night.
Four patterns of behavior have been identified in night eating disorder sufferers:
• Agitation/anxiousness
• Cravings
• Compulsion
• All-or-nothing belief about sleep
Orthorexia
Officially, this type of eating disorder is called orthorexia nervosa. It is a little-known disease marked by a fixation on eating the “proper” food. According to some eating disorder treatment experts, orthorexia nervosa may be more of a phenomena than pure disease, but others maintain that the treatment for it and anorexia nervosa differ only in finer points. In essence, individuals afflicted with orthorexia nervosa begin to spend more and more time concentrating on every single morsel of food in a constant attempt to monitor everything they eat, how much they eat, and what happens when they succumb to a momentary indiscretion. They seek only to consume “pure” food, which which somehow carries a spiritual connotation. The very act of eating such pure food elevates them, they may believe, to a holier state of consciousness.
Treating orthorexia nervosa causes some problems, however, since anything other than pure food will be rejected outright by the patient. Such individuals often regard drugs as impure, unholy and unnatural. This makes other treatment modalities more critical.
Pregorexia
Pregorexia is anorexia in a pregnant woman. It is particularly serious when those who are pregnant do not get sufficient nutrition. Sometimes a person in recovery for anorexia finds their eating disorder triggered by the normal weight gain of pregnancy. This can have dire consequences for both the mother and the baby and any potential for relapse should be addressed early on in the pregnancy.
Remaining Disorders – EDNOS
The term Eating Disorder Not Otherwise Specified (EDNOS) refers to persons who struggle daily with thoughts, behaviors and feelings characteristic of an eating disorder such as anorexia nervosa or bulimia nervosa but does not exhibit all the symptoms of either disorder.
The National Alliance on Mental Alliance considers the following as examples of EDNOS:
• Females meet all the criteria for anorexia nervosa except that they have regular menstrual periods
• Anorexia nervosa criteria are met except that the person maintains a weight within the range of normal despite considerable weight loss
• Recurrent episodes of binge eating minus regular inappropriate compensatory behaviors characteristic of bulimia nervosa
• Someone who chews and spits out, but does not swallow food – on a repetitive basis
• A normal-weight individual who compensates for eating small amounts of food by using inappropriate behavior – such as induced vomiting
It is a mistake to believe that EDNOS is less important than either anorexia nervosa or bulimia nervosa. In fact, according to estimates, more people suffer from EDNOS than anorexia and bulimia combined. In addition, many of those afflicted with EDNOS engage in the same damaging and risky behaviors as individuals afflicted with any other eating disorder.
